Parameters Of Glucose Metabolism Research Articles

THE ASSOCIATION OF CIRCULATING SERUM IRISIN LEVELS WITH GLUCOSE AND LIPID METABOLISM IN CHINESE ADOLESCENTS AGED 12∼18 YEARS

Objective: Irisin is an exercise-regulated myokine inducing browning of white adipose tissue and has gained interest as a potential new strategy to combat type 2 diabetes mellitus and dyslipidemia. The aim of this study was to evaluate the possible relationships between circulating serum irisin levels with glucose and lipid metabolism in Chinese adolescents. Design and method: This cross-sectional study included 1219 adolescents aged 12 to 18 years. Serum irisin levels were evaluated by enzyme-linked immunosorbent assay and all participants’ fasting blood glucose (FBG) and lipids,including totalcholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) were measured. Multiple linear regression was used to study the effect of irisin on glucose and lipid metabolism. Results: There were several significant negative correlations between circulating irisin and FBG (r = -0.120, P<0.001), TC(r = -0.091, P<0.001), LDL-C(r = -0.088, P = 0.002) and HDL-C(r = -0.094, P<0.001) across the study. In multivariate linear regression analysis, after controlling for potential confounders such as gender, age and BMI, irisin levels were independently associated with FBG( = -0.115, P<0.001), TC( = -0.078, P = 0.003), LDL-C( = -0.073, P = 0.005) and HDL-C(r = -0.087, P = 0.001). Conclusions: We found that serum irisin levels were inversely correlated with glucose and lipid metabolic parameters including FPG, TC, LDL-C and HDL-C,suggesting that irisin may play a crucial role in glucose and lipid metabolism from an early age.

GLUCOSE METABOLISM AND ATRIAL FIBRILLATION IN HYPERTENSIVE PATIENTS

Objective: We evaluated the association of abnormal glucose metabolism with risk of atrial fibrillation in hypertensive patients. Design and method: The study comprised 34.280 consecutive patients (51,87% males, mean age 58 years) with uncomplicated essential hypertension. The diagnosis of hypertension was based upon repeated office blood pressure measurements, 24 hours ambulatory blood pressure monitoring, clinical and laboratory evaluation. Patients were divided into four metabolic groups: normal glucose (NG), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM2). Then subdivided into three subgroups: sinus (SR), paroxysmal (PAF) and sustained (SAF) atrial fibrillation. Average glucose (eAG), hemoglobin A1c (HbA1c), insulin, homeostatic model assessment for insulin resistance (HOMA-IR) and the variation of them in relation to rhythm were assessed in each subgroup, corrected for confounders. Results: Among the patients (45,3%) with NG there was significant difference of all glucose metabolic parameters in correlation to three rhythms (glucose p = 0,004, eAG, HbA1c, insulin, HOMA-IR, p<0,001). These indices were higher, in SAF and in PAF compared to the SR subgroup (glucose p = 0,011, the rest indices p<0,001). In group IFG (20,3%), comparison of three rhythm indicated significant difference of glucose indices (glucose, eAG p<0,05, HbA1c, insulin, p<0,001) and they were increased in PAF in contrast to SR patients (p<0,05). Additionally, the insulin and the HbA1c were higher in SAF comparison the SR patients, (p<0,05). The eAG was comparably higher in SAF versus the PAF group, (p<0,05). In group IGT (17,3%), the patients had difference in levels of indices depending the rhythm (eAG, HbA1c, insulin, HOMA-IR p<0,05). Particularly the patients with SAF had higher levels of insulin and HOMA-IR than those who had SR (p<0,05). In group T2DM (16,9%), there was significant difference in glucose parameters dependent the rhythm (glucose p = 0,031, insulin p = 0,002, eAG, HOMA-IR, HbA1c p<0,001). The subgroup PAF showed higher values in eAG, HbA1c, HOMA-IR, (p<0,05) and the subgroup SAF in glucose, insulin, eAG, HOMA-IR (p<0,05), HbA1c (p<0,001) in compare to SR subgroup, respectively. Conclusions: Prediabetes and diabetes increase the risk of atrial fibrillation in hypertensive patients in a level response way.

Insulin Resistance Is the Main Characteristic of Metabolically Unhealthy Obesity (MUO) Associated with NASH in Patients Undergoing Bariatric Surgery.

(1) Background: Metabolically healthy obesity (MHO) is a concept that applies to obese patients without any elements of metabolic syndrome (metS). In turn, metabolically unhealthy obesity (MUO) defines the presence of elements of metS in obese patients. The components of MUO can be divided into subgroups regarding the elements of inflammation, lipid and glucose metabolism and cardiovascular disease. MUO patients appear to be at greater risk of developing non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) compared to MHO patients. The aim of this study was to evaluate the influence of different MUO components on NAFLD and NASH in patients with morbid obesity undergoing bariatric surgery. (2) Methods: 141 patients undergoing bariatric surgery from September 2015 and October 2021 at RWTH Aachen university hospital (Germany) were included. Patients were evaluated pre-operatively for characteristics of metS and MUO (HbA1c, HOMA, CRP, BMI, fasting glucose, LDL, TG, HDL and the presence of arterial hypertension). Intraoperatively, a liver biopsy was taken from the left liver lobe and evaluated for the presence of NAFLD or NASH. In ordinal regression analyses, different factors were evaluated for their influence on NAFLD and NASH. (3) Results: Mean BMI of the patients was 52.3 kg/m2 (36-74.8, SD 8.4). Together, the parameters HbA1c, HOMA, CRP, BMI, fasting glucose, LDL, TG, HDL and the presence of arterial hypertension accounted for a significant amount of variance in the outcome, with a likelihood ratio of χ2 (9) = 41.547, p < 0.001, for predicting the presence of NASH. Only HOMA was an independent predictor of NASH (B = 0.102, SE = 0.0373, p = 0.007). Evaluation of steatosis showed a similar trend (likelihood ratio χ2 (9) = 40.272, p < 0.001). Independent predictors of steatosis were HbA1c (B = 0.833, SE = 0.343, p = 0.015) and HOMA (B = 0.136, SE = 0.039, p < 0.001). (4) Conclusions: The above-mentioned model, including components of MUO, was significant for diagnosing NASH in patients with morbid obesity undergoing bariatric surgery. Out of the different subitems, HOMA independently predicted the presence of NASH and steatosis, while HbA1c independently predicted steatosis and fibrosis. Taken together, the parameter of glucose metabolism appears to be more accurate for the prediction of NASH than the parameters of lipid metabolism, inflammation or the presence of cardiovascular disease.

Plantar sensation, proprioception, and balance levels in pregnant women with gestational diabetes mellitus

BackgroundThe aim of the study was to compare plantar sensation, proprioception, and balance levels between pregnant women with Gestational Diabetes Mellitus and healthy pregnant women. Also, we aimed to investigate the relationship between parameters that were found to be different and sensory sensitivity, balance, and position sense. MethodsSeventy-two pregnant women (35 with Gestational Diabetes Mellitus and 37 controls) were included in this case-control study. Plantar sensory levels of the ankle joint (Semmes-Weinstein Monofilament-Test), position sense (digital inclinometer), and balance levels (Berg Balance Scale) were evaluated. FindingsThe Gestational Diabetes Mellitus group could not detect small filament thickness in the heel region compared to the control group (p < 0.05). In the ankle proprioception measurements of the Gestational Diabetes Mellitus group, deviation angle values were higher (p < 0.05) and the balance level was lower compared to the control group (p < 0.001). In addition, there was a positive correlation between glucose metabolism parameters and plantar sense and proprioception and a negative correlation with balance level (p < 0.05). InterpretationPlantar sense in the heel area, ankle joint position, and balance level of pregnant women with Gestational Diabetes Mellitus were lower than those of the healthy pregnant women. Disruption of glucose metabolite levels, which causes Gestational Diabetes Mellitus, is related to poorer balance, ankle position sense, and plantar sense in the heel. We recommend evaluating position sense and plantar sense for postural instability and risk of falling in pregnant women with Gestational Diabetes Mellitus.

Analysis of leptin, adiponectin and adiponectin gene polymorphism and leptin receptor in obese children and adolescents

Background: The aim of this study was to determine serum levels of leptin and adiponectin of obese children to identify the influence of leptin receptor gene polymorphisms on leptin resistance and leptin levels, as well as the association between the polymorphisms of adiponectin gene and adiponectin levels.Materials and methods: A case-control study comparing a study group of 74 obese children (age 13.34±2.60 years) to a normal weight-age matched (age 13.39±2.64 years) control group of 69 children. In both groups, body mass index (BMI) and waist/hip circumference, systolic and diastolic blood pressure were measured. Also, the leptin and adiponectin levels, as well as glucose and lipid metabolism parameters, and highly sensitive C-reactive protein (hs-CRP) were measured. Insulin sensitivity was evaluated using fasting insulinemia and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). All subjects were tested for gene-tic polymorphisms in LEPRQ223R (rs1137101), ADIPOQ G276T (rs1501299) and ADIPOT45G (rs2241766).Results: The phenotypes of the obese children study group were significantly higher than in the control group in weight, BMI, waist/hip circumferences and systolic blood pressure (SBP) (P&amp;lt;0.001). We confirmed that in obese children the levels of leptin in the blood are increased and levels of adiponectin are decreased (P&amp;lt;0.001). The differences of the genotype distributions of leptin receptor (LEPRQ223R) and adiponectin (ADIPOG276T and ADIPOT45G) gene polymorphisms in the study group of obese chil-dren and a control group was not observed.Conclusion: In this study, we demonstrated increased leptin level and significantly decreased level of adiponectin in the obese children group compared with the control group. The results of the analysis of glucose metabolism and lipidogram between the two groups showed that insulin, HOMA-IR, and triglycerides, as well as hsCRP were increased and significantly different in the group of obese children compared to the control group, as expected. However, by including a significantly larger number of tested and control samples of both sexes and age-specific groups, with a larger number of tested SNPs, the genes investigated in this study would probably give better insight into a multicomplex disease such as obesity.

Comparison of the effects of gemigliptin versus glimepiride on cardiac function in patients with type 2 diabetes uncontrolled with metformin: the Gemi-Heart study.

There are concerns about the adverse effects of dipeptidyl peptidase-4 (DPP-4) inhibitors on cardiac function. We investigated the effects of gemigliptin on cardiac function and compared the effects of gemigliptin and glimepiride in patients with type 2 diabetes (T2D). Sixty T2D patients being treated with metformin were assigned to a gemigliptin group (50 mg daily) or glimepiride group (2 mg daily) for 24 weeks. The preadjudicated extension period was up to 52 weeks. Glucose metabolism parameters and cardiac biomarkers were measured. Echocardiography was used to evaluate cardiac functions. Glycated hemoglobin level decreased significantly from 8.1% ± 0.6% to 6.8% ± 0.6% in the gemigliptin group and from 8.1% ± 0.6% to 7.0% ± 0.7% in the glimepiride group, without a between-group difference. Gemigliptin reduced insulin resistance, high sensitivity C-reactive protein and low-density lipoprotein cholesterol levels, and blood pressure, and increased adiponectin level compared with glimepiride therapy. Gemigliptin induced favorable changes in body composition. Left ventricular end diastolic volume decreased in the gemigliptin group but increased in the glimepiride group, with a borderline between-group difference. Cardiac biomarkers did not change significantly in either group. At 52 weeks, the HbA1c levels in both groups increased slightly; 7.3% ± 0.8% in the gemigliptin group vs 7.7% ± 1.3% in the glimepiride group, without a between-group difference. Gemigliptin had a comparable glucose-lowering efficacy without deleterious effects on cardiac functions or on biomarkers reflective of myocardial injury or heart failure during the 24-week observation period. However, larger, longer-term studies are needed to confirm these findings. ClinicalTrials.gov NCT05663736 This article is protected by copyright. All rights reserved.

Obesity-related parameters in carriers of some BDNF genetic variants may depend on daily dietary macronutrients intake

Some common single-nucleotide polymorphisms of the brain-derived neurotrophic factor (BDNF) gene have been associated not only with the neurodegenerative diseases but also with some eating disorders. The aim of this study was to assess the possible differences in the obesity-related and glucose metabolism parameters between some BDNF genotypes’, that may depend on the daily energy and macronutrients intake. In 484 adult participants we performed the anthropometric measurements, body composition analysis, and body fat distribution. The daily dietary intake was assessed using the 3-day food intake diaries. Blood glucose and insulin concentrations were measured at fasting and during oral glucose tolerance tests. Moreover, the visceral adipose tissue/subcutaneous adipose tissue (VAT/SAT) ratio and homeostatic model assessment of insulin resistance were calculated. We noted that participants carrying the GG genotype had lower skeletal muscle mass and fat free mass (FFM) when carbohydrate intake was > 48%, whereas they presented higher fat-free mass (FFM), and surprisingly higher total cholesterol and LDL-C concentrations when daily fiber intake was > 18 g. Moreover, in these subjects we noted higher waist circumference, BMI, and fasting glucose and insulin concentrations, when > 18% of total daily energy intake was delivered from proteins, and higher VAT content and HDL-C concentrations when > 30% of energy intake was derived from dietary fat. Our results suggest that glucose homeostasis and obesity-related parameters in carriers of some common variants of BDNF gene, especially in the GG (rs10835211) genotype carriers, may differ dependently on daily energy, dietary macronutrients and fiber intake.

Thyroid function, sensitivity to thyroid hormones, and metabolic syndrome in euthyroid children and adolescents with Down syndrome.

Patients with Down Syndrome (DS) showed multiple comorbidities, including thyroid disorders, obesity, and metabolic derangement. Different thyroid hormone (THs) patterns and sensitivity to thyroid hormone indices (STHI) seem to be associated with metabolic disorders. The study's aim was to evaluate the prevalence of metabolic syndrome (MS) in pediatric patients affected by DS, taking into consideration the relationship between the metabolic parameters, THs and STHI. We enlisted 50 euthyroid patients with DS (9.03 ± 4.46). Clinical parameters, TSH, FT3, FT4 and the presence of MS were recorded. Indexes of peripheral sensitivity (FT3/FT4 ratio) and central sensitivity (TSH index, TSHI; TSH T4 resistance index, TT4RI; TSH T3 resistance index, TT3RI) were also detected. Thirty healthy subjects were included as a control group. MS was detected in 12% of the subjects with DS. FT3, FT4, and TSH levels were higher in DS than in the control group (p < 0.01); higher levels of FT3/FT4 ratio, TSHI and TT3RI and lower TT4RI values (p < 0.01) were also detected. A significant correlation was detected between FT3 and fasting blood glucose (FBG) (R = 0.46), triglyceride (TG) (r = 0.37), total (r = 0.55) and high density lipoprotein-cholesterol (HDL-C) (r = -0.38), diastolic blood pressure (DBP) (r = -0.4); FT3/FT4 ratio and waist circumference (WC) (r = 0.36); TSHI and total (r = 0.30) and HDL cholesterol (r = -0.31); TT4RI and HDL cholesterol (r = -0.31); TT3RI and total (r = 0.39) and HDL cholesterol (r = -032). We confirmed a higher MS prevalence in children with DS compared to the control group. A significant association between THs, STHI, and the glucose and lipid metabolism parameters was detected supporting their role in metabolic alterations related to the DS.

The Relationship between Serum Iron and Thyroid Function in the Patients with Type 2 Diabetes.

Our primary objective in this study is to determine the relationship between serum iron (Fe3+) and thyroid functions in type 2 diabetes mellitus (T2DM) patients. Glucose metabolic parameters, trace elements, such as Fe3+, and thyroid functions for 1657 type 2 diabetic patients treated at the Shanghai Pudong Hospital's Department of Endocrinology from 2018 to 2021 were assessed. Variations in free thyroid hormones (FTH) and total thyroid hormones (TTH) were insignificant; however, thyroid-stimulating hormone (TSH) levels were markedly elevated in patients with positive thyroid peroxidase antibody (TPOAb) and/or positive antithyroglobulin antibody (TgAb) (p<0.05). Additionally, gender disparities affected FTH levels (p<0.05) but not TTH and TSH levels. The female gender was significantly negatively correlated with serum Fe levels (r=-0.381, p<0.05). Serum Fe3+ deficiency also had an effect on FT3 in both genders, FT4 and TT4 in males (p<0.05), but not TSH (p>0.05). The multilinear regression model showed that TT3 (β=0.702), eGFR (β=0.109), Fe3+ (β=0.003), female gender (β=-0.061), and age (β=-0.061) were the major determinants for FT3 change. Moreover, renal function, which was represented as the estimated glomerular filtration rate (eGFR), had no effects on Fe3+ and TSH levels but on the levels of FTH and TTH (p<0.05). FT3/FT4 exhibited correlations with Fe3+ (r=0.252) and eGFR (r=0.285). Finally, changes in Fe3+ levels had no significant impact on fasting plasma glucose (FPG), fasting C-peptide, HbA1c, and glycated albumin levels (p>0.05). In addition to age, gender, and renal functions, serum Fe3+ levels in T2DM patients have a significant relationship with thyroid functions.

High omega-6/omega-3 fatty acid and oxylipin ratio in plasma is linked to an adverse cardiometabolic profile in middle-aged adults

Omega-6 and omega-3 oxylipins may be surrogate markers of systemic inflammation, which is one of the triggers for the development of cardiometabolic disorders. In the current study, we investigated the relationship between plasma levels of omega-6 and omega-3 oxylipins with body composition and cardiometabolic risk factors in middle-aged adults. Seventy-two 72 middle-aged adults (39 women; 53.6±5.1 years old; 26.7±3.8 kg/m2) were included in this cross-sectional study. Plasma levels of omega-6 and omega-3 fatty acids and oxylipins were determined using targeted lipidomic. Body composition, dietary intake, and cardiometabolic risk factors were assessed with standard methods. The plasma levels of the omega-6 fatty acids and derived oxylipins, the hydroxyeicosatetraenoic acids (HETEs; arachidonic acid (AA)-derived oxylipins) and dihydroxy-eicosatrienoic acids (DiHETrEs; AA-derived oxylipins), were positively associated with glucose metabolism parameters (i.e., insulin levels and homeostatic model assessment of insulin resistance index (HOMA); all r≥0.21, P<.05). In contrast, plasma levels of omega-3 fatty acids and derived oxylipins, specifically hydroxyeicosapentaenoic acids (HEPEs; eicosapentaenoic acid-derived oxylipins), as well as series-3 prostaglandins, were negatively associated with plasma glucose metabolism parameters (i.e., insulin levels, HOMA; all r≤0.20, P<.05). The plasma levels of omega-6 fatty acids and derived oxylipins, HETEs and DiHETrEs were also positively correlated with liver function parameters (i.e., glutamic pyruvic transaminase, gamma-glutamyl transferase (GGT), and fatty liver index; all r≥0.22 and P<.05). In addition, individuals with higher omega-6/omega-3 fatty acid and oxylipin ratio showed higher levels of HOMA, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and GGT (on average +36%), as well as lower levels of high-density lipoprotein cholesterol (-13%) (all P<.05). In conclusion, the omega-6/omega-3 fatty acid and oxylipin ratio, as well as specific omega-6 and omega-3 oxylipins plasma levels, reflect an adverse cardiometabolic profile in terms of higher insulin resistance and impaired liver function in middle-aged adults.

Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals.

Both obesity and a poor diet are considered major risk factors for triggering insulin resistance syndrome (IRS) and the development of type 2 diabetes mellitus (T2DM). Owing to the impact of low-carbohydrate diets, such as the keto diet and the Atkins diet, on weight loss in individuals with obesity, these diets have become an effective strategy for a healthy lifestyle. However, the impact of the ketogenic diet on IRS in healthy individuals of a normal weight has been less well researched. This study presents a cross-sectional observational study that aimed to investigate the effect of low carbohydrate intake in healthy individuals of a normal weight with regard to glucose homeostasis, inflammatory, and metabolic parameters. The study included 120 participants who were healthy, had a normal weight (BMI 25 kg/m2), and had no history of a major medical condition. Self-reported dietary intake and objective physical activity measured by accelerometry were tracked for 7 days. The participants were divided into three groups according to their dietary intake of carbohydrates: the low-carbohydrate (LC) group (those consuming <45% of their daily energy intake from carbohydrates), the recommended range of carbohydrate (RC) group (those consuming 45-65% of their daily energy intake from carbohydrates), and the high-carbohydrate (HC) group (those consuming more than 65% of their daily energy intake from carbohydrates). Blood samples were collected for the analysis of metabolic markers. HOMA of insulin resistance (HOMA-IR) and HOMA of β-cell function (HOMA-β), as well as C-peptide levels, were used for the evaluation of glucose homeostasis. Low carbohydrate intake (<45% of total energy) was found to significantly correlate with dysregulated glucose homeostasis as measured by elevations in HOMA-IR, HOMA-β% assessment, and C-peptide levels. Low carbohydrate intake was also found to be coupled with lower serum bicarbonate and serum albumin levels, with an increased anion gap indicating metabolic acidosis. The elevation in C-peptide under low carbohydrate intake was found to be positively correlated with the secretion of IRS-related inflammatory markers, including FGF2, IP-10, IL-6, IL-17A, and MDC, but negatively correlated with IL-3. Overall, the findings of the study showed that, for the first time, low-carbohydrate intake in healthy individuals of a normal weight might lead to dysfunctional glucose homeostasis, increased metabolic acidosis, and the possibility of triggering inflammation by C-peptide elevation in plasma.

Cordyceps militaris extracts and cordycepin ameliorate type 2 diabetes mellitus by modulating the gut microbiota and metabolites.

Introduction: Cordyceps militaris, which has many potential medicinal properties, has rarely been reported to alleviate type 2 diabetes mellitus (T2DM). Methods: The effects of C. militaris extracts (CE) and cordycepin (CCS) on high-fat diet and streptozotocin (STZ) induced T2DM mice were analysed by gut microbiome and metabolomics methods in this study. Results: The results demonstrated that glucose and lipid metabolism parameters, oxidative stress biomarkers and inflammation cytokines were down-regulated in the CCS and CE groups. A comparative analysis of the fecal samples from mice in the model and experimental groups showed that experimental groups resulted in a higher abundance of Firmicutes/Bacteroidetes. Conclusion: This study provides evidence that C. militaris can be used as a food supplement to relieve T2DM, which provides a promising prospect for new functional food in it.

Association of Interleukin-32α with Interleukin-35 and Transforming Growth Factor-β Produced by the Peripheral Blood Mononuclear Cells from Patients with Type 2 Diabetes Mellitus

Background and Objective: Cytokine production was shown to be changed in Type 2 diabetes mellitus (T2DM). Nonetheless, the relationship of pro-inflammatory interleukin (IL)-32α with anti-inflammatory IL-35 and transforming growth factor (TGF)-β is unclear in T2DM. The present study aimed to evaluate the IL-32α, IL-35, and TGF-β levels produced by peripheral blood mononuclear cells (PBMCs) in patients compared to healthy controls (HCs). Correlations between the IL-32α and IL-35 and TGF-β, as well as between those cytokines and paraclinical parameters [(fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c), GFR, albumin, and creatinine)] were assessed. Materials and Methods: Blood samples were taken from 38 patients and 38 HCs. The PBMCs from each donor were isolated with the ficoll method and cultured with in vitro stimulator for four days. The production of IL-32α, IL-35, and TGF-β in culture supernatants was determined with ELISA. Paraclinical parameters were evaluated by standard laboratory methods. Results: High levels of IL-32α and low levels of IL-35 were found in patients compared to in HCs (P=0.006; P&lt;0.001). A negative correlation between IL-32α and IL-35 was detected in patients (P&lt;0.001). IL-32α was positively correlated with FPG and HbA1c (P=0.002, P=0.005), whereas IL-35 was negatively correlated with them in patients (both P&lt;0.001). No correlations were detected between the cytokines and BMI, GFR, albumin, and creatinine, as well as between the TGF-β levels. Conclusion: Increased IL-32α but diminished IL-35 production are linked with each other and with the glucose metabolism parameters in T2DM. It seems that IL-32α and IL-35 have a potential role in T2DM pathogenesis.

Abstract P145: The Effect of Exercise Level on Weight Maintenance and Cardiometabolic Risk Factors After Clinically Significant Weight Loss: Results From the Prevail-p Study

Introduction: Clinically significant weight loss is associated with health benefits for overweight and obese adults. Participation in adequate amounts of physical activity is critical for weight maintenance. However, few studies in the literature have evaluated the amount of physical activity needed to promote weight maintenance in a supervised exercise training study with corresponding data on cardiovascular risk factors. Methods: Overweight and obese adults (N=39) completed a 10-week OPTIFAST ® weight loss program with supervised aerobic exercise training with the goal of achieving clinically significant weight loss (≥7%). Participants who met the weight loss goal were randomized to levels of aerobic training consistent with physical activity recommendations (PA-REC) (~550 MET minutes per week) or weight maintenance recommendations (WM-REC) (~970 MET minutes per week) for 18 additional weeks. Weight, body composition, and blood measures (e.g., fasting glucose, insulin, and lipids) were measured at baseline, after weight loss (10 weeks), and at follow-up (28 weeks). Results: Thirty-three of the 39 participants achieved clinically significant weight loss (~85%). There were reductions in weight (-8.8 kg), body fat (-2.1%), visceral fat (-120.4 g), along with other health indicators (systolic blood pressure [-6.8 mmHg], diastolic blood pressure [-5.9 mmHg], HOMA-IR [-2.4] and lipids) after the weight loss phase (all p’s&lt; 0.05). Full data for the weight maintenance phase were available in 21 participants due to the COVID pandemic (PA-REC: 12, WM-REC:9). Larger improvements in cardiorespiratory fitness (as assessed by estimated METs [1.7 vs. 0 METs, p=0.01] and relative VO 2 peak [2.3 vs.0.5 ml/kg/min, p=0.04]) were observed in the WM-REC group compared to the PA-REC group, while changes in waist circumference (-2.4 vs. 0.5 cm, p=0.06), visceral fat (-45.7 vs. 8.2 g, p=0.06), and absolute VO 2 (0.1 vs. 0.2 L/min, p=0.09) approached significance. No significant changes were observed between groups for changes in weight, blood pressure, glucose metabolism, or lipid parameters during the maintenance phase (all ps&gt;0.05). Discussion: Clinically significant weight loss combined with aerobic exercise resulted in improvements in cardiometabolic parameters. Exercise at levels associated with the weight maintenance guidelines resulted in greater improvements in cardiorespiratory fitness and may have the potential to improve measures of central adiposity to a greater extent than the minimum physical activity recommendations following weight loss. Future studies should evaluate the impact of different levels of aerobic exercise after clinically significant weight loss in long term interventions.

Urocortin 2 - a protective effect in hypertension?

Urocortin 2, an endogenous selective ligand for the corticotropin-releasing hormone receptor type 2, has been suggested to exert cardioprotective effects. We analyzed the possible relationship between the level of Ucn2 and specific indicators of cardiovascular risk factors in patients with untreated hypertension and in healthy subjects. Sixty seven subjects were recruited: 38 with newly diagnosed treatment-naive hypertension (with no pharmacological treatment - HT group) and 29 healthy subjects without hypertension (nHT group). We evaluated ambulatory blood pressure monitoring, Ucn2 levels and metabolic indices. Multivariable regression analyses were performed to assess the effects of gender, age, and Ucn2 levels on metabolic indices or blood pressure (BP) level. Log of Ucn2 levels were higher in healthy subjects than in hypertensive patients (2.44±0.7 versus 2.09±0.66, p<.05) and correlated inversely with 24-hour diastolic blood pressure, and both night-time systolic and diastolic blood pressure regardless of age and gender (R2=0.06; R2=0.06; R2=0.052; respectively). Furthermore, Ucn2 levels inversely correlated with cholesterol and low-density cholesterol (LDL) concentrations in healthy subjects only. Ucn2 was independently related to total cholesterol (but not to LDL) regardless of age, gender and the presence of hypertension (R2=0.18). However, we did not find any relationship between urocortin 2, body mass index or waist-hip ratio as well as parameters of glucose metabolism. Our data indicates that higher levels of urocortin 2 are related to more favorable lipid profiles and lower blood pressure.

Urocortin 2 - a protective effect in hypertension?

Urocortin 2, an endogenous selective ligand for the corticotropin-releasing hormone receptor type 2, has been suggested to exert cardioprotective effects. We analyzed the possible relationship between the level of Ucn2 and specific indicators of cardiovascular risk factors in patients with untreated hypertension and in healthy subjects. Sixty seven subjects were recruited: 38 with newly diagnosed treatment-naive hypertension (with no pharmacological treatment - HT group) and 29 healthy subjects without hypertension (nHT group). We evaluated ambulatory blood pressure monitoring, Ucn2 levels and metabolic indices. Multivariable regression analyses were performed to assess the effects of gender, age, and Ucn2 levels on metabolic indices or blood pressure (BP) level. Log of Ucn2 levels were higher in healthy subjects than in hypertensive patients (2.44±0.7 versus 2.09±0.66, p<.05) and correlated inversely with 24-hour diastolic blood pressure, and both night-time systolic and diastolic blood pressure regardless of age and gender (R2=0.06; R2=0.06; R2=0.052; respectively). Furthermore, Ucn2 levels inversely correlated with cholesterol and low-density cholesterol (LDL) concentrations in healthy subjects only. Ucn2 was independently related to total cholesterol (but not to LDL) regardless of age, gender and the presence of hypertension (R2=0.18). However, we did not find any relationship between urocortin 2, body mass index or waist-hip ratio as well as parameters of glucose metabolism. Our data indicates that higher levels of urocortin 2 are related to more favorable lipid profiles and lower blood pressure.

Hypolipidemic Effects of Beetroot Juice in SHR-CRP and HHTg Rat Models of Metabolic Syndrome: Analysis of Hepatic Proteome

Recently, red beetroot has attracted attention as a health-promoting functional food. Studies have shown that beetroot administration can reduce blood pressure and ameliorate parameters of glucose and lipid metabolism; however, mechanisms underlying these beneficial effects of beetroot are not yet fully understood. In the current study, we analysed the effects of beetroot on parameters of glucose and lipid metabolism in two models of metabolic syndrome: (i) transgenic spontaneously hypertensive rats expressing human C-reactive protein (SHR-CRP rats), and (ii) hereditary hypertriglyceridemic (HHTg) rats. Treatment with beetroot juice for 4 weeks was, in both models, associated with amelioration of oxidative stress, reduced circulating lipids, smaller visceral fat depots, and lower ectopic fat accumulation in the liver compared to the respective untreated controls. On the other hand, beetroot treatment had no significant effects on the sensitivity of the muscle and adipose tissue to insulin action in either model. Analyses of hepatic proteome revealed significantly deregulated proteins involved in glycerophospholipid metabolism, mTOR signalling, inflammation, and cytoskeleton rearrangement.

Association between Intrapancreatic Fat Deposition and Lower High-Density Lipoprotein Cholesterol in Individuals with Newly Diagnosed T2DM.

Intrapancreatic fat deposition (IPFD) usually occurs in individuals with type 2 diabetes mellitus (T2DM), but its physiopathological influence remains controversial. The present study aimed to investigate IPFD and its associations with various aspects of glucose and lipid metabolism in individuals with newly diagnosed T2DM. A total of 100 individuals were included, consisting of 80 patients with newly diagnosed T2DM and 20 age- and sex-matched healthy controls. Then, we assessed IPFD using magnetic resonance imaging (MRI) and various parameters of glucose and lipid metabolism. Individuals with newly diagnosed T2DM had a significantly higher IPFD (median: 12.34%; IQR, 9.19-16.60%) compared with healthy controls (median: 6.35%; IQR, 5.12-8.96%) (p < 0.001). In individuals with newly diagnosed T2DM, IPFD was significantly associated with FINS and HOMA-IR in unadjusted model (β = 0.239, p=0.022; β = 0.578, p=0.007, respectively) and adjusted model for age and sex (β = 0.241, p=0.022; β = 0.535, p=0.014, respectively), but these associations vanished after adjustment for age, sex, and BMI. The OR of lower HDL-C for the prevalence of high IPFD was 4.22 (95% CI, 1.41 to 12.69; p=0.010) after adjustment for age, sex, BMI, and HbA1c. Lower HDL-C was an independent predictor for a high degree of IPFD.

A low chromium diet increases body fat, energy intake and circulating triglycerides and insulin in male and female rats fed a moderately high-fat, high-sucrose diet from peripuberty to young adult age.

Trivalent chromium (Cr) may function to potentiate the action of insulin, but the effects of chromium intakes on metabolic parameters are unclear. Cr is listed as a potentially beneficial element for rodents based on studies that show feeding low quantities affect glucose metabolism. Cr is recommended at 1 mg per kg in rodent diets. This study examined the effects of different levels of dietary Cr on body weight, body composition, energy intake, food efficiency and metabolic parameters of lipid and glucose metabolism in male and female rats when fed from peripuberty to young adult age in the background of a moderately high-fat, high-sucrose diet. Sprague-Dawley CD rats (n = 10 males and 10 females/group) at 35 days of age were assigned by weight to the low (LCr, 0.33 ± 0.06 mg/kg), normal (NCr, 1.20 ± 0.11 mg/kg) or high (HCr, 9.15 ± 0.65 mg/kg) Cr diets. Diets were fed ad libitum for 12 weeks (83 days). At baseline, body weights and composition were similar (p≥0.05) among diet groups. Compared to the NCr group, the LCr group weighed more (p<0.01) and consumed more energy (food) from Day 56 onwards, but food efficiency was unaffected. Following an oral glucose challenge (Day 77), dietary chromium levels did not affect plasma glucose, but fasting plasma insulin and insulin at 30 and 60 min after dosing were higher in the LCr group compared to the NCr group. At the end of the study, whole-body fat, accrued body fat from baseline and fasting serum triglycerides were higher in the LCr group compared to the NCr group. Effects were similar in both sexes and not observed in the HCr group. These data show that low dietary Cr affects metabolic parameters common in chronic diseases underscoring the need for clinical trials to define the nutritional and/or pharmacological effects of Cr.

Effect of the Ketogenic Diet on the Prophylaxis and Treatment of Diabetes Mellitus: A Review of the Meta-Analyses and Clinical Trials.

The exponentially growing frequency of diagnosing diabetes mellitus means that a verification of the previous dietetic approach to treating the disease seems justified. The simultaneous growth of interest in the ketogenic diet and the development of knowledge in this field have contributed to the increasingly frequent application of the ketogenic diet in diabetes treatment. This paper also deals with that issue; its aim includes an extensive analysis of the influence of the ketogenic diet on the prophylaxis and treatment of diabetes. The paper has been prepared based on a wide, meticulous analysis of the available literature on the subject. Among other findings, a favorable effect of that nutrition model has been demonstrated on the values of glycated hemoglobin, glucose, insulin, or other metabolic parameters in diabetes patients. The effect of the ketogenic diet on the pharmacotherapy of type 1 and type 2 diabetes has been presented and compared with the standard nutritional management plan recommended for that disease. Further research is needed in this field, especially studies with a long follow-up period. The discussed articles report interesting therapeutic advantages to the ketogenic diet in comparison with standard diets.