Obese Diabetic Patients Research Articles

Management Strategies for Obese Diabetes

In recent years, there has been a growing emphasis on the relationship between obesity and diabetes. An analysis of Korean data revealed that more than 75% of diabetic patients were overweight or obese, with two-thirds having abdominal obesity. Traditional treatment goals for diabetes have primarily focused on lowering blood glucose levels to prevent and treat microvascular and macrovascular complications, which is known as the glucocentric approach. However, with the recognition of the shared pathophysiology of insulin resistance in both diabetes and obesity, a weight-centric approach has emerged, particularly beneficial for patients in whom insulin resistance is a primary driver of type 2 diabetes. Of note, the overlap of various physiological aspects in diabetic patients necessitates a multicentric approach for effective type 2 diabetes management. Recent guidelines now recommend weight loss as a primary treatment goal alongside blood glucose control for overweight and obese diabetic patients, highlighting the significance of weight management in diabetes care. Medications such as glucagon-like peptide-1 (GLP-1) receptor agonist or dual glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonist with weight-loss effects are recommended for this patient population. Ongoing research is exploring the potential of various gut hormone-based therapies, offering hope for effective weight management and improved diabetes outcomes in the growing population of obese diabetic individuals.

The potential effects of metformin and/or sitagliptin on leptin/adiponectin ratio in diabetic obese patients: a new therapeutic effect.

To explore how metformin, alone or in conjunction with sitagliptin, affects the leptin/adiponectin ratio in obese type 2 diabetes mellitus patients. The case-control study was conducted from March to August 2021 at the Department of Clinical Pharmacology, College of Medicine, Mustansiriyah University, Baghdad, Iraq, and comprised adult, obese type 2 diabetes mellitus patients of either gender and age-matched healthy controls. The MT group included patients taking metformin 1g/day, MTS group had patients taking metformin 1g/day plus sitagliptin 100mg/day, and the control group comprised healthy subjects. Serum levels of human leptin and adiponectin were recorded along with body mass index, blood pressure, lipid profile and glycaemic indices. Data was analysed using SPSS 20. Of the 90 subjects, 62(69%) were patients; 36(40%) in MT group and 26(29%) in MTS. The control group had 28(31%) individuals. The mean age of the patient groups was 48.62±8.17 years, and male: female ratio was 49:41, mean age of controls was 47.64± 5.77 years with the same male to female ratio as that of the patients. Leptin levels were higher in patients compared to controls (p=0.002), and leptin levels were lower in MTS (89.93±9.51) than MT group (93.69±13.69). Patients in MT (30.57±6.31) and MTS (32.99±7.10) groups had lower adiponectin levels than controls (48.83±9.21) (p=0.001). MT and MTS patients had a greater leptin-to-adiponectin ratio than controls (p=0.0001). Leptin-to-adiponectin ratio could be a viable marker for assessing risks related to type 2 diabetes mellitus and other health conditions.

Assessment of Left Arterial Function by using 2-Dimensional Speckle Tracking in Obese versus Non-Obese Diabetic Patients

Both obesity and diabetes are major problems for the public's health. Both are known to contribute to the development of atrial cardiomyopathy. However, the consequences of obesity on the function of the left atrium(LA) in diabetic individuals have not been determined as of yet. The aim of this study is to compare the peak atrial longitudinal strain (PALS) measured by two-dimensional (2D) speckle tracking in obese versus non-obese diabetic Iraqi patients. For a study that was designed to be cross-sectional, the data collection period lasted for a total of ten months. In this study, the participants had to have diabetes mellitus type 2. A comparison was made between patients who were obese and patients who were not obese using 2-D speckle tracking to measure the peak left atrial longitudinal strain. Several additional factors, such as age, gender, body mass index, conventional echocardiographic parameters, and volume-derived LA function, were investigated during this study. A total of 59 patients participated in this study. The ratio of males to females was exactly 1:1.5, and the average age was (54 ± 9.4) years old. Coexistent systemic arterial hypertension was observed in 25 % of the study population. Patients with type 2 diabetes mellitus and obesity had ad higher E/e` ratio and lower PALS than patients with type 2 diabetes mellitus without obesity, whereas all other parameters were statistically non-significant (EF, E/A, S prime, LA volume index). It was found that the peak longitudinal strain of the LA, which was measured using 2-D speckle tracking, was lower in the obese diabetic individuals. This was in contrast to diabetic people, who did not have obesity issues. An evaluation of the global strain in the left atrium can help in the early detection of remodeling and dysfunction in the left atrium if it is compared to the size of the left atrium and the filling pressures of the left ventricle, both of which are respectively determined by the E/e' ratio and the left atrial volume.

Correlations between serum Afamin, retinol binding protein-4 and plasminogen activator inhibitor-1 in obese diabetic and non-diabetic patients

Correlations between serum Afamin, retinol binding protein-4 and plasminogen activator inhibitor-1 in obese diabetic and non-diabetic patients

Platelet/High-Density Lipoprotein Ratio (PHR) Predicts Type 2 Diabetes in Obese Patients: A Retrospective Study.

Background: Obesity and type 2 diabetes (T2D) pose global health problems that continue to rise. A chronic low-grade inflammation and activation of the immune system are well established in both conditions. The presence of these factors can predict disease development and progression. Emerging evidence suggests that platelet-high density lipoprotein ratio (PHR) is a potential inflammatory marker. The purpose of this study was to investigate the relationship between PHR and T2D among obese patients. Methods: 203 patients with BMI ≥ 30 kg/m2 participated in the study. Patients were categorized into two groups: non-diabetic obese and diabetic obese. Comorbidities, baseline characteristics, laboratory data, as well as PHR levels of the study groups were analyzed. Medians, risk assessment, and the diagnostic performance of PHR values were examined in both groups. Results: In obese patients, the median PHR were significantly increased in obese patients with T2D compared to non-diabetic obese (p < 0.0001). Furthermore, T2D obese with high PHR had a significantly higher FBG and HbA1c (p < 0.05). Although PHR was weakly yet significantly correlated with glycemic markers, ROC curve analysis of the PHR indicated an AUC of 0.700 (p < 0.0001) in predicting T2D in obese patients, and the cutoff value was 6.96, with a sensitivity and specificity of 53.4% and 76.1%, respectively. Moreover, increased PHR (OR = 4.77, p < 0.0001) carried a significantly higher risk for developing T2D in obese individuals. Conclusions: The PHR is a convenient and cost-effective marker that can reliably predict the presence of T2D in high-risk obese population.

Brain-Gut and Microbiota-Gut-Brain Communication in Type-2 Diabetes Linked Alzheimer's Disease.

The gastrointestinal (GI) tract, home to the largest microbial population in the human body, plays a crucial role in overall health through various mechanisms. Recent advancements in research have revealed the potential implications of gut-brain and vice-versa communication mediated by gut-microbiota and their microbial products in various diseases including type-2 diabetes and Alzheimer's disease (AD). AD is the most common type of dementia where most of cases are sporadic with no clearly identified cause. However, multiple factors are implicated in the progression of sporadic AD which can be classified as non-modifiable (e.g., genetic) and modifiable (e.g. Type-2 diabetes, diet etc.). Present review focusses on key players particularly the modifiable factors such as Type-2 diabetes (T2D) and diet and their implications in microbiota-gut-brain (MGB) and brain-gut (BG) communication and cognitive functions of healthy brain and their dysfunction in Alzheimer's Disease. Special emphasis has been given on elucidation of the mechanistic aspects of the impact of diet on gut-microbiota and the implications of some of the gut-microbial products in T2D and AD pathology. For example, mechanistically, HFD induces gut dysbiosis with driven metabolites that in turn cause loss of integrity of intestinal barrier with concomitant colonic and systemic chronic low-grade inflammation, associated with obesity and T2D. HFD-induced obesity and T2D parallel neuroinflammation, deposition of Amyloid β (Aβ), and ultimately cognitive impairment. The review also provides a new perspective of the impact of diet on brain-gut and microbiota-gut-brain communication in terms of transcription factors as a commonly spoken language that may facilitates the interaction between gut and brain of obese diabetic patients who are at a higher risk of developing cognitive impairment and AD. Other commonality such as tyrosine kinase expression and functions maintaining intestinal integrity on one hand and the phagocytic clarence by migratory microglial functions in brain are also discussed. Lastly, the characterization of the key players future research that might shed lights on novel potential pharmacological target to impede AD progression are also discussed.

New Insights on Using Oral Semaglutide versus Dapagliflozin in Patients with Type 2 Diabetes and Metabolic Dysfunction-Associated Steatotic Liver Disease.

Increases in both the prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity are closely related. Type 2 diabetes (T2DM) has been associated with metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis and hepatocellular carcinoma. Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist approved for the treatment of T2DM and has an important role in weight loss. Also, it may represent a new therapeutic option for the treatment of MASH in obese diabetic patients. The main outcomes were changes from baseline in liver steatosis and fibrosis at week 24. A total of one hundred eighty-seven patients with T2DM were eligible for this prospective study; ninety-five subjects were treated with oral semaglutide, and ninety-two patients were treated with dapagliflozin as an add-on to metformin. All the subjects were evaluated using Vibration Controlled Transient Elastography (VCTE) from June to December 2022. From our cohort, 54% of the patients were females, with a mean age of 59.92 ± 11.89 years and a mean body mass index (BMI) of 29.53 ± 5.33 kg/m2. Following a six-month medication period, we observed a substantial reduction in anthropometric measurements, including the BMI, waist circumference (WC), and waist-to-hip ratio (WtHr), in both groups. Regarding HbA1c, a notable decrease was observed in the semaglutide group (p < 0.001) when compared to the dapagliflozin group (p = 0.011). In addition, the liver stiffness measurement (LSM) according to VCTE improved significantly in the semaglutide group participants from 8.07 ± 2.90 kPa at baseline to 6.51 ± 3.09 kPa after medication (p < 0.001). The superior metabolic effects of semaglutide, correlated to dapagliflozin, may contribute to a more efficient decrease in hepatic stress and injury, leading to a substantial enhancement of liver function in T2DM patients. Further investigations conducted over an ideal timeframe are necessary to confirm the evidence presented in this study.

Effect of intermittent fasting 16:8 and 14:10 compared with control-group on weight reduction and metabolic outcomes in obesity with type 2 diabetes patients: A randomized controlled trial.

To compare the percent weight change and metabolic outcomes among diabetic participants with obesity on intermittent fasting (IF) 16:8, IF 14:10, or normal controlled diets. A randomized controlled trial was conducted to randomize participants into three groups. Each group followed IF 16:8, IF 14:10, according to the protocol 3 days/week for 3 months or a control group. A total of 99 participants completed the study. The percentage weight changefrom baseline was -4.02% (95% CI, -4.40 to -3.64) in IF 16:8, -3.15% (95% CI, -3.41 to -2.89) in IF 14:10, and -0.55% (95% CI, -1.05 to -0.05) in the control group. The percentage weight loss from baseline was significantly more in both IF groups (P < 0.001, both) when compared with the control group. Weight loss was significantly more in the IF 16:8 group than in that of the IF 14:10 group (P < 0.001). Metabolic outcomes (decrease in FBS and HbA1C, and improvement in lipid profiles) were significantly improved from baseline in both IF groups in comparison with the control group. Either IF 16:8 or 14:10 had a benefit in the percentage weight change, glucose and lipid profiles in obese diabetic patients compared with the control group when consumed for 3 days a week for 3 months.

#1860 Oral semaglutide in diabetic kidney transplant recipients: Evaluating effectiveness and safety

Abstract Background and Aims Glucagon-like peptide 1 receptor agonists (GLP1-RA) have demonstrated cardiovascular and renal benefits in obese diabetic patients. However, the evidence for oral semaglutide in kidney transplant (KT) patients is very limited. Our study aims to analyze the effectiveness and safety of oral semaglutide in diabetic KT patients. Method Retrospective cohort study of KT with diabetes who started oral semaglutide in 3 Spanish hospitals (Puerta del Mar University Hospital, Jerez de la Frontera University Hospital and Puerto Real University Hospital) between December 2021 and December 2023. None of them had previously received subcutaneous GLP1-RA. Clinical and demographic variables were analyzed. Glomerular filtration rate (eGFR), proteinuria, and weight were collected at the start of the treatment and after 6 and 12 months. We analyze glycemic control, blood pressure, lipid profile and trough level, dose and C/D ratio of tacrolimus. Acute rejections (AR), de novo donor-specific antibodies (dnDSA) and adverse effects were documented. Parametric and non-parametric tests were performed according to the normality of the sample. Results In this period, 22 KT with DM started treatment with oral Semaglutide, of which 16 patients completed follow-up for 6 months and 11 patients for 1 year. Fourteen (63.6%) had developed post-transplant DM. The mean age was 61 years, and 77% were men. The mean baseline estimated glomerular filtration rate (eGFR) was 46.1 ml/min/1.73 m2, the baseline body mass index was 34.7 kg/m2 and the median KT vintage was 45 months. Three patients were on treatment with SGLT2i at the start of the drug. Variables compared during the follow-up are shown in Table 1. Four patients (18%) suffered gastrointestinal side effects. No dnDSA were documented during follow-up. One episode of AR was documented after drug initiation. Conclusions We show the longest series of oral semaglutide in KT patients. Our results support that it can be a good option for managing DM in KT, especially in obese patients.

Improvement of non-alcoholic steatohepatitis as measured by elastography in obese diabetic and non-diabetic patients undergoing bariatric surgery, after one-year follow-up

Improvement of non-alcoholic steatohepatitis as measured by elastography in obese diabetic and non-diabetic patients undergoing bariatric surgery, after one-year follow-up

Vitamin D status and steatohepatitis in obese diabetic and non-diabetic patients

Vitamin D status and steatohepatitis in obese diabetic and non-diabetic patients

Overview of the Effectiveness of Dietary Modification and the Role of Andrographis Paniculata in Obese Diabetic Patients

Overview of the Effectiveness of Dietary Modification and the Role of Andrographis Paniculata in Obese Diabetic Patients

Assessing the Ability to Reverse High Fat High Sugar Diet-Induced Hepatic Steatosis by Dietary Modification

Background: Metabolic syndrome includes a plethora of symptoms ultimately leading to obesity and type 2 diabetes. Increased consumption of ‘Western diets’ rich in fat and sugar increase the development of metabolic syndrome, diabetic obesity and furthermore increase the risk of non-alcoholic fatty liver disease. We aimed to better understand the influence of chronic consumption of a ‘western-type’ high fat-high sugar diet (HFS) on hepatic health and moreover we assessed the ability of dietary modifications (i.e., removal of fat and sugar from the diet) to reverse these detrimental hepatic effects. This would represent what is seen clinically, advocated by a provider in a clinical setting as a first line treatment for diabetic obese patients. Methods: Thirty male C57BL/6J mice were randomly assigned into the following groups: 12-weeks HFS then 12-weeks of standard diet and water (Std), control groups were fed standard chow and water for the entire 24-weeks (lean control) or fed HFS diet for the entire 24-weeks (HFS). At the end of the 24-week diet study, livers were removed and fixed (for sectioning and staining with Oil-Red-O or trichrome and quantified with Image J) or frozen and kept at -80°C (for PCR studies and assays). Serum was collected for assays. Results: At the end of the diet study, body weight was significantly increased 1.5-fold by HFS and reduced 34% (p&lt;0.05) in the Std group. Liver weight/body weight ratio followed the same trend as body weight. Percent fat area, total number of lipid droplets and average total lipid area were all significantly increased in the HFS group versus lean controls and were all significantly reduced by Std (p&lt;0.05). Serum ALT activity was increased 3-fold by HFS and then reduced to lean levels by Std. Serum TNF-α and MCP1 levels followed the same trend. Serum TBARS were significantly increased 1.6-fold, but unchanged with Std. Trichrome analysis demonstrated deposition of collagen in liver from HFS fed mice (15.53% area), which was significantly reversed by the switch to Std (4.58% area). This data will be complemented with mRNA levels currently being run for collagens 1, 3, 4. Preliminary findings indicate that HFS fed mice have a significant increase in expression of collagen-1 but not collagen-3. We aim to further explore the metabolic mechanisms involved in the reversal of hepatic steatosis and fibrosis between the three diet groups. Conclusions: We conclude that removal of the HFS diet and switching to standard chow and water (Std) is an effective treatment regimen and results in robust reversal of hepatic steatosis along with reversal of collagen deposition, with concomitant beneficial changes in key serum markers of hepatic health, systemic inflammatory profile, and body/liver weight. The mechanistic pathways triggering these effects are being explored. Midwestern-Arizona Alzheimer’s consortium and Midwestern University Intramural Grant. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

De-Intensification from Basal-Bolus Insulin Therapy to Liraglutide in Type 2 Diabetes: Predictive Value of Mean Glycaemia during Fasting Test.

Successful conversion from insulin therapy to glucagon-like peptide 1 receptor agonist (GLP-1RA) with basal insulin in well-controlled patients has already been demonstrated. However, the data concerning individuals with poor glycaemic control are scarce. The aim of this work was to assess the success rate of insulin therapy to liraglutide transition in poorly controlled diabetes in a real-world clinical setting and to define predictors of success. We are the first to present the method of a fasting test as a way to identify the patients at higher risk of failure after treatment de-intensification. The retrospective observational study analyzed data of 62 poorly controlled obese diabetic patients on high-dose insulin therapy, who were subjected to a 72 h fasting test during hospitalization and subsequently switched to liraglutide ± basal insulin therapy. During the fasting, all antidiabetic treatment was discontinued. Patients were classified as responders if they remained on GLP-1RA treatment after 12 months. Non-responders restarted the basal-bolus insulin (BBI) regimen. Development of glycated hemoglobin (HbA1c) and body weight in both groups, alongside with parameters associated with the higher risk of return to the BBI regimen, were analyzed. A total of 71% of patients were switched successfully (=responders). Responders had more significant improvement in HbA1c (-6.4 ± 19.7 vs. -3.4 ± 22.9 mmol/mol) and weight loss (-4.6 ± 7.1 vs. -2.5 ± 4.0). Statistically significant difference between groups was found in initial HbA1c (75.6 ± 17.9 vs. 90.5 ± 23.6; p = 0.04), total daily dose of insulin (67.6 ± 36.4 vs. 90.8 ± 32.4; p = 0.02), and mean glycaemia during the fasting test (6.9 ± 1.7 vs. 8.6 ± 2.2 mmol/L; p < 0.01). This study confirms that therapy de-intensification in poorly controlled patients with a BBI regimen is possible. Higher baseline HbA1c, total daily insulin dose, and mean glucose during fasting test are negative predictive factors of successful therapy de-escalation.

Factors affecting weight management in overweight or obese diabetic patients: the 2018-2021 Korea national health and nutrition examination survey.

Diabetes is a chronic metabolic disease that affects approximately 422 million people worldwide and leads to the death of 1.5 million people every year. The prevalence of diabetes among the population aged 30 or older in Korea has steadily increased since 2018, reaching 16.7% in 2020, with one in six adults having diabetes. This study was conducted to identify factors affecting weight management in overweight or obese patients with diabetes (OOPD) in Korea using data from the 2018-2022 National Health and Nutrition Examination Survey. Therefore, the goal of this study is to analyze weight perception and factors related to weight perception and to identify factors that influence weight loss efforts among OOPD in Korea. Socioeconomic characteristics, disease morbidity, weight perception, and weight loss efforts were investigated in 950 participants. Data were analyzed using descriptive statistics, cross-tabulation, and logistic regression. Among the overweight or obese patients with diabetes, 24.4% perceived their weight to be normal, with a higher proportion among men (29.6%) than among women (14.6%). Weight loss efforts were 5.11 times (95% CI: 3.02-8.66) higher in people with overweight perceptions than in those with normal weight perceptions. Additionally, the rate was 1.54 times (95% CI: 1.06 2.25) higher in people with dyslipidemia than in those without dyslipidemia. These results suggest that weight management approaches for overweight or obese patients with diabetes should be designed individually based on weight perception and disease morbidity.

Apolipoprotein A-IV and its derived peptide, T55−121, improve glycemic control and increase energy expenditure

Abstract It is crucial to understand the glucose control within our bodies. Bariatric/metabolic surgeries, including laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB), provide an avenue for exploring the potential key factors involved in maintaining glucose homeostasis since these surgeries have shown promising results in improving glycemic control among patients with severe type 2 diabetes (T2D). For the first time, a markedly altered population of serum proteins in patients after LSG was discovered and analyzed through proteomics. Apolipoprotein A-IV (apoA-IV) was revealed to be increased dramatically in diabetic obese patients following LSG, and a similar effect was observed in patients after RYGB surgery. Moreover, recombinant apoA-IV protein treatment was proven to enhance insulin secretion in isolated human islets. These results showed that apoA-IV may play a crucial role in glycemic control in humans, potentially through enhancing insulin secretion in human islets. ApoA-IV was further shown to enhance energy expenditure and improve glucose tolerance in diabetic rodents, through stimulating glucose-dependent insulin secretion in pancreatic β cells, partially via Gαs-coupled GPCR/cAMP (G protein-coupled receptor/cyclic adenosine monophosphate) signaling. Furthermore, T55−121, truncated peptide 55−121 of apoA-IV, was discovered to mediate the function of apoA-IV. These collective findings contribute to our understanding of the relationship between apoA-IV and glycemic control, highlighting its potential as a biomarker or therapeutic target in managing and improving glucose regulation.

Trabecular bone score in obese patients with and without diabetes

The link between obesity, diabetes and bone metabolism is quite complex and not entirely clear. Although many clinical and epidemiological studies demonstrate that obesity enhances bone mineral density, its effect on bone microarchitecture is uncertain. The objective of this study was to examine the bone microarchitecture in obese patients with and without diabetes. The study included 119 individuals with ages from 30 to 50. Participants were divided into three groups: obese patients, obese diabetic patients, and a healthy control group. Results showed that obesity has a positive effect on trabecular bone score (TBS). Diabetes and obesity have a significant interactive impact on bone microarchitecture (TBS). Furthermore, HbA1c influences TBS in both obese diabetic patients and obese non-diabetic subjects. In contrast to the majority of studies, we found that obesity positively influenced TBS. TBS was inversely related to HbA1c levels in obese type 2 diabetics. Diabetes and obesity have a significant interactive impact on bone structure, in particular on bone microarchitecture.

Significant Promising Effects of Bariatric Surgery on the Biochemical Control of Glycemia and Lipidemia in Diabetic Patients in Western Saudi Arabia: A Tertiary Center Experience and a Retrospective Study.

The prevalence of obesity has increased globally and is associated with many comorbidities such as type 2 diabetes and fatty liver and cardiovascular diseases. Bariatric surgery is considered an effective intervention for achieving weight loss and controlling lipidemia and glycemia. This Saudi retrospective observational studyevaluates the clinical and biochemical benefits following bariatric surgery to obese diabetic patients. Methodology: After gaining ethical committee approval, data was collected from the patients' medical records at a tertiary medical center (King Fahad General Hospital, Al-Madinah Al-Munawwarah, Saudi Arabia). The total sample size was 61 patients, of whom 78.33% (n=48) had a body mass index (BMI) of 40 or greater (obese class III). Following bariatric surgery, there were statistically significant reductions (p<0.001) in BMI and HbA1C (decreased from 45.53±7.791 kg/m2 and 7.9±1.82% to 33.42±6.18 kg/m2 and 6.06±1.35%, respectively, after surgery).Likewise, significant reductions (p<0.001) occurred to serum total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides that decreased from 234.4±26.7 mg/dl, 152.2±19.4 mg/dl, and 187.3±24.6 mg/dl to 158.4±17.3 mg/dl, 95.6±15.7 mg/dl, and 132.5±19.5 mg/dl, respectively. Interestingly, serum high-density lipoprotein (HDL) significantly increased (p<0.001) from 43.8±6.2 mg/dl to 52.3±4.6 mg/dl.Using the novel clinical therapeutic index, bariatric surgery decreased BMI by about 26.6%. Using the novel biochemical therapeutic index, bariatric surgery decreased HbA1C, serum total cholesterol, serum LDL cholesterol, and serum triglycerides by about 22.99%, 32.42%, 37.18%, and 29.26%, respectively, while serum HDL increased by about 19.4%. Bariatric surgery is an effective intervention for obese diabetic patients resulting in weight loss, better control of diabetes and hyperlipidemia, and the metabolic profile. It is also recommended in Saudi Arabia for the high prevalence of obesity and diabetes mellitus.

Genetic Investigation of the Trail Mechanism in Diabetic and Non-diabetic Obese Patients.

Obesity is an important healthcare issue caused by abnormally increased adipose tissue because of energy-intake overcoming energy expenditure. Disturbances in the physiological function of adipose tissue mediate the development of diabetes. It is a metabolic disease that results from decreased insulin-levels and/or changes in the insulin action mechanism. Tumor Necrosis Factor-Associated Apoptosis-Inducing Ligand(TRAIL), which is a member of the Tumor Necrosis Factor(TNF)-family with an important role in adipose tissue biology, is included in many studies with its ability to induce apoptosis in cancer cells, but the number of human-studies conducted on the gene related to its protective-role against diabetes and obesity at this level is insufficient. Our study was carried out as a case and control and included three groups (80 diabetic obese, 80 non-diabetic obese, and 80 healthy individuals as the control group). The Real-Time-PZR(RT-qPZR), and DNA Sanger-Sequencing Methods were used for gene expression and gene squences. As a result of the analyses, TRAIL gene expression level was found to be higher in the controls than in the diabetic-obese and non-diabetic-obese group. This change in TRAIL gene expression suggests that TRAIL maybe a protective factor against diabetes. The presence of rs781673405, rs143353036, rs1244378045, rs767450259, rs759369504, rs750556128, and rs369143448 mutations, which was determined with the Sequencing-Method, was shown for the first time in the present study. In addition, it is the first study in which human TRAIL gene-expression and sequencing were performed together. We believe that these data will make an important contribution to the literature.

Metabolomic signature between diabetic and non-diabetic obese patients: A protocol for systematic review.

Type 2 diabetes mellitus (T2DM) is a chronic and progressive condition defined by hyperglycemia caused by abnormalities in insulin production, insulin receptor sensitivity, or both. Several studies have revealed that higher body mass index (BMI) is associated with increasing risk of developing diabetes. In this study, we perform a protocol for systematic review to explore metabolite biomarkers that could be used to identify T2DM in obese subjects. The protocol of this review was registered in PROSPERO (CRD42023405518). Three databases, EMBASE, PubMed, and Web of Science were selected to collect potential literature from their inceptions to July December 2023. Data for collection will include title, authors, study subjects, publication date, sample size, detection and analytical platforms, participant characteristics, biological samples, confounding factors, methods of statistical analysis, the frequency and directions of changes in potential metabolic biomarkers, and major findings. Pathway analysis of differential metabolites will be performed with MetaboAnalyst 5.0 based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) and the Human Metabolome Database. The results of this systematic review will be published in a peer-reviewed journal. This systematic review will summarize the potential biomarkers and metabolic pathways to provide a new reference for the prevention and treatment of T2DM in obese subjects.