Serum Triglyceride Levels Research Articles

The Association Between Metabolic Syndrome and the Risk of Endometrial Cancer in Pre- and Post-Menopausal Women: A UK Biobank Study

Background: Metabolic syndrome (MetS) is a syndrome that comprises central obesity, increased serum triglyceride (TG) levels, decreased serum HDL cholesterol (HDL) levels, raised blood pressure (BP), and impaired glucose regulation, including prediabetic and diabetic glycaemic levels. Recently, the association with endometrial cancer (EC) has been described but it is unclear if the risk associated with MetS is higher than the individual effect of obesity alone. This study investigates the association between MetS components and differing MetS definitions on EC risk and compares the risk of MetS with the risk posed by obesity alone. It also analyses how MetS affects the risk of EC development in the pre- and post-menopausal subgroups. Methods: A prospective cohort study was undertaken using data from the UK biobank. Multivariable Cox proportional risk models with the time to diagnosis (years) were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of MetS and its components on the risk of EC. A subgroup analysis was also undertaken for pre- and post-menopausal participants. Kaplan–Meier (KM) was undertaken to assess the difference in the risk of EC development in differing BMI classes, and in pre- and post-menopausal subgroups. Results: A total of 177,005 females from the UK biobank were included in this study. Of those participants who developed EC (n = 1454), waist circumference > 80 cm, BMI > 30 kg/m2, hypertension > 130/80 mmHg, hyperlipidaemia and diabetes (HbA1C > 48 mmol/L were significant predictors of EC development, with waist circumference being the strongest predictor (HR = 2.21; 95% CI: 1.98–2.47, p < 0.001). Comparing the pre- and post-menopausal subgroup, hypertriglyceridaemia and diabetes were the strongest predictors of EC in the pre-menopausal subgroup (HR = 1.53; 95% CI: 1.18–1.99 and HR = 1.51; 95% CI: 1.08–2.12, p < 0.05, respectively). Raised waist circumference was not a significant independent predictor in the pre-menopausal subgroup. A KM curve analysis showed a clear distinction between those with and without MetS in the pre-menopausal group, suggesting a benefit of testing for MetS components in pre-menopausal women with obesity. Conclusions: Components of MetS, both independently and in combination, significantly increase the risk of EC. Screening those with obesity for MetS in their pre-menopausal years may help to identify those at the highest risk.

Timosaponin B II as a novel KEAP1-NRF2 inhibitor to alleviate alcoholic liver disease:Receptor structure-based virtual screening and biological evaluation.

Oxidative stress induced by excess ethanol is an important factor in the progression of alcoholic liver disease (ALD). In recent years, inhibiting Kelch-like ECH-associated protein 1 (KEAP1) to activate the antioxidant regulator Nuclear factor erythroid 2-related factor 2 (NRF2) has been considered an effective strategy for treating oxidative stress-related diseases, but its application in ALD remains insufficiently explored. This study aims to discover high-affinity inhibitors targeting the KEAP1 receptor. We conducted virtual screening of a compound library based on a structure-based pharmacophore model, ultimately identifying the candidate compound Timosaponin B II (TBII). Subsequently, we established ALD models in AML-12 cells and C57BL/6 mice, and evaluated the therapeutic effects and mechanisms of TBII on ALD using methods including Immunofluorescence, Western blotting, RT-qPCR, Biochemical assays, and histological staining. Results indicate that TBII significantly improved ethanol-induced liver injury, inhibited the elevation of serum Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Total Cholesterol (T-CHO), and Triglycerides (TG) levels, and reduced lipid droplet accumulation in liver tissues. Furthermore, TBII treatment enhanced the antioxidant capacity of AML-12 cells and mouse liver, increasing Glutathione (GSH) and Superoxide Dismutase (SOD) levels while reducing Malondialdehyde (MDA) and Reactive Oxygen Species (ROS) levels. Mechanistic studies indicated that TBII inhibited the ethanol-induced increase in KEAP1 and reversed the ethanol-induced changes in NRF2 and its downstream targets. In conclusion, this study suggests that TBII may become a potential therapeutic agent for ALD by modulating the KEAP1-NRF2 pathway to alleviate oxidative stress and lipid metabolism abnormalities.

Triglyceride lowering in patients with different severities of hypertriglyceridaemia-associated acute pancreatitis: secondary analysis of a multicentre, prospective cohort study

ObjectiveIt is controversial whether rapid lowering of triglyceride (TG) levels is associated with clinical benefits in patients with hypertriglyceridaemia-associated acute pancreatitis (HTG-AP). In particular, patients with different severity of disease...

Ferula (Ferula elaeochytris) as a phytoestrogen: Use of Ferula in laying hens

This study aims to examine the effects of Ferula root powder (FRP) on performance, egg quality, egg oxidant/antioxidant levels, some serum hormone/biochemical parameters, and physical properties of the oviduct in laying hens. A total of 72 (8 replicates, 3 hens/subgroup) laying hens (Nick Brown, 30 weeks) were divided into three groups (FRP-0, FRP-1, FRP-2). During the 9-week trial, FRP-0 (control) was fed with a basal diet (16.88% crude protein, 2,725 kcal/kg metabolizable energy). FRP-1 and FRP-2 groups, however, were fed a diet supplemented with 1 g/kg and 2 g/kg FRP, respectively. The results showed that laying performance, serum hormone (estradiol, progesterone) levels, and some internal organ weights were not affected by FRP supplementation. In comparison to the control group, higher yolk height and yolk index were found in the FRP-added groups. The albumen pH was found to have decreased in FRP-2 group. DPPH radical scavenging activity increased in egg yolk. TBARs value decreased in FRP-1 and FRP-2 groups. Serum triglyceride and cholesterol levels decreased in group FRP-2. Moreover, a higher uterus length was found in the FRP-supplemented group. Given the results achieved, it was determined that FRP does not have a significant estrogenic effect. However, FRP can be utilized to prevent lipid oxidation and for its hypocholesterolemic effect.

Application of fourier transform infrared vibrational spectroscopy in identifying early biochemical changes in lipid profiles of individuals undergoing Roux-en-y gastric bypass

BackgroundFourier transform infrared spectroscopy (FTIR) is an analytical technique increasingly applied in biological analysis. This study investigates the application of FTIR to identify early biochemical changes, particularly in lipid profiles, in individuals undergoing Roux-en-Y gastric bypass (RYGB).MethodsAn observational study involving patients from a university hospital’s Bariatric and Metabolic Surgery Program, with evaluations performed before (T0) and two months after (T1) RYGB. Biochemical parameters, anthropometric data, and body composition were assessed. FTIR spectra were pre-processed and analyzed using Principal Component Analysis and Partial Least Squares Discriminant Analysis. The normality of the data was evaluated using the Kolmogorov-Smirnov test, followed by paired T-tests or Wilcoxon tests as appropriate. Spearman correlation analysis of spectral information with biochemical parameters was also performed. A significance level of p < 0.05 was set for all tests. The university hospital’s Research Ethics Committee approved the study (protocol CAAE 59075722.7.0000.5071).ResultsThe study evaluated 29 individuals (86.2% female) with a mean age of 41.2 ± 7.8 years. Significant differences were observed in anthropometric parameters and body composition (p < 0.001). Additionally, early improvements in the lipid profile were noted, with significant decreases in triglycerides, total cholesterol, and LDL cholesterol (p < 0.05) just two months post-surgery. FTIR identified correlations between biochemical parameters and specific spectral regions at T0 and T1. Notably, serum triglycerides showed a significant correlation with the lipid-specific spectral region (1796–1685 cm− 1) at both time points (p < 0.05).ConclusionFTIR can effectively monitor biochemical changes in RYGB surgery patients. The spectral range associated with lipid functional groups (1796 –1675 cm⁻¹) showed a significant relationship with serum triglyceride levels before and after RYGB. Additionally, various biochemical parameters exhibited strong correlations with other spectral regions, implying that the serum spectral profile can indicate biochemical variations at different post-surgery stages.Trial registrationBrazilian Registry of Clinical Trials (Rebec), September 5, 2022, protocol RBR-26chs2g.

Nucleotide sequence variants, gene expression and serum profile of immune and antioxidant markers associated with brucellosis resistance/susceptibility in Shami goat

Brucellosis is a highly contagious zoonotic bacterial disease. It has considerable negative consequences on the animal production industry worldwide. The objective of this study was to investigate the genetic and molecular variations in Shami goat susceptible to Brucella infection. Blood samples were collected from fifty mature Shami goats (30 Brucella-infected does and 20 non-infection). DNA was extracted and selected parts the immunity; solute carrier family 11 member 1 (SLC11A1), toll-like receptor 1 (TLR1), toll-like receptor 9 (TLR9), SP110 nuclear body protein (SP110), the adenosine A3 receptor (ADORA3), caspase activating recruitment domain 15 (CARD15) and interferon regulatory factor 3 (IRF3), antioxidant glutathione peroxidase 1 (GPX1), nitric oxide synthase (NOS), NAD(P)H dehydrogenase [quinone] 1 (NQO1) and transcription factor NF-E2-related factor 2 (Nrf2) and erythritol related transketolase (TKT), ribose 5-phosphate isomerase (RPIA) and Adenosine monophosphate deaminase (AMPD) genes were sequenced. Likewise, the levels of gene expressions were investigated. The results identified polymorphic variants between healthy and infected does. Levels of gene expression of SLC11A1, TLR1, TLR9, SP110, ADORA3, CARD15, IRF3, HMOX1, TKT, RPIA and AMPD were significantly (P < 0.05) up regulated in the infected compared to the non-infected ones. On the other hand, GPX1, NOS, NQO1 and Nrf2 genes were significantly (P < 0.05) downregulated in the infected compared to the non-infected does. The results of serum profile indicated that there is a significant (P < 0.05) increase in the activities of AST, ALT, GGT, LDH, ALP as well as serum level of globulin, triglycerides, cholesterol, MDA, NO, IL-1β, TNF-α, IgM, IgG, haptoglobin and amyloid A. On the other hand, there were significant reductions in the glucose, total protein albumin, urea, calcium, inorganic phosphorus, sodium, copper, zinc, iron, TAC, GSH, SOD, GPx, IL-10 and fibrinogen in the infected compared to the non-infected does. Our results provide valuable information about the serum profile variations and putative genetic markers for Brucella infection in goats. This could be utilized in controlling goat brucellosis through selective breeding of natural resistant animals.

Effects of Enterococcus faecalis Supplementation on Growth Performance, Hepatic Lipid Metabolism, and mRNA Expression of Lipid Metabolism Genes and Intestinal Flora in Geese.

The effects of Enterococcus faecalis (E. faecalis) at a concentration of 1.0 × 108 CFU/mL on growth performance, hepatic lipid metabolism, and mRNA expression related to lipid metabolism, intestinal morphology, and intestinal flora were investigated in geese. A total of 60 male geese, aged 30 days and of similar weight, were randomly assigned to 2 groups. Each group was divided into six replicates, with five geese per replicate. During the 45-day experiment, the control group received a basal diet, while the experimental group was provided with the same basal diet supplemented with E. faecalis in drinking water at a concentration of 1.0 × 108 CFU/mL. E. faecalis significantly increased the half-eviscerated weight of geese and improved ileal intestinal morphology (p < 0.05). Serum triglyceride (TG) levels were significantly reduced on day 5, while serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels were significantly decreased on day 25 (p < 0.05). By day 45, serum TG and free fatty acid (FFA) levels were also significantly reduced (p < 0.05). Additionally, E. faecalis significantly increased the HDL/LDL ratio and serum high-density lipoprotein cholesterol (HDL-C) levels (p < 0.05). Serum insulin levels were significantly elevated on day 25, and glucagon-like peptide-1 (GLP-1) levels were significantly increased on day 45 (p < 0.05). On day 25 of the trial, hepatic TG levels, FFA levels, and Oil Red O-stained areas in the liver were significantly reduced (p < 0.05), accompanied by significantly decreased mRNA expression of hepatic acetyl-CoA carboxylase (ACCA) (p < 0.05). Conversely, the mRNA expression levels of fatty acid synthase (FASN), farnesoid X receptor (FXR), sterol regulatory element-binding protein 1 (SREBP-1), and peroxisome proliferator-activated receptor-α (PPARα) were significantly elevated (p < 0.05). A 16S rRNA diversity analysis of ileal contents on day 25 revealed significant differences in intestinal flora composition between the control and E. faecalis groups. The 16S rRNA data demonstrated a strong correlation between microbial communities and lipid-related physiological and biochemical indicators (p < 0.05). In conclusion, E. faecalis supplementation promoted fatty acid oxidation, reduced blood lipid levels, alleviated hepatic lipid accumulation, and improved ileal morphology and intestinal flora diversity, thereby enhancing growth performance and lipid metabolism in geese. These findings suggest that E. faecalis is a promising probiotic candidate for development as a feed additive.

Clinical Outcomes in A Multi-center Cohort Involving 919 Patients with Hypertriglyceridemia-associated Acute Pancreatitis.

Hypertriglyceridemia-associated acute pancreatitis (HTG-AP) is one of the most common etiologies of acute pancreatitis (AP) worldwide. Compared to other etiologies, patients with HTG-AP may develop more severe AP, but previous studies yielded controversial conclusion due to the lack of adequate adjustment for the confounders. Therefore, this study aimed to examine the possibility and risk factors of developing severe AP in HTG-AP. Data from patients with an established diagnosis of AP were collected from January 2013 to December 2023 using a pre-designed data collection form and were gathered from five tertiary cross-regional centers of China. HTG-AP was defined as serum triglyceride (TG) levels >500 mg/dl and excluded other etiologies. The possibility and risk factors of severe AP were assessed by multivariable logistic regressions after adjusting potential confounders. A prediction model was established and validated. Between 2013 to 2023, we identified a total of 6996 patients with AP, of whom 4378 were included in the final analysis. Compared to other etiologies, patients with HTG-AP had a higher risk of developing severe AP (odds ratio [OR]: 1.897; 95% confidence interval [CI]: 1.380-2.608; p<0.001) and organ failure. HTG-AP patients showed higher possibility for developing respiratory and circulation failure but renal failure compare to other etiologies. In HTG-AP patients, risk factors for severe AP included age, fasting blood glucose, white blood cell (WBC) counts, and the presence of pleural effusion. Triglyceride level was found not significantly associated with severity in HTG-AP patients. A prediction model incorporating these risk factors demonstrated an AUC of 0.837 in the training and 0.883 in the testing set, with adequate calibration. Using a multi-center cross-regional cohort, we demonstrated that HTG-AP had a higher risk of developing severe AP and organ failure. A risk prediction model for predicting severe AP was developed and effectively stratified patients.

Beneficial Effect of Fenofibrate in Combination with Silymarin on Parameters of Hereditary Hypertriglyceridemia-Induced Disorders in an Animal Model of Metabolic Syndrome.

Background: Hypertriglyceridemia has serious health risks such as cardiovascular disease, type 2 diabetes mellitus, nephropathy, and others. Fenofibrate is an effective hypolipidemic drug, but its benefits for ameliorating disorders associated with hypertriglyceridemia failed to be proven in clinical trials. Methods: To search for possible causes of this situation and possibilities of their favorable influence, we tested the effect of FF monotherapy and the combination of fenofibrate with silymarin on metabolic disorders in a unique model of hereditary hypertriglyceridemic rats (HHTg). Results: Fenofibrate treatment (100 mg/kg BW/day for four weeks) significantly decreased serum levels of triglyceride, (-77%) and free fatty acids (-29%), the hepatic accumulation of triglycerides, and the expression of genes encoding transcription factors involved in lipid metabolism (Srebf2, Nr1h4. Rxrα, and Slco1a1). In contrast, the hypertriglyceridemia-induced ectopic storage of lipids in muscles, the heart, and kidneys reduced glucose utilization in muscles and was not affected. In addition, fenofibrate reduced the activity of the antioxidant system, including Nrf2 expression (-35%) and increased lipoperoxidation in the liver and, to a lesser extent, in the kidneys and heart. Adding silymarin (micronized form, 600 mg/kg BW/day) to fenofibrate therapy increased the synthesis of glycogen in muscles, (+36%) and reduced hyperinsulinemia (-34%). In the liver, it increased the activity of the antioxidant system, including PON-1 activity and Nrf2 expression, and reduced the formation of lipoperoxides. The beneficial effect of combination therapy on the parameters of oxidative stress and lipoperoxidation was also observed, to a lesser extent, in the heart and kidneys. Conclusions: Our results suggest the potential beneficial use of the combination of FF with SLM in the treatment of hypertriglyceridemia-induced metabolic disorders.

Lipid levels and insulin resistance markers in patients with colorectal cancer: Propensity score matching analysis.

Colorectal cancer (CRC) is a prevalent malignant neoplasm characterized by subtle early manifestations. To investigate the correlation among serum lipid profiles, the triglyceride-glucose (TyG) index, and the atherosclerotic index (AI) in patients with CRC. Furthermore, it explored the clinical diagnostic utility of combining serum lipids with cancer antigens in the context of CRC. A retrospective analysis encompassed 277 patients with CRC and 1034 healthy individuals. Following propensity score matching, patients with CRC exhibited significantly reduced levels of serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C), as well as a diminished TyG index. Conversely, they displayed elevated AI levels compared to their healthy counterparts. Patients in advanced stages exhibited lower serum levels of TG, TC, and LDL-C compared to those in early stages. Patients with positive lymph node metastasis demonstrated reduced levels of TG, LDL-C, and the TyG index. Receiver operating characteristic analysis revealed that the combination of the TyG index, carcinoembryonic antigen, and carbohydrate antigen 19-9 yielded the highest positive prediction rate for CRC at 75.3%. Preoperative serum lipid profiles exhibit a robust association with patients with CRC. The concurrent assessment of multiple serum lipids and cancer antigens effectively enhances the diagnostic accuracy for CRC.

Clinical Value of Renal Function Markers Combined with Blood Lipid Levels during Late Pregnancy to Predict Preeclampsia: A Retrospective Case-Control Study

Background: Preeclampsia (PE) is a common complication of pregnancy and there is currently a lack of valuable diagnostic and predictive methods for it. This study aimed to explore the association between renal function markers, blood lipid levels in late pregnancy and PE, then assess the combined predictive value for PE. Methods: This was a retrospective case-control study that selected 263 eligible patients in late pregnancy diagnosed with PE as the case group and 264 healthy parturients as the control group. All participants were hospitalized from January 2021 to December 2023. The levels of serum renal function [creatinine (Cr), uric acid (UA) and urea] and blood lipid [total cholesterol (TC), triglycerides (TG) and high-density lipoprotein (HDL)] were compared between two groups. Logistic regression analysis was used to explore the association between these indicators and PE. Then the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of them for PE. p &lt; 0.05 was considered statistically significant. Results: Univariate analysis showed that the PE group had significantly higher levels of TG, Cr, UA, and urea than the control group [3.56 (3.01–4.38) mmol/L vs. 2.98 (2.50–3.42) mmol/L, 54.00 (47.00–62.00) μmol/L vs. 46.00 (42.00–51.00) μmol/L, 367.00 (305.50–425.00) μmol/L vs. 278.00 (244.00–306.00) μmol/L, 3.50 (2.75–4.40) mmol/L vs. 2.90 (2.60–3.55) mmol/L respectively]. Multivariable analysis showed that the serum TG [adjusted odds ratio (AOR) = 1.827 (95% confidence interval (95% CI) = 1.277–2.615)], Cr [AOR = 1.066 (95% CI = 1.028–1.106)] and UA [AOR = 1.016 (95% CI = 1.011–1.022)] were risk factors for PE (p &lt; 0.001). ROC curves revealed that areas under the curve (AUC) were 0.703 (95% CI = 0.658–0.747), 0.734 (95% CI = 0.691–0.777) and 0.822 (95% CI = 0.786–0.857) respectively. The AUC, sensitivity and specificity of the combination of TG, Cr and UA were 0.864 (95% CI = 0.833–0.896), 76.4%, and 84.8%. Conclusions: The increased levels of serum TG, Cr and UA imply greater possibility of PE, thus they are considered as the risk factors. And their combination has a certain predictive value for PE, which may offer a fresh, convenient and efficient method for the diagnosis and treatment of PE.

Submicron Dispersions of Phytosterols Reverse Liver Steatosis with Higher Efficacy than Phytosterol Esters in a Diet Induced-Fatty Liver Murine Model.

Consumption of phytosterols is a nutritional strategy employed to reduce cholesterol absorption, but recent research shows that their biological activity might go beyond cholesterol reduction for the treatment of metabolic dysfunction-associated fatty liver disease (MAFLD), and novel phytosterol formulations, such as submicron dispersions, could improve these effects. We explored the therapeutic activity of phytosterols, either formulated as submicron dispersions of phytosterols (SDPs) or conventional phytosterol esters (PEs), in a mouse model of MAFLD. MAFLD was induced in mice by atherogenic diet (AD) feeding. The reversion of distorted serum and liver parameter values after a period of AD feeding was investigated after supplementation of the AD with SDPs, PEs, or a placebo (PT). Additionally, the metabolic parameters of fatty acid synthesis, fatty acid oxidation, and inflammation were studied to understand the mechanism of action of phytosterols. AD supplementation with SDPs was shown to reduce liver fat, along with showing a significant improvement in liver triglycerides (TGs), free fatty acids (FFAs), and liver cholesterol levels. These results were reinforced by the analyses of the liver steatosis scores, and liver histologies, where SDP intervention showed a consistent improvement. Treatment with PEs showed slighter effects in the same analyses, and no effects were observed with the PT treatment. Additionally, SDP intervention reversed, with a higher efficacy than PEs, the effect of AD on the serum levels of TGs, total- and LDL-cholesterol levels, and glucose levels. And, exceptionally, while SDP improved HDL-cholesterol serum levels, PEs did not show any effect on this parameter. We provide evidence for the therapeutical activity of phytosterols in MAFLD beyond the regulation of cholesterol levels, which is increased when the phytosterols are formulated as submicron dispersions compared to ester formulations.

Left ventricular hypertrophy in young hypertensives: the possible crosstalk of mTOR and angiotensin-II -a case-control study

BackgroundHypertension is a major cause of cardiac dysfunction. The earliest manifestation is left ventricular remodeling/hypertrophy. The occurrence of adverse cardiac remodeling and outcomes occurs irrespective of age in blacks. This necessitated an estimate of the prevalence of left ventricular hypertrophy (LVH) and an assessment of the roles of the mammalian target organ of rapamycin (mTOR) and angiotensin-II (Ang II) as possible pathogenic markers of LVH among young hypertensives.MethodsThis prospective case-control study involved 110 hypertensive and 60 normotensive (control) participants aged 18–45 across tertiary hospitals in Ekiti state. Ethical approval was obtained from all the various institutions. Participants were recruited consecutively after giving informed consent. Sociodemographic/clinical information, resting electrocardiogram and echocardiography were obtained. Venous blood was obtained to estimate mTOR, Ang II, Chemerin, lipids – triglyceride (TG), high-density lipoprotein (HDL), total cholesterol (TC), troponin-T, NF-Kβ, and Galectin-3 using enzyme-linked immunosorbent assay.ResultsThe prevalence of LVH among the hypertensive group was 20.9%, 39%, 11.01%, and 15.74% using 2D-transthoracic echocardiography, Sokolow-Lyon, Cornell’s and Cornell product ECG criteria. Also, hypertensives with LVH had a significantly increased blood pressure, body mass index, serum level of TG, TG/HDL, TC/HDL, chemerin, troponin T, Galectin-3 and total mTOR compared to normotensive and hypertensives without LVH. At the same time, serum NF-kβ and Ang II were only significant when compared with normotensive but not hypertensives without LVH. The total mTOR moderately correlated positively with ANG-II.ConclusionsThe results suggest an interaction between mTOR and Ang II in the development of LVH. In addition, it shows that LVH is associated with dyslipidemia, inflammation, and fibrosis.

Changes in blood glucose and lipid metabolism levels in children with central precocious puberty and its correlation with obesity.

This study analyzed the changes in blood glucose and lipid metabolism levels in children with central precocious puberty (CPP) and the correlation between CPP and obesity. In total, 88 children with CPP aged 6-10 years who were admitted to our hospital between January 2023 and June 2024 (the CPP group), and 88 children without CPP in the same age group who received health check-ups (the non-CPP group) were retrospectively enrolled in this study. General data [gender, age, bone age, and body mass index (BMI)] were collected. Levels of blood glucose metabolism indicators [fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), and hemoglobin A1c (HbA1c)] and blood lipid metabolism indicators [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] were compared. The incidence of obesity was calculated, and the Tanner stages of the obese group and the non-obese group were compared. The correlation between CPP degree (measured by Tanner staging) and obesity degree (measured by BMI) was analyzed using Spearman's correlation analysis. The differences in gender and age between the CPP and non-CPP groups were insignificant (P > 0.05). Bone age and BMI in the CPP group were higher than in the non-CPP group (P < 0.05). The CPP group had higher serum FPG, 2hPG, HbA1c, TG, TC, and LDL-C levels and lower serum HDL-C levels than the non-CPP group. The incidence of obesity was higher in the CPP group (21.59%, 19/88) than in the non-CPP group (6.82%, 6/88). The Tanner staging scores in the obese group for the boys (testes and pubic hair), girls (breasts and pubic hair), and as a whole (testes/breasts and pubic hair) were elevated compared to those in the non-obese group (P < 0.05). Spearman's correlation showed that the CPP degree (measured by Tanner staging) was positively correlated with the obesity degree (measured by BMI) in boys, girls, and the study sample as a whole (P < 0.001). Children with CPP had abnormal levels of blood glucose and lipid metabolism, and the CPP degree in these children was positively correlated with the degree of obesity.

Clinical features and risk factors of HIV-infected patients with intracerebral hemorrhage: a retrospective study with propensity score matching analysis.

To investigate the clinical features and risk factors of the human immunodeficiency virus (HIV)-infected patients with intracerebral hemorrhage (ICH). The patients with HIV-infected without ICH group were matched to the group of HIV-infected ICH patients. Logistic regression analysis using 1:1 propensity score matching (PSM) was performed to investigate the independent risk factors for ICH in HIV-infected patients. The receiver operating characteristic (ROC) curve was configured to calculate the optimal predictors of ICH in HIV-infected patients. A total of 59 HIV-infected patients with ICH and 180 HIV-infected patients without ICH were included. A cohort of 118 patients was ascertained utilizing PSM. Multivariate binary logistic regression analysis revealed that drug abuse-related HIV-infected, prolonged prothrombin time (PT), and elevated triglyceride (TG) levels were independent risk factors of ICH in HIV-infected patients. The ROC curve demonstrated that the combined predictor, composed of drug abuse-related HIV-infected, prolonged PT, and elevated TG levels, exhibited the highest area under the curve (AUC), with a cut-off point at 0.426, sensitivity of 78%, and specificity of 81.4%. The present study revealed that a valuable factor combined with drug abuse-related HIV-infected, prolonged PT, and elevated serum TG levels could serve as predictors of ICH in HIV-infected patients.

The Glucose-Lowering Effect of Mesembryanthemum crystallinum and D-Pinitol: Studies on Insulin Secretion in INS-1 Cells and the Reduction of Blood Glucose in Diabetic Rats.

Background: Ice plant (Mesembryanthemum crystallinum) is a vegetable with various therapeutic uses, one of which is its ability to prevent diabetes. The present study examined the insulin secretion effect related to the mechanism of action of ice plant extract (IPE) and its active compound D-pinitol in a rat insulin-secreting β-cell line, INS-1, as well as in diabetic rats. Methods: The glucose-stimulated insulin secretion (GSIS) test and Western blotting were used to measure GSIS. The glucose-stimulated index (GSI) and expression levels of insulin-related pathway factors, including insulin receptor substrate-2 (IRS-2), phosphoinositide 3-kinase (PI3K), Akt, and pancreatic and duodenal homeobox-1 (PDX-1), were measured in INS-1 cells. Results: The results showed that the GSI values were found to be 8.17 ± 0.22 and 12.21 ± 0.22 for IPE (25 μg/mL) and D-pinitol (100 μM), respectively. GSI values increased statistically significantly. In addition, IPE and D-pinitol upregulated the expression of insulin-related pathway factors. These findings indicate that insulin secretion was significantly stimulated by IPE and D-pinitol in the INS-1 cells, partly by upregulating the expression of IRS-2, PI3K, Akt, and PDX-1. Additionally, IPE administration significantly reduced excessive weight gain and improved glucose tolerance by decreasing the OGTT-AUC. It demonstrated liver-function-improving and lipid-lowering effects by reducing serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), triglyceride levels, and total cholesterol levels. Mechanistically, IPE enhances insulin signaling by increasing insulin receptor substrate 1 (IRS-1) phosphorylation and improving glucose metabolism and insulin sensitivity. Conclusions: These results offer important new information on the potential of D-pinitol and IPE as functional foods for improving insulin secretion and managing metabolic dysregulation associated with diabetes.

The Impact of Hepatic Hydrothorax on the Outcome of Liver Cirrhosis: A Comparative Study.

Introduction: Hepatic hydrothorax (HH) is a severe cirrhosis complication requiring early diagnosis and appropriate management. This study aimed to assess the impact of HH on the disease severity and mortality of cirrhotic patients and compare their clinical and biological profiles with those of patients without HH. Materials and Methods: This retrospective study involved 155 patients diagnosed with cirrhosis, of whom 31 had HH. The diagnosis of HH was based on imaging techniques such as X-ray, ultrasound, and thoracic CT scans. The severity of cirrhosis was evaluated using the Child-Pugh, MELD, MELD-Na, and MELD 3.0 scoring systems. Results: Of the included patients, 83.87% (n = 26) were men, with a 20% incidence of HH. The main etiology was chronic alcohol use. The pleural fluid localization revealed similar numbers of patients with bilateral and right pleural distribution. Patients with HH were predominantly classified in Child-Pugh-Turcotte class C. The MELD, MELD-Na, and MELD 3.0 scores had higher median values in the group of patients with hepatic hydrothorax. Still, death occurred at lower MELD scores when compared with cirrhotic patients without HH (MELD score > 22.5 for patients with HH vs. MELD > 32.5 for patients without HH). (The cirrhotic patients with HH presented lower serum albumin, cholesterol, and triglyceride levels and higher bilirubin, INR, and creatinine values. The mortality rate was higher in the group with HH-58,06% versus 20.97% in the control group (cirrhotics without HH). Conclusions: Hepatic hydrothorax is a serious complication of cirrhosis that requires early recognition and proper management, supported by using biomarkers and scoring systems.

Parameters Predictive of Propofol-Associated Acute Pancreatitis in Critically Ill Patients with COVID-19 Pneumonia: A Retrospective Cohort Study.

Propofol, a commonly used agent for short- and long-term sedation, is associated with acute pancreatitis. The main indirect mechanism of propofol-associated acute pancreatitis is by inducing hypertriglyceridemia. Patients with severe coronavirus disease 2019 (COVID-19) pneumonia often require prolonged mechanical ventilation and sedation. We examined the incidence rate of acute pancreatitis among critically ill adults with COVID-19 pneumonia on mechanical ventilation receiving propofol. In addition, we attempted to determine cutoff levels of serum triglycerides and doses of propofol that are predictive of propofol-associated acute pancreatitis. This was a multicenter retrospective cohort study using a large dataset of hospitalized patients with COVID-19. The collected data included the number of days on propofol, cumulative doses of propofol, peak levels of serum triglycerides, serum lipase levels, and abdominal imaging findings. We used receiver-operating characteristic analysis in conjunction with Youden's index to identify the optimal thresholds for propofol administration parameters and levels of triglycerides that would provide maximal sensitivity and specificity for predicting acute pancreatitis. Out of 499 critically ill patients with COVID-19 pneumonia, 154 met the inclusion criteria. Six (4%) patients had suspected acute pancreatitis based on elevated serum lipase levels. Cutoff values greater than 688 mg/dL for peak level of triglycerides, 4.5 days on propofol, 3007 mg/day for average daily propofol dose, and 24 113 mg for cumulative propofol dose were associated with high risk of suspected acute pancreatitis. The negative predictive values for suspected acute pancreatitis using these cutoffs ranged from 98% to 100%. Propofol use in critically ill COVID-19 patients is associated with a low incidence rate of acute pancreatitis. We identified cutoff values for serum triglycerides and cumulative propofol dose that are linked to higher risk of propofol-associated pancreatitis. More research is needed to examine the true incidence of propofol-associated pancreatitis and help develop optimal cutoff values for certain parameters to help guide safe propofol administration.

Hypertriglyceridemia and younger age are associated with effectiveness of growth hormone therapy on hepatic steatosis.

Adult growth hormone deficiency (AGHD) is often accompanied with metabolic dysfunction-associated steatotic liver disease (MASLD). Although some studies reported that MASLD is ameliorated by growth hormone replacement therapy (GHRT), the characteristics of AGHD that are associated with an improvement of hepatic steatosis by GHRT remain unknown. We aimed to investigate whether GHRT affects hepatic lipid accumulation as well as biochemical parameters, and investigated the association between these parameters (UMIN000044989). Thirty people with AGHD were recruited, and assigned to either the GHRT group or the non-GHRT group. Serum laboratory data were analyzed before and after GHRT. Hepatic lipid content was evaluated using magnetic resonance imaging-proton density fat fraction (MRI-PDFF). Correlations between MRI-PDFF and other clinical parameters were investigated. Twenty-nine people completed this study (19 in the GHRT group and 10 in the non-GHRT group). In the GHRT group, significant decreases in MRI-PDFF and serum levels of aspartate aminotransferase, alanine aminotransferase, and γ-glutamyl transpeptidase were observed after the treatment. The decrease in MRI-PDFF levels after GHRT significantly correlated with initial MRI-PDFF, triglyceride (TG), lactate dehydrogenase, and ALT levels, and age. Multiple regression analysis demonstrated that younger age and high serum TG levels were independent predictors of a decrease in MRI-PDFF levels. GHRT in people with AGHD significantly reduced lipid accumulation in the liver on MRI, and improved serum liver parameters. Age and serum TG levels were found to be associated with the effectiveness of GHRT.

A very low carbohydrate diet improved metabolic profile in congenital generalized lipodystrophy type 4.

A 17-year-old girl presented with recurrent attacks of acute pancreatitis, associated with severe hyperglycemia and hypertriglyceridemia, despite being on intensive insulin therapy for the last 10 years. She had severe acanthosis nigricans, generalized loss of subcutaneous fat and prominent veins over extremities. The serum levels of glucose and triglyceride did not reduce significantly, even with maximally tolerated doses of metformin (2 g), pioglitazone (45 mg) and fenofibrate (160 mg), not uncommonly seen in poor rural families in West Bengal, India. A detailed dietary recall revealed a very high carbohydrate intake (70% of total calorie) with very low protein and fat intake. A switch to a very low carbohydrate (30% of total calorie) diet led to a remarkable improvement in glucose and lipid profiles (the daily insulin requirement came down by 50% and triglyceride level came down to 600 mg/dL from 950 mg/dL). A whole-exome sequencing study confirmed congenital generalized lipodystrophy type 4. A carbohydrate restriction strategy may improve difficult-to-control glycometabolic profile in lipodystrophic subjects on high-carbohydrate diet. Lipodystrophy should be suspected in patient presenting with hyperglycemia, hypertriglyceridemia and low BMI. A very low carbohydrate diet (30% of total daily calorie intake) may significantly improve glucose and lipid profiles in patients with lipoatrophic diabetes. Blood glucose may be the most important initial step to control hypertriglyceridemia and risk of pancreatitis in this group of patients.