Metabolic Parameters In Patients Research Articles

An Observational Study of Electrolytes and Other Metabolic Parameters in Patients with Delirium in Hospital Settings

Abstract Background: Despite extensive research, pathophysiology of delirium remains inadequately understood, with studies suggesting a role for inflammatory mediators, cholinergic deficiency, and metabolic disturbances. Aim: This study aims to explore the association of electrolytes and other metabolic parameters in hospitalized delirium patients as compared to age- and gender-matched nondelirious controls. Materials and Methods: The observational case–control study was conducted at a multispecialty hospital in eastern India where 100 inpatients diagnosed with delirium (cases) and an equal number of age- and gender-matched nondelirious inpatients (controls) were administered a semi-structured pro forma for sociodemographic variables and assessed for electrolytes and other metabolic parameters. Statistical analysis employed Pearson’s Chi-square test to assess the significance of differences between the two groups. Results: The study revealed statistically significant differences in metabolic disturbances in delirium cases as compared to controls with a greater association of hyperglycemia (P = 0.009), hyponatremia (P = 0.002), hypercalcemia (P = 0.001), hyperkalemia (P = 0.030), and hypokalemia (P = 0.005) among delirium patients. Hypoalbuminemia (P = 0.002) and elevated bilirubin levels (P = 0.014) as well as uremia (P < 0.001) and elevated creatinine levels (P < 0.001) also had a greater association with delirium cases than controls. Sociodemographic analysis revealed a higher incidence of delirium in older adults and males. Conclusion: There was a significant association between delirium and various biochemical disturbances, highlighting the importance of thorough metabolic workup to identify and correct these disturbances which would potentially enhance delirium outcomes. There is a need for further studies to explore the causal pathways of these associations and the impact of targeted metabolic interventions on delirium outcomes.

Unveiling Resmetirom: A systematic review and meta-analysis on its impact on liver function and safety in non-alcoholic steatohepatitis treatment.

The role of Resmetirom in non-alcoholic steatohepatitis (NASH) represents a promising therapeutic approach in addressing the growing global burden of liver disease. With NASH emerging as a leading cause of liver-related morbidity and mortality worldwide, there is an urgent need for effective treatments. Resmetirom, a selective thyroid hormone receptor-β agonist, offers potential benefits in improving liver histology and metabolic parameters in patients with NASH. This review examines the current evidence surrounding Resmetirom's role in NASH management. A systematic review and meta-analysis was done by searching in Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess) (OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tool was used for assessing risk of bias in randomized controlled trials (RCTs). In the analysis, we used RevMan Cochrane software. The study showed that patients who were treated with Resmetirom had significantly lower low-density lipoprotein-cholesterol (LDL-C) levels (mean difference [MD] -10.45; 95% confidence interval [CI] -15.86 to -5.83; P < 0.001) and alanine aminotransferase (ALT) levels (MD -7.18; 95% CI -12.67 to -1.68; P = 0.01) as compared with those in the placebo group. The risk of adverse events including diarrhea [risk ratio (RR)1.81; 95% CI 1.40 to 2.35; P < 0.001] and nausea (RR 1.72; 95% CI 1.31 to 2.27; P < 0.001) was significantly increased for the Resmetirom group as compared with the placebo group. Resmetirom presents a promising therapeutic option for NASH, offering potential benefits in reducing liver fat content and improving histological outcomes. The encouraging results from clinical trials suggest that Resmetirom may address an unmet need in NASH management, providing hope for patients with this progressive liver disease. Further research and long-term studies are warranted to validate its efficacy and safety profile in larger patient populations.

The Relationship Between Computerized Face and Tongue Image Segmentation and Metabolic Parameters in Patients with Type 2 Diabetes Based on Machine Learning.

We aim to examine and reestablish the correlational and linear regression relationships, as well as the predictive value, between the significant facial and tongue features and the metabolic parameters in type 2 diabetes mellitus (T2DM). From March to May 2024, we studied 269 patients with T2DM in the endocrinology department of Shanghai Pudong Hospital. The patients' facial and tongue characteristics were sampling by a tongue imaging device equipped with artificial intelligence (AI) (XiMaLife, Sinology, China) of automated and advanced machine learning algorithms. Then, the imaging features were examined in relation to the blood examination. Multiple facial and tongue features, as well as dimensional facial and tongue color parameters, were significantly correlated with glycated hemoglobin A1c (HbA1c) (r < 0.3, p < 0.05), glycated albumin (GA) (-0.20 < 0.30, p < 0.05), C-peptide (-0.20.20, p < 0.05), plasma insulin (r < 0.30, p < 0.05), fasting plasma glucose (FPG) (r < 0.3, p < 0.05), significant hepatic and renal function indicators (-0.30 < r < 0.20, p<0.05), cardiac injury markers (-0.30 < r < 0.30, p < 0.05), tumor markers (-0.5 < r < 0.5, p < 0.05), thyroid function (-0.15 < r < 0.55, p < 0.05), and blood cell count, including white blood cells (r < 0.2, p < 0.05), and hemoglobin (Hb) (-0.30 < r < 0.3, 0.0001. The correlational results demonstrated that the tongue's characteristics and signsmay be linked with the dynamic of the metabolic status of T2DM. In order to examine the causal relationships, we performed linear regression analyses, which revealed that various facial and tongue imaging parameters partially determined the metabolic indicators. The predictive value of imaging features was evaluated by receiver operating characteristic curve (ROC) to assess metabolic status in T2DM. This study demonstrated that metabolic status, renal and hepatic, cardiac, and thyroid function, the proportion of blood cells, and Hb in T2DM were intimately associated with facial and tongue features. The precise analysis of facial and tongue features through AI and advanced machine learning could be used to predict T2DM's conditions and progression.

The effect of anxiety on metabolic parameters in patients with primary hypertension

Aims: Although the role of anxiety in the pathogenesis of hypertension is known, the effect of anxiety on metabolic parameters in hypertension has not been demonstrated. This study aimed to evaluate the effect of anxiety on metabolic parameters and blood pressure regulation in patients with primary hypertension. Methods: The study was designed as a single-center, descriptive cross-sectional study. A total of 150 patients receiving antihypertensive therapy for primary hypertension were included in the study. Patients were divided into minimal, mild, moderate, and severe anxiety groups according to the Beck Anxiety Inventory. Anthropometric measurements, metabolic parameters, and blood pressure measurements were compared between groups. Results: Significant positive correlations were found between anxiety severity and total cholesterol, LDL cholesterol, body mass index, and waist circumference (p&lt;0.05). Subgroup analyses showed that total cholesterol, LDL cholesterol, body mass index, and waist circumference were higher in the severe anxiety group than in the minimal anxiety group (p&lt;0.05). Conclusion: Anxiety in patients with primary hypertension appears to have negative consequences on total cholesterol, LDL cholesterol, body mass index, and waist circumference. In hypertension, female gender and obesity are associated with increased anxiety levels.

Features of the relationship of intestinal microbiota indicators with clinical and biochemical parameters in obese young people

The prevalence of obesity is rising dramatically worldwide. Recently, there is increasing evidence linking obesity with the functional state of the intestinal microbiota. The understanding of this relationship may provide new approaches to the treatment of obesity by manipulating the qualitative and quantitative parameters of intestinal bacterial-fungal associations. To study the features of the qualitative and quantitative composition of the colon microbiota and to evaluate associations with anamnestic, anthropometric and biochemical parameters in young obese patients. A single-center, cross-sectional, single-stage, controlled study was conducted with the participation of 118 young people, of whom 87 were obese, and 31 people with normal body weight formed the control group. All participants underwent a biochemical blood test (total cholesterol, high-density lipoproteins, low-density lipoproteins, very low-density lipoproteins, triglycerides, uric acid, glucose, glycated hemoglobin, C-reactive protein), as well as an assessment of the state of the colon microbiota using polymerase chain reaction in real time using a set of Colonoflor-16 (premium) reagents. The Microsoft Excel 2010 and IBM SPSS Statistics 26.0 application software package was used for statistical calculations. The results were evaluated as statistically significant at a level of p&lt;0.05. Analyzing the result of Colonoflor-16 premium, the discrepancy between the obtained data of the control group and the reference values of the analysis was revealed. There was a clear tendency to decrease the content of Lactobacillus spp and Bifidobacterium spp in the obesity group. In addition, in comparison with the control group (10.3%), in the obesity group Fusobacterium nucleatum significantly prevailed (37.6%) (p=0.005), with a significant decrease in the bacteria Faecalibacterium prausnitzii (p=0.030), and an increase in the bacteria Prevotella spp (p=0.029). A lot of associations of representatives of the colon microbiota with the most important anamnestic, anthropometric and biochemical parameters were revealed in young obese patients. There is a redistribution of microbiota phylotypes characterized by a decrease in apathogenic microorganisms and the appearance and increase of opportunistic and pathogenic microorganisms, which generally indicates the formation of the pro-inflammatory potential of dominants and associates in young obese patients. The presence of statistically significant correlations strongly indicates of existence of close and diverse relationships between the quantitative and qualitative parameters of the microbiota and the metabolic parameters of patients.

Effectiveness of DASH Diet versus Other Diet Modalities in Patients with Metabolic Syndrome: A Systematic Review and Meta-Analysis.

Metabolic syndrome refers to the coexistence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia, and hypertension. These conditions are interrelated and share underlying mediators, mechanisms, and pathways. Improvement in dietary habits has been shown to improve metabolic parameters in patients undergoing treatment with different diets. A systematic search in different databases was realized using the keywords "Metabolic syndrome", "X syndrome", "Dash dietary" and "Dash diet". Finally, six studies were included in this meta-analysis. All articles comparing the DASH diet vs. other diet modalities reported significant differences in favor of the DASH diet on Systolic blood pressure (SBP) (standardized mean difference [SMD] = -8.06, confidence interval [CI] = -9.89 to -7.32, and p < 0.00001), Diastolic blood pressure (SMD = -6.38, CI = -7.62 to -5.14, and p < 0.00001), Cholesterol HDL (SMD = 0.70, CI = 0.53 to 0.88, and p < 0.00001) and Cholesterol LDL (SMD = -1.29, CI = -1.73 to -0.85, and p < 0.00001) scales. The DASH diet has been shown to be beneficial in altered parameters in patients with MS, and the resulting improvements can significantly affect the daily health of these patients. We therefore recommend that professionals who manage these pathologies promote the use of the DASH diet for the management of specific symptoms.

A Randomized Controlled Trial Comparing the Effects of Vilazodone, Escitalopram, and Vortioxetine Monotherapy on the Metabolic Parameters in Patients With Major Depressive Disorder.

The coexistence of major depressive disorder (MDD) and metabolic illness could culminate in an aberrant metabolic profile. Individuals with MDD and type 2 diabetes mellitus (T2DM) are more likely to have impaired metabolic indicators. Effective antidepressant therapy can alleviate depressive symptoms and metabolic abnormalities. We focused on the effects of vilazodone, escitalopram, and vortioxetine on metabolic indices. Our research aimed to examine changes after 16 weeks of intervention in the glycemic indices, serum creatinine, lipid profile, hepatic parameters, and the Hamilton Depression Rating Scale (HDRS) 17-item version. A three-arm, randomized, open-label trial with 96 MDD patients was executed. Participants were divided into three distinct groups in a 1:1:1 ratio for 16 weeks and issued tablets of vilazodone (20-40 mg/day), escitalopram (10-20 mg/day), or vortioxetine (5-20 mg/day). Vilazodone and vortioxetine were the two test medications, while escitalopram served as the control. We stratified the participants as non-diabetics and diabetics. Follow-up appointments were slated four weeks after the initial visit. HDRS scores and other metabolic indicators were assessed at each visit in the per-protocol (PP) population. After 12 weeks, glycated hemoglobin (HbA1c) levels were measured. Lower HDRS scores indicated that depression-related symptoms had improved. We investigated the relationship between the 16-week differences in the fasting blood sugar(FBS) and HDRS scores. The Kruskal-Wallis test, Bonferroni correction, and Pearson correlation were all used in our analysis. We registered our trial prospectively in the Clinical Trial Registry of India (CTRI) (2022/07/043808). Of the 134 people we screened, 119 (81.34%) were deemed eligible. The PP population included 96 (88.07%) of those who completed the 16-week study. The population's average age was 46.3 ± 6.2 years. Across all study groups, the median baseline HDRS score was 30.0 (p = 0.964). At 16 weeks, the equivalent scores dropped to 15.0, 14.0, and 13.0 (p = 0.002). The median FBS levels at baseline and 16 weeks were 100.5, 104.0, and 98.0 (p = 0.491) and 91.5, 98.5, and 91.5 (p = 0.561), respectively. The post hoc analysis manifested no statistically significant changes between any parameters. Except for the reductions in glycemic indices in diabetic patients, no other data differed significantly. There was a positive relationship between FBS and HDRS scores. Irrespective of the diabetic situation, all three drugs substantially lowered HDRS scores. People with diabetes experienced noticeable declines in glycemic indices. Despite this, the patients' other metabolic indicators showed no significant alterations. We urge additional research with a larger sample size to investigate these medications' long-term impact on various metabolic indicators.

Metabolic Changes Following Smoking Cessation in Patients with Type 2 Diabetes Mellitus.

Smoking cessation is crucial for reducing complications of type 2 diabetes mellitus (T2DM), but associated weight gain can worsen glycemic control, discouraging quitting attempts. Varenicline, a partial agonist of α4β2 nicotinic receptors, aids smoking cessation. This study examines the effects of varenicline on body weight and metabolic parameters in patients with T2DM and prediabetes. Fifty-three patients were enrolled, of which 32 successfully quit smoking after a three-month course of varenicline and were examined after an additional month with no medication. Measurements taken at baseline, 2.5 months, and 4 months included body weight, blood pressure, resting metabolic rate (RMR), glycated hemoglobin (HbA1c), fasting glucose, blood lipids, C-reactive protein (CRP), appetite-related hormones, and physical activity. Post-treatment, there were no significant changes in body weight, blood pressure, RMR, or glycemic control. Total (CHOL) and low-density lipoprotein (LDL-C) cholesterol decreased significantly at 4 months of the study (from 168 to 156 mg/dL, p = 0.013, and from 96 to 83 mg/dL, p = 0.013, respectively). Leptin levels increased (from 11 to 13.8 ng/dL, p = 0.004), as did glucagon-like peptide-1 (GLP-1) levels (from 39.6 to 45.8 pM, p = 0.016) at 4 months of follow-up. The percentage of participants who reported moderate-intensity activity increased from 28% to 56%, while those reporting high-intensity activity increased from 19% to 22%, respectively (p = 0.039). Our study showed that smoking cessation with varenicline in smokers with T2DM and prediabetes led to significant improvements in lipid profile, significant increase in plasma leptin and GLP-1 levels, and increased physical activity, without significant weight gain. Thus, smoking cessation without weight gain or deteriorated glycemic control is feasible for these smokers, with added benefits to lipid profiles, GLP-1 regulation, and physical activity.

The effect of an educational video about healthy diet on metabolic control of patients on hemodialysis: an interventional study with a one-year follow-up

BackgroundAdherence to diet is effective for metabolic control in patients on hemodialysis. There are educational pamphlets or booklets to improve patients’ knowledge about healthy diets. As video presentation is more desirable than the presentation of readable materials, we designed an educational video on healthy diets in renal failure patients who was played during several sessions of hemodialysis. We compared the effect of this modality on the knowledge, attitudes and metabolic control of the patients before and after the intervention.MethodsIn this interventional study, all the patients who were referred to the hemodialysis ward at Ashrafi-Esfahani Medical Center (Tehran, Iran) between May 2018 and March 2019 were enrolled (N = 190). Totally, 130 patients had inclusion criteria. An educational video about a healthy diet was shown seven times (once a week in the first month, once every two weeks in the second month, and once in the third month) during hemodialysis for the patients. The nephrologist prepared a video in the form of a lecture with graphic images for 20 min based on the healthy nutrition of the Kidney Federation of Iran’s Guide for hemodialysis patients. The questionnaire was completed in terms of awareness and attitudes, and blood and urine tests were performed at the 1st, 3rd, and 12th months. Serum parameters, including electrolytes, lipid profile, CBC-diff, dialysis efficacy (Kt/V), and the URR (urine filtration rate) were examined. Pre and post intervention values were compared via the statistical analysis performed using IBM SPSS. P-Value < 0.05 was significant.ResultsThe data of 128 people were analyzed at the end of the study. 55% of patients were 10–40 years old and 60% were male. 56% of patients were illiterate or had an elementary school education. The most common underlying diseases were hypertension and diabetes mellitus. Ten to 19% of participants had enough knowledge about the various components of a healthy diet for patients on hemodialysis. Approximately 25%, 14%, and 45% of the participants consumed a healthy diet for breakfast, lunch and dinner, respectively. A comparison of the mean values of the serum parameters before and after the intervention revealed significant changes in phosphorus, blood urea nitrogen, and hemoglobin with mean differences of -118.41 ± 22.84, 21.51 ± 10.38 (both P < 0.001), and 0.29 ± 1.18 (P = 0.044), respectively. The mean Kt/V was similar at all phases.ConclusionThe use of an educational video was effective for normalizing the metabolic parameters in patients under hemodialysis and can be an appropriate option, especially for illiterate patients.Trial registrationIRCT2016082229481N1.

Effectiveness of switching from dipeptidyl peptidase-4 inhibitor to oral glucagon-like peptide-1 receptor agonist in Japanese participants with type 2 diabetes mellitus: Prospective observational study using propensity score matching.

Recently, the development of the oral glucagon-like peptide-1 receptor agonist semaglutide has drawn a great deal of attention. This study aimed to compare the effectiveness of oral glucagon-like peptide-1 receptor agonist semaglutide and dipeptidyl peptidase-4 (DPP-4) inhibitors on glycaemic control and several metabolic parameters in patients with type 2 diabetes mellitus over a 6-month period. Fifty-nine participants were included, and we compared various clinical parameters between before and after switching from DPP-4 inhibitors to oral semaglutide in 'study 1' (pre-post comparison) and set the control group using the propensity score matching method in 'study 2'. In 'study 1', 6 months after the switching, the glycated haemoglobin value was significantly reduced from 7.5% to 7.0%, and the body mass index was also decreased from 29.7 kg/m2 to 28.8 kg/m2. Such effects were more clearly observed in participants whose glycaemic control was poor. In 'study 2', after 1:1 propensity score matching, 51 participants from each group were matched, and glycaemic control as well as body weight management were improved in the switching group compared with the DPP-4 inhibitor continuation group over the 6-month observation period. In this study, including obese participants with poor glycaemic control, switching DPP-4 inhibitors to oral semaglutide showed more beneficial effects on both glycaemic and weight control, irrespective of age, body weight and diabetes duration. Therefore, we should bear in mind that it would be better to start using an oral semaglutide in clinical practice, particularly in obese participants with poor glycaemic control with DPP-4 inhibitors.

Comparison of the effects of empagliflozin and sitagliptin, as add-on to metformin, on serum levels of asprosin and metabolic parameters in patients with type 2 diabetes mellitus.

The effect of sitagliptin and empagliflozin on serum levels of asprosin and metabolic parameters in patients with type 2 diabetes mellitus (T2DM) was assessed in a non-randomized, prospective observational study. Seventy-nine T2DM patients, without adequate glycemic control with metformin monotherapy, were included in the study. In addition to the ongoing metformin treatment, patients received sitagliptin 100mg and empagliflozin 10mg once daily for 12weeks. Anthropometric parameters, lipid and glycemic profile, insulin resistance (homeostasis model assessment of insulin resistance index [HOMA-IR]), and asprosin serum levels were assessed at baseline and after 12weeks of therapy. Both empagliflozin and sitagliptin treatments led to similar, significant improvement in fasting blood glucose (FBG) and hemoglobin A1C (HbA1C). Compared to baseline, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) were improved with both treatments, but empagliflozin led to the more improvement. No significant change of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were observed in either group. Insulin resistance was significantly attenuated in both groups, but to a greater degree with empagliflozin treatment. The reduction in serum asprosin levels from baseline was significantly higher in patients taking empagliflozin compared to those receiving sitagliptin. Additionally, individuals on empagliflozin exhibited a more decrease in body mass index (BMI) and body weight compared to those on sitagliptin. According to our findings, the addition of empagliflozin to metformin appeared to offer greater benefits compared to the addition of sitagliptin in terms of decreasing asprosin levels and improving certain metabolic parameters in T2DM patients.

Transforming body composition with semaglutide in adults with obesity and type 2 diabetes mellitus.

Glucagon-like peptide-1 receptor-agonists (GLP-1ra), such as semaglutide, have emerged as promising treatments, demonstrating sustained weight reduction and metabolic benefits. This study aims to assess the impact of oral and subcutaneous semaglutide on body composition and metabolic parameters in patients with T2DM and obesity. A 24-week quasi-experimental retrospective study including adults with T2DM and obesity (BMI ≥ 30 kg/m²) who were treated with either daily-oral or weekly-subcutaneous semaglutide. Body composition was measured using bioelectrical impedance analysis, evaluating fat mass, fat-free mass, total body water, skeletal muscle mass, and whole-body phase angle. Analytical parameters included lipid profile and glycaemic control. Statistical analyses were performed using SPSS v.26. Participants (n=88) experienced significant weight loss after treatment with semaglutide (9.5% in subcutaneous, 9.4% in oral, P<0.001). Weight reduction primarily resulted from fat mass reduction without substantial lean mass compromise. Visceral fat area decreased, whiles phase-angle remained stable. Improvements in lipid profiles and glycaemic control were observed, with a decrease in both HbA1c and insulin requirements. Multivariate analysis demonstrated comparable impacts of oral and subcutaneous semaglutide on body composition. Semaglutide, administered orally or subcutaneously, demonstrated positive effects on body composition, metabolic and glycaemic control in patients with T2DM and obesity. This real-world study highlights the potential of bioelectrical impedance analysis in assessing antidiabetic drugs' impact on body composition, providing valuable insights for future research and clinical applications.

Does berberine impact anthropometric, hepatic, and metabolic parameters in patients with metabolic dysfunction-associated fatty liver disease? Randomized, double-blind placebo-controlled trial.

Globally, the metabolic dysfunction-associated fatty liver disease (MAFLD) holds the position as the most widespread chronic liver condition. Berberine (BBR) shows promise as a natural compound for managing obesity, hepatic steatosis, and metabolic disorders. The study aimed to investigate the effectiveness of BBR in addressing factors linked to MAFLD. This is a randomized, double-blind, and placebo-controlled clinical trial. Seventy individuals with MAFLD were enrolled in this study and randomly assigned in a 1:1 ratio to two groups. BBR (1500 mg/day) or placebo was administrated orally for 12 weeks. Selected anthropometric, hepatic, and metabolic parameters were assessed. After a 12-week intervention, the BBR group demonstrated a statistically significant decrease in alanine transaminase (ALT) p=0.0105, and de Ritis ratio p=0.0011 compared to the control group. In both groups we observed a decrease in trunk fat (kg) - BBR group p=0.0185, and placebo group p=0.0323. After three months, a significant divergence between the BBR and placebo groups was evident in the alteration of Δ total cholesterol (TC) p=0.0009, favoring the BBR group. Nevertheless, there were no significant differences detected in other lipid and glucose parameters. In the BBR group, we found significant correlations between changes and amelioration of certain variables: Δ body mass index (BMI) correlated with ΔALT (r=0.47; p=0.0089) and D aspartate aminotransferase (AST) (r=0.47; p=0.0081) levels; Δ trunk fat with Δ fatty liver index (FLI) (r=0.55; p=0.0337), Δ homeostasis model assessment for insulin resistant index (HOMA-IR) (r=0.37; p=0.0020), and AST (r=0.42; p=0.0202); D the de Ritis ratio correlated with Δ fibrosis-4 index (FIB-4) levels (r=0.59; p=0.0011); and ΔFLI correlated with ΔHOMA-IR (r=0.37; p=0.0409) and Δ visceral adiposity index (VAI) (r=0.54; p=0.0019), while no significant differences were observed in the Placebo group. The results show that BBR appears to be a bioactive compound that positively impacts MAFLD, however, additional research with extended intervention durations is required to fully assess its efficacy and potential clinical use.

Long-term uroseptic and metabolic effects of a herbal medicinal preparation in women with type 2 diabetes taken gliflosins

Background. The problem of urinary tract infections, including recurrent cystitis, and the choice of effective and safe means of treatment and prevention, taking into account the increasing burden of antibiotic resistance, are extremely relevant. Aim. To evaluate the effectiveness and safety of the herbal medicine Canephron® N for the prevention of exacerbations of recurrent cystitis and its effect on metabolic parameters in patients with type 2 diabetes mellitus taking sodium glucose cotransporter type 2 inhibitors. Material and methods. A prospective, randomized, open-label, parallel group study of 60 women without exacerbation of recurrent cystitis. The main group took the drug Canephron® N for 3 months, 2 tablets 3 times a day, and for the next 3 months they were monitored without taking the drug. The main evaluation parameters were: frequency of cystitis relapses, albumin/creatinine ratio in the morning urine, glomerular filtration rate, plasma lipid profile, glycemia and malondialdehyde in low-density lipoproteins. Results. 3 months after the end of taking the drug Canephron® N, patients in the main group maintained a positive effect in reducing exacerbations of cystitis – 3.3 times less relapses of the disease (3 and 10%, respectively; p=0.038). The urine albumin/creatinine ratio, lipid profile, glycemia and malondialdehyde in low-density lipoproteins after a 3-month treatment period had positive dynamics, but in the long-term period they corresponded to the values at the inclusion stage, both in the main and control groups. Conclusion. Prophylactic use of the herbal drug Canephron® N for 3 months is safe and reduces the frequency of relapses of cystitis in women with chronic cystitis against the background of diabetes mellitus taking sodium glucose cotransporter type 2 inhibitors, this effect persists for 3 months after discontinuation of the drug. Positive metabolic effects are associated with taking Canephron® N and are gradually leveled out when it is discontinued.

Study of various dietary interventions in patients with hypertension and metabolic syndrome

Obesity is an independent risk factor оf cardiovascular diseases (CVD), type 2 diabetes mellitus and arterial hypertension (HT). Optimization of CVD control methods is one of the most relevant and urgent problems for Russia. Many studies have shown that body weight correlates with blood pressure, and this relationship is due to complex pathogenetic mechanisms. Therefore, therapeutic approaches in a patient with obesity, metabolic syndrome and HT require consideration of all pathophysiologic changes associated with these diseases. Non-pharmacological treatments such as lifestyle changes including weight loss, following dietary guidelines and increasing physical activity can directly affect of BP levels and improve BP control. A wide range of nutritional interventions are effective in treating obesity and comorbidities, and clinicians must consider all options and provide personalized interventions. The Mediterranean diet, vegetarian diets, DASH-diet, Nordic diet, and low-carbohydrate diets have all been associated with improved metabolic health with or without changes in body weight. Recent evidence reinforce more the role of dietary fiber supplementation to the daily diet in patients with HT and metabolic syndrome, although no evidence of significant benefit has been found. Taking into account national dietary characteristics, we have proposed a study in which we plan to study the effect of the Russian diet with fiber supplementation on metabolic parameters in patients with HT. It is planned to evaluate the effect of diet therapy on indicators of metabolic disorders of intestinal metabolites.

The impact of metformin on weight and metabolic parameters in patients with obesity: A systematic review and meta-analysis of randomized controlled trials.

There are conflicting data on the weight-reducing potential of metformin (MTF) in nondiabetic patients with obesity. The purpose of this systematic review and meta-analysis was to evaluate the effect of MTF on weight and cardiometabolic parameters in adults with overweight/obesity with or without nonalcoholic fatty liver disease (NAFLD) (CRD42018085512). We included randomized controlled trials (RCTs) in adults without diabetes mellitus, with mean body mass index (BMI) ≥ 25 kg/m2, with or without NAFLD, comparing MTF to placebo/control, lifestyle modification (LSM) or a US Food and Drug Administration-approved anti-obesity drug, reporting on weight or metabolic parameters, and extending over at least 3 months. We conducted a systematic search in MEDLINE, EMBASE, PubMed and the Cochrane Library without time limitation (until March 2022). We screened and selected eligible articles, abstracted relevant data, and assessed the risk of bias. All steps were in duplicate and independently. We conducted a random-effects model meta-analysis using Review Manager version 5.3, with prespecified subgroup analyses in case of heterogeneity. We identified 2650 citations and included 49 trials (55 publications). Compared to placebo, MTF was associated with a significant reduction in BMI (mean difference [MD] -0.56 [-0.74, -0.37] kg/m2; p < 0.0001), at doses ranging from 500 to 2550 mg/day, and with a significant percentage change in BMI of -2.53% (-2.90, -2.17) at the dose 1700 mg/day. There was no interaction by baseline BMI, MTF dose or duration, nor presence or absence of NAFLD. There was no significant difference between MTF and LSM. Orlistat was more effective than MTF (at doses of 1000-1700 mg/day) in terms of weight loss, with an MD in BMI of -3.17 (-5.88; -0.47) kg/m2, favouring the former. Compared to placebo/control, MTF improved insulin parameters, while no effect was detected when compared to LSM. A few small trials showed heterogenous effects on liver parameters in patients with NAFLD treated with MTF compared to placebo/control. There was a large variability in the expression of outcome measures and RCTs were of low quality. In conclusion, MTF was associated with a modest weight reduction in obese nondiabetic patients. Further high-quality and better powered studies are needed to examine the impact of MTF in patients with insulin resistance and NAFLD.

Effect of Vortioxetine in Comparison to Fluoxetine on Metabolic Parameters in Patients With Depressive Disorder: A Randomized Controlled Trial.

Background Major depressive disorder (MDD) is a debilitating mood disorder that increases the risk of metabolic syndrome (MS), emphasizing the need for mental and physical health treatments. Although many studies have linked atypical antipsychotics to metabolic disturbances, there is limited evidence linking selective serotonin reuptake inhibitor use to MS. This study aimed to assess the risk of MS among patients with MDD who were administered vortioxetine and fluoxetine. Methodology This was a prospective, open-label, randomized controlled trial conducted in the psychiatry department. Using computer-generated random numbers, the physician assigned fluoxetine 20 mg or vortioxetine 10 mg and recorded MS parameters at baseline and each visit (4, 8, 12, 16, 20, and 24 weeks). This study was registered with CTRI (CTRI/2021/07/034892). Results A total of 122 participants were allocated randomly to the following two groups: group A (n = 60) and group B (n = 62). An independent-sample t-test showed a significant improvement in fasting plasma glucose (FPG) at week eight (p = 0.005), triglycerides (TGs) at week 16 (p = 0.005), high-density lipoprotein (HDL) at week 20 (p = 0.005), and waist circumference at week 24 (p = 0.005) in group A compared to group B.However, systolicblood pressure (SBP) and diastolic blood pressure (DBP) were not significantly associated with either group (p = 0.126 and p = 0.793, respectively). Overall depression remission (Hamilton Depression Rating Scale (HAM-D)) and medication adherence rating scale scores were similar between groups (p = 0.337 and 0.325, respectively). Furthermore, most adverse drug reactions were possibly associated with the study drugs. Conclusions In comparison to group B, group A showed significant improvements in FPG, HDL, and waist circumference more effectively; however, both groups led to higher TG levels, with non-significant numerical improvements observed in SBP and DBP in both groups. In addition, both treatment groups reduced the HAM-D score and had a similar MDD remission rate.

Effect of mild cortisol cosecretion on body composition and metabolic parameters in patients with primary hyperaldosteronism.

To investigate the effects of simultaneous cortisol cosecretion (CCS) on body composition in computed tomography(CT)-imaging and metabolic parameters in patients with primary aldosteronism (PA) with the objective of facilitating early detection. Retrospective cohort study. Forty-sevenpatients with PA and CCS confirmed by 1-mg dexamethasone suppression test (DST) with a cutoff of ≥1.8 µg/dL were compared with PA patients with excluded CCS(non-CCS, n = 47) matched by age and sex. Segmentation of the fat compartments and muscle area at the third lumbar region was performed on non-contrast-enhanced CT images with dedicated segmentation software. Additionally, liver, spleen, pancreas and muscle attenuation were compared between the two groups. Mean cortisol after DST was 1.2 µg/dL (33.1 nmol/L) in the non-CCS group and 3.2 µg/dL (88.3 nmol/L) in the CCS group with mild autonomous cortisol excess (MACE). No difference in total, visceral and subcutaneous fat volumes was observed between the CCS and non-CCS group (p = .7, .6 and .8, respectively). However, a multivariable regression analysis revealed a significant correlation between total serum cholesterol and results of serum cortisol after 1-mg DST (p = .026). Classification of the patients based on visible lesion on CT and PA-lateralization via adrenal venous samplingalso did not show any significant differences in body composition. MACE in PA patients does not translate into body composition changes on CT-imaging. Therefore, early detection of concurrent CCS in PA is currently only attainable through biochemical tests. Further investigation of the long-term clinical adverse effects of MACE in PA is necessary.

The relationship of vitamin D levels with hemogram indices and metabolic parameters in patients with type 2 diabetes mellitus

&lt;abstract&gt;&lt;sec&gt; &lt;title&gt;Background&lt;/title&gt; &lt;p&gt;Vitamin D deficiency and Type 2 Diabetes (T2DM) are two important health problems that have rapidly increased prevalences in recent years. Chronic inflammation and susceptibility to infection are the characteristic features of T2DM. Vitamin D deficiency has been associated with high serum inflammatory marker levels due to its immunomodulatory effect. Moreover, studies have pointed out that vitamin D insufficiency could be associated with T2DM. Additionally, in recent years, inflammatory markers derived from hemogram have been associated with diabetes and its complications. Therefore, in our study, vitamin D levels, metabolic markers (i.e., serum uric acid, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol), and hemogram indices were analyzed in well controlled and poorly controlled T2DM patients. Furthermore, we compared those variables in vitamin D deficient and non-deficient groups.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Methods&lt;/title&gt; &lt;p&gt;Laboratory data, including vitamin D and hemogram markers, were compared between poorly and well controlled T2DM patients who visited the outpatient internal medicine clinics of our institution.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Results&lt;/title&gt; &lt;p&gt;A total of 240 T2DM individuals were included in the present study: 170 individuals had vitamin D deficiency and 70 individuals had normal vitamin D levels, who served as controls. The median neutrophil to lymphocyte ratio (NLR) value was 2.2 (0.74–7.4) in the vitamin D deficient group and 2.02 (0.73–5.56) in the vitamin D normal group (p = 0.025). Among the study parameters, the NLR and glycated hemoglobin (HbA1c) levels showed a significant positive correlation (r = 0.30, p &amp;lt; 0.001). The sensitivity and specificity of the NLR to predict vitamin D deficiency were determined as 60% and 49%, respectively (AUC: 0.59, p = 0.03, 95% CI: 0.51–0.67). The sensitivity and specificity of the NLR to predict an improved control of diabetes were 72% and 45%, respectively (AUC: 0.67, p &amp;lt; 0.001, 95% CI: 0.60–0.74).&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Conclusions&lt;/title&gt; &lt;p&gt;We think that NLR can be helpful in follow up of T2DM and vitamin D deficiency.&lt;/p&gt; &lt;/sec&gt;&lt;/abstract&gt;

Relationship between polycystic ovary syndrome and high periostin level.

There is growing evidence suggesting a relationship between periostin levels, inflammation, and ovarian dysfunction. In this prospective case-control study, we aimed to investigate serum periostin levels and their relationship with metabolic parameters in patients with polycystic ovary syndrome. We conducted a prospective case-control study involving 45 polycystic ovary syndrome patients and 45 control subjects, matched in a 1:1 ratio. Serum samples collected from both study and control groups were analyzed using enzyme-linked immunosorbent assay. The demographic characteristics were similar between the polycystic ovary syndrome and control groups (p>0.05). Periostin levels were significantly higher in patients with polycystic ovary syndrome compared with the control group (4.67±2.46 vs. 2.60±1.41 ng/mL, respectively; p=0.000). Our study revealed a significant elevation in periostin levels among polycystic ovary syndrome patients compared with controls. These findings suggest that periostin could serve as a potential marker for assessing disease severity in polycystic ovary syndrome patients.