Metabolic Disorders In Patients Research Articles

Evaluation of routine health monitoring for metabolic disorders in patients with serious mental illness on psychotropic medications: a study from Ethiopia.

Compared to the overall population, patients with mental health problems are more likely to experience concurrent physical illnesses, poorer health outcomes, and mortality. Psychotropic medications, which are the pillars in the management of mental health conditions, are associated with adverse effects such as weight gain, an increased level of glucose, and elevated circulating lipid levels, all of which contribute to metabolic disorders. Inadequate health monitoring may led to suboptimal interventions and worsening of these conditions. However, there is a lack of studies assessing routine health monitoring practices for metabolic disorders and their determinants among patients with serious mental illnesses taking psychotropic medications in Ethiopia. This study aimed to evaluate routine health monitoring for metabolic disorders and its determinants in patients with serious mental illnesses on psychotropic medications in Ethiopia. A hospital based prospective follow-up study was conducted among patients with serious mental illness taking psychotropic medications who attended the outpatient psychiatry department at Debre Markos Comprehensive Specialized Hospital. Eligible participants were selected using a simple random sampling technique. Routine health monitoring was evaluated using guidelines and previous literature. Binary logistic regression was employed to identify the determinants of routine health monitoring, with statistical significance determined by a p-value of less than 0.05 and a 95% confidence interval (CI). The overall routine health monitoring practice for metabolic disorders was found to be sub-optimal. Vital signs were the most commonly assessed parameters. Key determinants of routine health monitoring included participants aged 45 and above (AOR (95% CI): 2.82 (1.34-5.92), having social insurance (AOR (95% CI): 2.94 (1.86-4.64), availability of laboratory tests at the hospital (AOR (95% CI): 3.46 (2.16-5.55), and reporting of medication-related side effects (AOR (95% CI): 1.96 (1.21-3.17)). Routine health monitoring for metabolic disorders in patients with serious mental illnesses attending the outpatient psychiatry department was inadequate. Health care providers should give more attention to younger patients, those without health insurance, and who are not reported side effects. These findings provide crucial insights for improving routine health monitoring and promoting better health outcomes.

Metabolic disorders in patients with chronic thromboembolic pulmonary hypertension

To analyze the relationship between metabolic disorders and obesity with hemodynamic parameters and the severity of the condition of patients with chronic thromboembolic pulmonary hypertension (CTEPH) based on the POLET register. The study included patients with CTEPH from the POLET register. Data from medical history, lipid profile, glycemia, uric acid level, weight, height, functional class (FC), distance in the 6-minute walk test (6MWT), echocardiography, and right heart catheterization were used for analysis. The study included 84 patients 60±14 years old, including 45 men. The majority of patients had FC III - 51 (65%), which corresponded to 6MWT - 338±113 m. Nineteen (23%) people had experience in taking PAH specific therapy, 37 (46%) had cardiovascular comorbidity. In the general group, the body mass index (BMI) was 25.7±4.5 kg/m2, and normal glycemia, lipid profile, and uric acid levels were also determined. mPAP was 51±12 mmHg, RA area was 25.5 (20; 30) cm2. Correlations were identified between: RA area and the level of total cholesterol (r=0.60; p<0.01), triglycerides (r=-0.24; p<0.001), LDL cholesterol (r=0.75; p=0.04), uric acid (r=0.75; p=0.03); total cholesterol and 6MWT (r=0.44; p=0.04). Analysis of metabolic disorders, FC and comorbidity revealed differences between FC III and IV groups in the level of HDL cholesterol (p=0.02) and triglycerides (p<0.01). The POLET registry includes mainly older patients. Severe FC (87% - III and IV) may be a result of the older age and the presence of concomitant pathology in almost half of the patients. The discovered relationships between the area of RA and FC with lipid and purine metabolism were discovered for the first time, however, they correspond to the direction of the world scientific researches, are important due to the use of these indicators in the scale for calculating the risk of death in patients with PAH and require further development.

PURULENT-NECROTIC COMPLICATIONS AFTER AMPUTATION OF THE LOWER EXTREMITIES: ISSUES OF TREATMENT AND PREVENTION

Transfemoral amputation of a limb performed by a patient with obliterating atherosclerosis with irreversible ischemia is a difficult, traumatic operation and is accompanied by high mortality. High mortality after amputation of a limb at the hip level is associated with the severity of the general condition of patients and complications of the postoperative period. As our studies have shown, the most common complication after limb amputation is an infection of the femoral stump wound, its development is directly related to metabolic disorders in patients, a decrease in the immune status, ischemia of the stump tissues and foci of secondary infection. The clinical picture of infection of the femoral stump wound is variable. It depends, first, on the patient's general condition, the process's spread, the trophism of the stump tissues, and the nature of the microflora. Improving the treatment results of patients who have undergone limb amputation is possible by performing all the necessary preventive measures regarding ischemia and stump infection in the prescribed volume and the development of infectious complications, as well as treatment by the requirements of modern purulent surgery.

Neutrophil-to-Lymphocyte Ratio Any Association with Metabolic Syndrome in Schizophrenia

To date, hematologic inflammation coefficients (HICs) have been considered as biological markers linking the functions of the immune, endocrine, and autonomous nervous systems. HICs are markers of immune abnormalities that accompany various pathologic conditions and, to a large extent, determine disease prognosis, survival time, and function. According to the results of a meta-analysis covering the results of examination of more than 168 thousand patients, it was found that the ratio of neutrophils to lymphocytes (NLR) is associated with higher levels in patients with metabolic syndrome and can potentially be used for early detection of this pathology. Given these facts, it seems reasonable to test the assumption of the role of HICs in the pathogenesis of psychiatric disorders, their participation in the mechanisms of development of comorbid conditions, or predicting the outcome and effects of therapy. In 2024, the team of the Bekhterev Center began to perform work under the state assignment of the Ministry of Health of the Russian Federation, the purpose of which was to develop and validate a model for predicting individual risks of metabolic disorders in patients with psychiatric disorders, on the basis of which interpretive software will be presented. The team of authors of this article focused on conducting a systematic review of publications to test this hypothesis.

The relationship of cholecalciferol and parathyroid hormone with metabolic disorders in patients with arterial hypertension

The relationship of cholecalciferol and parathyroid hormone with metabolic disorders in patients with arterial hypertension

Evaluating the efficacy of surgical and conservative approaches in mild autonomous cortisol secretion: a meta-analysis.

The management of Mild Autonomous Cortisol Secretion (MACS) remains a topic of debate among clinicians, with differing opinions on the effectiveness of surgical intervention compared to conservative treatment methods. This meta-analysis provides a comprehensive assessment of available literature to determine the most effective approach for treating this condition. On December 1, 2023, an exhaustive literature search of English databases Embase, PubMed, the Cochrane Library, Scopus, Web of Science, as well as the Chinese databases China HowNet, Wanfang Database, SinoMed Database, and Weipu Database using the keywords "Mild Autonomous Cortisol Secretion", "Subclinical Cushing's Syndrome", "Subclinical Hypercortisolism", "Mild Cortisol Autonomous Secretion", "Adrenal Incidentaloma", "Surgical Treatment" and "Adrenalectomy". The data were statistically analyzed using STATA version 15.0. In this comprehensive analysis involving 629 patients with MACS, the therapeutic efficacy of adrenalectomy was evident. The meta-analysis results indicate that compared to conservative treatment, surgical intervention more effectively improves obesity indicators in patients: waist circumference (SMD=-0.62, 95% CI: -1.06 to -0.18), BMI (SMD=-0.41, 95% CI: -0.62 to -0.20), enhances glycemic control: fasting blood glucose (SMD=-0.47, 95% CI: -0.68 to -0.26), glycated hemoglobin (SMD=-0.66, 95% CI: -0.95 to -0.38), improves lipid metabolism: triglycerides (SMD=-0.45, 95% CI: -0.73 to -0.16), lowers blood pressure: systolic blood pressure (SMD=-1.04, 95% CI: -1.25 to -0.83), diastolic blood pressure (SMD=-0.89, 95% CI: -1.12 to -0.65), and ameliorates hormonal metabolic disorder: 24h urinary free cortisol (SMD=-1.10, 95% CI: -1.33 to -0.87), ACTH (SMD=2.30, 95% CI: 1.63 to 2.97). All these differences are statistically significant. This meta-analysis shows that, compared to conservative treatment, surgical treatment is more effective in improving obesity indicators, glycemic control, lipid metabolism, reducing blood pressure, and ameliorating hormonal metabolic disorders in patients with MACS. These statistically significant results highlight the importance of considering surgical intervention in the management of patients with MACS. https://www.crd.york.ac.uk/prospero, identifier CRD42023492527.

Relationships between apolipoprotein E and insulin resistance in patients with obstructive sleep apnoea: a large-scale cross-sectional study

BackgroundObstructive sleep apnoea (OSA) is commonly associated with insulin resistance (IR) and dyslipidaemia. Apolipoprotein E (APOE) plays important roles in lipid metabolism. The study aimed to disentangle the multifactorial relationships between IR and APOE based on a large-scale population with OSA.MethodsA total of 5,591 participants who underwent polysomnography for OSA diagnosis were finally enrolled. We collected anthropometric, fasting biochemical and polysomnographic data for each participant. Linear regression analysis was performed to evaluate the relationships between APOE, IR, and sleep breathing-related parameters. Logistic regression, restricted cubic spline (RCS) and mediation analyses were used to explore relationships between APOE and IR in patients with OSA.ResultsIncreasing OSA severity was associated with greater obesity, more obvious dyslipidaemia, and higher levels of APOE and IR. APOE was positively correlated with the apnoea-hypopnoea index (AHI), oxygen desaturation index (ODI) and microarousal index (MAI) even after adjusting for age, sex, body mass index, and smoking and drinking levels (β = 0.107, β = 0.102, β = 0.075, respectively, all P < 0.001). The risks of IR increased from the first to fourth quartiles of APOE (odds ratio (OR) = 1.695, 95% CI: 1.425–2.017; OR = 2.371, 95% confidence interval (CI): 2.009–2.816; OR = 3.392, 95% CI: 2.853–4.032, all P < 0.001) after adjustments. RCS analysis indicated non-linear and dose response relationships between APOE, AHI, ODI, MAI and insulin resistance. Mediation analyses showed that HOMA-IR explained 9.1% and 10% of the association between AHI, ODI and APOE. The same trends were observed in men, but not in women.ConclusionsThis study showed that APOE is a risk factor for IR; moreover, IR acts as a mediator between OSA and APOE in men. APOE, IR, and OSA showed non-linear and multistage relationships. Taken together, these observations revealed the complex relationships of metabolic disorders in patients with OSA, which could lead to the development of new treatment modalities and a deeper understanding of the systemic impact of OSA.

Effects of atypical antipsychotics on serum asprosin level and other metabolic parameters in patients with schizophrenia

AbstractBackgroundIn this cross‐sectional study, we compared fasting serum asprosin levels and metabolic parameters between patients receiving one of three atypical antipsychotics (olanzapine, risperidone, or aripiprazole) and healthy subjects.MethodsThe study population included 62 adult outpatients with schizophrenia and 22 healthy controls, matched for age and gender. Patients were in remission and had been on stable monotherapy with one of these atypical antipsychotics for over 6 months. Body Mass Index (BMI) and fasting serum levels of asprosin, glucose, HA1c, insulin, and lipid profile were compared across the investigated groups. Additionally, the number of participants meeting the insulin resistance criterion, defined as homeostasis model assessment for insulin resistance (HOMA‐IR) &gt;2.5, as well as the number of participants with elevated BMI levels (men &gt;27 kg/m2, women &gt;25 kg/m2) were compared among the groups.ResultsWe observed statistically significant differences in BMI and fasting serum levels of glucose, HA1c, insulin, triglyceride (TG), high‐density lipoprotein cholesterol, and asprosin among patients receiving olanzapine or risperidone, as compared to those receiving aripiprazole and healthy subjects. Patients on aripiprazole exhibited values comparable to healthy subjects, whereas those on risperidone or olanzapine showed significantly higher values, with the highest observed in the olanzapine group. Additionally, the prevalence of participants meeting the insulin resistance criterion and those with elevated BMI was also greater in individuals receiving olanzapine or risperidone compared to those on aripiprazole and healthy subjects. Serum asprosin levels showed a significant positive correlation with BMI and several metabolic parameters, including HbA1c, fasting insulin, HOMA‐IR, and TG. No significant differences were observed among the investigated groups in terms of serum levels of total cholesterol and low‐density lipoprotein cholesterol.ConclusionsOur cross‐sectional study highlights the association between elevated asprosin levels, weight gain, and metabolic disorders in patients treated with olanzapine and risperidone. Given the bidirectional nature of the relationship between serum asprosin levels and these metabolic disturbances, further research is warranted to elucidate potential causative pathways.

Endometrial microbial dysbiosis and metabolic alteration promote the development of endometrial cancer.

Emerging evidence suggests that the endometrial microbiome plays important roles in the development of endometrial cancer (EC). Here, we evaluate stage-specific roles of microbial dysbiosis and metabolic disorders in patients with EC, patients with endometrial hyperplasia (EH), and patients afflicted with benign uterine conditions (CK). This prospective cohort study included 33 women with EC, 15 women with endometrial EH, and 15 women with benign uterine conditions (CK) from November 2022 to September 2023. Different typical endometrial samples were imaged with a scanning electron microscope and a transmission electron microscope. The endometrial microbiome was assessed by sequencing the V3-V4 region of the 16S rRNA gene and the ITS1 to fill the gap in relation to the study of the uterine fungal microbiome. Moreover, liquid chromatography-mass spectrometry-based metabolomics was used to identify and quantify metabolic changes among these groups. The endometrial microbiome revealed that there is a structural microbiome shift and an increase in the α-diversity in the EC and EH cases, distinguishable from the benign cases, especially the fungal community structure. The fungal microbiome from patients with EC and EH was altered relative to controls and dominated by Penicillium sp. By contrast, Sarocladium was more abundant in controls. Significant differences were observed in the composition and content of compounds between benign cases and EC, especially estradiol-like metabolism-related substances. Altered microbiota was correlated with the concentrations of interleukin-6 (IL-6), IL-11, transforming growth factor-beta, and β-glucuronidase activity especially the relative abundance increase of Penicillium sp. This study suggested that the endometrial microbiome is complicit in modulating the development of EC such as estrogen activity and a pro-inflammatory response. Our work provides a new insight into the endometrial microbiome from a perspective of stages, which opens up new avenues for EC prognosis and therapy.

Metabolic disorders in patients diagnosed with colorectal cancer.

e15618 Background: Colorectal cancer (CRC) is the third most common cancer globally and ranks second as a cause of cancer-related death. As survival rates among CRC patients continue to rise, addressing accompanying metabolic comorbidities is becoming increasingly important. This study aims to explore the prevalence of metabolic comorbidities and metabolic syndrome among CRC patients, as well as their impact on survival. Methods: The ColoCare Study is a prospective cohort study conducted across seven U.S. and European sites. Data from a single site, Cedars-Sinai Medical Center in Los Angeles, California was analyzed. Adults with newly diagnosed stage I-IV CRC and available medical records were eligible. Basic demographic information and medical history, including hypertension, hyperlipidemia, and diabetes mellitus (DM) diagnosis at or before CRC diagnosis were collected by manually reviewing electronic medical records. Additionally, BMI was calculated using patients' weight and height at the time of diagnosis and classified according to the CDC’s published ranges. Patients were considered to have metabolic syndrome if they met three or more of the following criteria: hypertension, hyperlipidemia, DM, or obesity. Overall survival rates for patients with each metabolic condition were compared. Results: A total of 295 patients (58.3% male, 41.7% female, mean age at diagnosis = 58.3) were identified. 172 were non-Hispanic White (58.3%), 52 were Hispanic/Latino (17.6%), 36 (12.2%) were Asian, 27 (9.2%) were Black, and 8 (1.8%) were unknown/other. Metabolic conditions were prevalent in the cohort: hypertension affected 33.9%, hyperlipidemia affected 21.4%, and DM affected 13% of patients. Additionally, over half of the patients (56.6%) were overweight or obese. Individuals meeting criteria for metabolic syndrome (8.8%) had lower survival rates compared to those without this condition (73.1% vs. 81.4%). Similarly, patients with DM had lower survival rates compared to their counterparts without DM (72.5% vs. 82.0%). Patients with hypertension, hyperlipidemia, and elevated BMI did not have significantly different survival rates compared to patients without such conditions. Conclusions: Our study highlights the prevalence of metabolic comorbidities, specifically metabolic syndrome and DM, among CRC patients and emphasizes how these factors can impact patient outcomes post-diagnosis. This information is valuable for physicians when considering lifestyle changes or treatment strategies following CRC diagnosis. Further, it highlights the importance of coordination between oncologists and primary care providers to effectively manage metabolic diseases in CRC patients.

#1190 Expression of metabolic disorders in patients with hypertension and chronic kidney disease

Abstract Background and Aims To study the frequency of metabolic disorders in patients with hypertension depending on the stage of chronic kidney disease (CKD). Method The study analyzed 594 case histories of patients with AH of I-III degree (ESC/ESH 2018). CKD stages were determined according to eGFR (EPI-2021), according to the modern KDIGO 2013 classification. All patients were tested for uric acid, glucose, creatinine, and blood lipids using a Daytona autoanalyzer from RANDOX (UK). The study was conducted against the background of antihypertensive therapy (AHT). Statistical analysis was carried out using the SPSS 24.0 software package. Results Among the examined patients, intact renal function of CKD C1 (eGFR&amp;gt;90 ml/min/1.73 m2) was observed in 19.5% (n = 116); CKD C2 (eGFR 60-89 ml/min/1.73 m2) – in 50.5% (n = 300); CKD C3A (eGFR 45-59 ml/min/1.73 m2) – in 20.4% (n = 121); CKD C3B (eGFR 30-44 ml/min/1.73 m2) – in 6.4% (n = 38); CKD C4 (eGFR 29-15 ml/min/1.73 m2) - in 3.2% (n = 19) p &amp;lt; 0.0001. The terminal stage of CKD was not revealed. The mean creatinine in the groups was 66.20 ± 11.74 vs 83.44 ± 11.30 vs 105.84 ± 17.36 vs 139.78 ± 24.40 vs 212.00 ± 19.73 µmol/l, respectively (p &amp;lt; 0.00001) . Mean eGFR 97.99 ± 6.98 vs 75.44 ± 7.15 vs 53.46 ± 4.30 vs 37.82 ± 3.63 vs 23.11 ± 5.63 ml/min/1.73 m2, respectively, (p &amp;lt; 0.00001). The groups did not differ significantly in body mass index (BMI), but patients with high stage of CKD have pronounced abdominal obesity. BMI was 30.71 ± 4.4 vs 32.25 ± 5.8 vs 31.45 ± 4 vs 31.6 ± 5.6 vs 30.36 ± 10.2 kg/m2, respectively, p = 0.11. Waist measurement (WT): 98.68 ± 10 vs 104.36 ± 13.6 vs 103.62 ± 10.7 vs 104.51 ± 12.4 vs 106.94 ± 27.3 cm, respectively (p = 0.001) . It should be noted that the high stages of CKD are characterized by significantly pronounced asymptomatic hyperuremia. At the same time, the level of uric acid was 5.07 ± 1.4 vs 6.1 ± 4.7 vs 6.6 ± 1.7 vs 7.87 ± 1.7 vs 7.52 ± 1.01 µmol/l, respectively (p &amp;lt; 0.00001). When analyzing lipid spectrum data, total blood cholesterol (TC) and triglycerides (TG) in the blood did not differ significantly among the studied groups. However, it was found that increasing of CKD leads to significantly rising of low-density lipoproteins: 107.04 ± 42.57 vs 103.53 ± 38.04 vs 112.44 ± 44.27 vs 120.64 ± 39.27 vs 133.94 ± 29.83 mmol/l, respectively, р = 0.03, while the amount of high density lipoproteins significantly decrease: 42.64 ± 13.79 vs 41.86 ± 11.03 vs 41.51 ± 10.64 vs 39.62 ± 11.08 vs 36.72 ± 7.72 mmol/l, respectively, p = 0.0001. Conclusion In patients with hypertension and CKD, metabolic disorders are more pronounced, which increases the risk of developing complications of arterial hypertension.

Shexiang Baoxin Pill enriches Lactobacillus to regulate purine metabolism in patients with stable coronary artery disease

BackgroundIt has been clinically confirmed that the Shexiang Baoxin Pill (SBP) dramatically reduces the frequency of angina in patients with stable coronary artery disease (SCAD). However, potential therapeutic mechanism of SBP has not been fully explored. PurposeThe study explored the therapeutic mechanism of SBP in the treatment of SCAD patients. MethodsWe examined the serum metabolic profiles of patients with SCAD following SBP treatment. A rat model of acute myocardial infarction (AMI) was established, and the potential therapeutic mechanism of SBP was explored using metabolomics, transcriptomics, and 16S rRNA sequencing. ResultsSBP decreased inosine production and improved purine metabolic disorders in patients with SCAD and in animal models of AMI. Inosine was implicated as a potential biomarker for SBP efficacy. Furthermore, SBP inhibited the expression of genes involved in purine metabolism, which are closely associated with thrombosis, inflammation, and platelet function. The regulation of purine metabolism by SBP was associated with the enrichment of Lactobacillus. Finally, the effects of SBP on inosine production and vascular function could be transmitted through the transplantation of fecal microbiota. ConclusionOur study reveals a novel mechanism by which SBP regulates purine metabolism by enriching Lactobacillus to exert cardioprotective effects in patients with SCAD. The data also provide previously undocumented evidence indicating that inosine is a potential biomarker for evaluating the efficacy of SBP in the treatment of SCAD.

Characterization of the gut microbiota in polycystic ovary syndrome with dyslipidemia

BackgroundPolycystic ovary syndrome (PCOS) is an endocrinopathy in childbearing-age females which can cause many complications, such as diabetes, obesity, and dyslipidemia. The metabolic disorders in patients with PCOS were linked to gut microbial dysbiosis. However, the correlation between the gut microbial community and dyslipidemia in PCOS remains unillustrated. Our study elucidated the different gut microbiota in patients with PCOS and dyslipidemia (PCOS.D) compared to those with only PCOS and healthy women.ResultsIn total, 18 patients with PCOS, 16 healthy females, and 18 patients with PCOS.D were enrolled. The 16 S rRNA sequencing in V3-V4 region was utilized for identifying the gut microbiota, which analyzes species annotation, community diversity, and community functions. Our results showed that the β diversity of gut microbiota did not differ significantly among the three groups. Regarding gut microbiota dysbiosis, patients with PCOS showed a decreased abundance of Proteobacteria, and patients with PCOS.D showed an increased abundance of Bacteroidota compared to other groups. With respect to the gut microbial imbalance at genus level, the PCOS.D group showed a higher abundance of Clostridium_sensu_stricto_1 compared to other two groups. Furthermore, the abundances of Faecalibacterium and Holdemanella were lower in the PCOS.D than those in the PCOS group. Several genera, including Faecalibacterium and Holdemanella, were negatively correlated with the lipid profiles. Pseudomonas was negatively correlated with luteinizing hormone levels. Using PICRUSt analysis, the gut microbiota community functions suggested that certain metabolic pathways (e.g., amino acids, glycolysis, and lipid) were altered in PCOS.D patients as compared to those in PCOS patients.ConclusionsThe gut microbiota characterizations in patients with PCOS.D differ from those in patients with PCOS and controls, and those might also be related to clinical parameters. This may have the potential to become an alternative therapy to regulate the clinical lipid levels of patients with PCOS in the future.

Does an episode of diabetic ketoacidosis affect thyroid function tests in pediatric patients?

The aim of our study was to investigate the changes in thyroid hormone levels during and after acute metabolic disorder in patients with diabetic ketoacidosis (DKA). Eighty five patients diagnosed with DKA were included in the study. Patients with control thyroid function test (TFT) values at admission (the first blood sample) and 1month later were included in the study. Thyroid function tests obtained during diabetic ketoacidosis and at the first month follow-up were compared. Euthyroidism and euthyroid sick syndrome were defined and grouped according to current guidelines. The mild and moderate groups, according to DKA classification, were combined and compared with the severe group. A significant increase was observed between the first admission and the control TFT values 1month later. However, there was no significant difference found in TFT between mild/moderate and severe groups taken at the time of DKA. Difference between two groups, euthyroid sick syndrome and euthyroid, was examined and the result that was different from the literature was the difference between TSH levels. We found that low FT4 levels were associated with higher HgbA1c, although the correlation was weak. Thyroid hormone levels may not reflect a thyroid disease during severe DKA attack. Therefore, it is unnecessary to check thyroid function tests.

Metabolic stress and stress-limiting mechanisms in bronchial asthma combined with type 2 diabetes mellitus

Objective: to study the indicators of lipid peroxidation and the antioxidant system in the blood and moisture condensate of exhaled air in patients with AD combined with type 2 diabetes, and in the blood of these patients — total metabolites of nitric oxide. Materials and methods: the study involved 215 patients with persistent BA of moderate severity aged (38.6±2.4) years, including 88 men (40.9%), 127 women (59.1%). Among the examined patients with BA there were 64 — group I, persons with BA combined with type 2 diabetes — 151 (group II). The parameters of the lipid peroxidation system (LPS) in the blood serum were studied: malondialdehyde (MDA), diene conjugates (DC), and the antioxidant system (AOS) according to the activity of catalase and superoxide dismutase (SOD), the amount of total metabolites of nitric oxide (NOx), in the condensate of exhaled air moisture (KEAM) was determined general oxidant (GOA) and antioxidant (AOA) activity. Results: in patients with BA combined with type 2 diabetes, an increase in the concentration of POL products in the blood was revealed: MDA was 2.6 times (p&lt;0.05) compared with the control group and 1.3 times (p&lt;0.05) compared with the indicator in patients with AD, DC, respectively, 2.0 times (p&lt;0.05) compared with the control group and 1.2 times (p&lt;0.05) compared with I group. The activity of the enzymes AOS catalase and SOD in patients with comorbidity of BA and type 2 diabetes was found to be lower than in patients of group I. In the KEAM of patients with comorbidity of BA and type 2 diabetes, a significant increase in OOA and a decrease in OAA were noted. The concentration of NOx in the blood serum of group II patients was 1.6 times higher than in the control group (p&lt;0.05), but 1.4 times lower than in patients with AD without comorbidity with type 2 diabetes (p&lt;0.05). The direction of the revealed correlations between the products of POL in blood serum and KEAM confirmed the systemic nature of metabolic changes in the body of patients with AD, and their strength in group II patients — the negative effect of comorbid type 2 diabetes on the greater severity of these metabolic changes. Conclusions: the resulting changes in the state of LPS and AOS in the blood and KEAM of patients with BA combined with type 2 diabetes can be characterized as systemic metabolic stress, both components of which: oxidative and nitrosive are supported by insufficient stress-limiting mechanisms — low activity of AOS enzymes and possible depletion of nitric oxide production, which should be reflected in the means of correcting metabolic disorders in patients with this comorbidity.

Serum tumor markers expression (CA199, CA242, and CEA) and its clinical implications in type 2 diabetes mellitus.

Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus (T2DM) is associated with the levels of serum tumor markers of the digestive tract, such as cancer antigen (CA)199. Therefore, tumor markers in T2DM are important. To evaluate the expression of serum tumor markers [CA199, CA242, and car-cinoembryonic antigen (CEA)] and the clinical implications of the expression in T2DM. For this observational study conducted at Hefei BOE Hospital, China, we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020. Levels of fasting blood glucose (FBG), tumor markers (CA199, CEA, and CA242), glycosylated hemoglobin (HbA1c), etc. were measured and group index levels were compared. Moreover, FBG and HbA1c levels were correlated with tumor marker levels. Tumor markers were tested for diagnostic accuracy in patients with > 9% HbA1c using the receiver operating curve (ROC) curve. The T2DM group had high serum FBG, HbA1c, CA199, and CEA levels (P < 0.05). A comparative analysis of the two groups based on HbA1c levels (Group A: HbA1c ≤ 9%; Group B: HbA1c > 9%) revealed significant differences in CEA and CA199 levels (P < 0.05). The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809, respectively. CA199, CEA, and CA242 levels positively correlated with HbA1c (r = 0.308, 0.426, and 0.551, respectively) and FBG levels (r = 0.236, 0.231, and 0.298, respectively). As compared to controls, serum CEA and CA199 levels were higher in patients with T2DM. HbA1c and FBG levels correlated with CA199, CEA, and CA242 levels. Patients with poorly controlled blood sugar must be screened for tumor markers.

The Role of Bioimpedance Analysis of Body Composition in the Diagnosis of Metabolic Disorders in Patients with Obesity of the 1st Degree

Obesity and overweight have become common phenomena in today’s realities. The degree of obesity only allows to determine the presence of excessive body weight, but does not assess the real state of the problem. An excess of visceral adipose tissue is the main risk factor for the development of metabolic disorders and dysfunction of all human organs and systems. The mechanism of development of obesity and insulin resistance attracts the greatest attention of doctors. The objective: to study the influence of the percentage of visceral fat on the state of metabolic indicators in patients with obesity of the 1st degree. Materials and methods. The study included 70 patients (44 women and 26 men) with a body mass index (BMI) 30–35 kg/m2. The average age of the study participants was 47.1±1.65 years old. The degree of obesity, body fat mass, percentage of fat in the body, metabolic age, indicators of visceral obesity were determined using bioelectrical resistance analysis technology. Fasting plasma glucose (FPG), total cholesterol, low-density lipoprotein cholesterol (LDL-C) were determined in all patients. Descriptive statistics were conducted to obtain demographic data. Results. A positive relationship was determined between the level of visceral obesity and BMI, slowing down of the general metabolism, and increasing the metabolic age of patients. A positive relationship between metabolic age and FPG was also registered (CI 95%) = 1.70(0.33/3.07), p=0.01; between age difference and LDL-C level (CI 95%) = 1.12 (0.36/3.88), p=0.02. Conclusions. Obesity is a serious disease that requires great attention and a special treatment approach. Assessing the level of visceral adiposity and metabolic age provides more useful information for physicians to find new approaches to obesity treatment.

SLC16A7 Facilitates aGVHD through Regulating Calcium Influx and Lipid Metabolism of CD4 + T Cells

T cell metabolic disorders in patients with acute graft-versus-host disease (aGVHD) have been studied, but the underlying mechanisms remain poorly understood. Solute carrier (SLC) transporters play a crucial role in cell metabolism, but their involvement in T cell-mediated aGVHD has not been investigated. In this study, we observed that SLC16A7 levels were down-regulated in CD4 + T cells of both aGVHD mice and patients, which in turn increased calcium (Ca 2+) influx in activated CD4 + T cells and promoted the differentiation of Th1 and Th17 cells, leading to the exacerbated aGVHD cascade. Moreover, deficiency of SLC16A7 promoted calcium overload in activated CD4 + T cells through regulating SERCA3 proteins and altered characteristics of lipid metabolism, decreasing levels of oleic acid, thereby aggravating aGVHD. Interestingly, supplementation of oleic acid rescued the survival of aGVHD mice. This study characterized a previously unknown role of SLC16A7 in T cell-mediated aGVHD and provided a promising therapeutic strategy to target T cell metabolism for the alleviation of aGVHD.

Bone marrow-derived exosomes promote inflammation and osteoclast differentiation in high-turnover renal osteodystrophy

Introduction Renal osteodystrophy (ROD) is a type of bone metabolic disorder in patients with chronic kidney disease (CKD). Inflammation is associated with bone loss in ROD. However, its precise mechanism has not yet been elucidated. The present study was conducted to investigate whether exosomes (Exos) in bone marrow (BM) are involved in the pathogenesis of high-turnover ROD. Methods Bone mass, osteoclast number, and pro-inflammatory cytokines levels of BM supernatant were detected in adenine-induced ROD rats. The effect of Exos derived from BM (BM-Exos) of ROD (ROD-Exos) on inflammatory genes and osteoclast differentiation of BM-derived macrophages (BMMs) were further examined. Then, exosomal miRNA sequencing was performed and an miRNA-mRNA-pathway network was constructed. Results we found increased osteoclasts and decreased bone mass in ROD rats, as well as inflammatory activation in the BM niche. Furthermore, BMMs from ROD rats displayed overproduction of proinflammatory cytokines and increased osteoclast differentiation, accompanied by nuclear factor κB (NF-κB) signaling activation. Mechanistically, we found that ROD-Exos activates NF-κB signaling to promote the release of proinflammatory cytokines and increase osteoclast differentiation of BMMs. Meanwhile, a total of 24 differentially expressed miRNAs were identified between BM-Exos from ROD and normal control (NC). The miRNA-mRNA-pathway network suggests that rno-miR-9a-5p, rno-miR-133a-3p, rno-miR-30c-5p, rno-miR-206-3p, and rno-miR-17-5p might play pivotal roles in inflammation and osteoclast differentiation. Additionally, we validated that the expression of miR-9a-5p is upregulated in ROD-Exos. Conclusion The BM niche of ROD alters the miRNA cargo of BM-Exos to promote inflammation and osteoclast differentiation of BMMs, at least partially contributing to the pathogenesis of high-turnover ROD.

Endothelial Dysfunction and Metabolic Disorders in Patients with Sudden Sensorineural Hearing Loss.

Sudden sensorineural hearing loss (SSNHL) is defined as a sensorineural hearing loss of 30 dB or greater on at least three contiguous audiometric frequencies occurring within a 72 h period. Although SSNHL is commonly encountered in clinical audiology and otolaryngology practice, its etiopathogenesis continues to be poorly understood. Scientific investigations have highlighted the vulnerability of cochlear microcirculation to blood flow alterations. Even mild hypoperfusion can lead to immediate dysfunction in the organ of Corti, given the heightened susceptibility of cochlear hair cells to hypoxia and ischemic damage. The purpose of this review paper is to present evidence of endothelial and vascular involvement in SSNHL and the risk factors, such as metabolic syndrome, that may negatively impact the inner ear's vascular supply, influencing the onset pattern, incidence, and prognosis of SSNHL. By addressing these variables, we can deepen our comprehension of the mechanisms underlying SSNHL and potentially uncover strategies for prevention.