Blood Total Cholesterol Research Articles

Protective effect of melatonin against metabolic disorders and neuropsychiatric injuries in type 2 diabetes mellitus mice

BackgroundType 2 diabetes mellitus (T2DM) is a metabolic disease characterized by hyperglycemia and progressive cognitive dysfunction, and our clinical investigation revealed that the plasma concentration of melatonin (Mlt) decreased and was closely related to cognition in T2DM patients. However, although many studies have suggested that Mlt has a certain protective effect on glucose and lipid metabolism disorders and neuropsychiatric injury, the underlying mechanism of Mlt against T2DM-related metabolic and cognitive impairments remains unclear. PurposeThe aim of the present study was to investigate the therapeutic effect of Mlt on metabolic disorders and Alzheimer's disease (AD)-like neuropsychiatric injuries in T2DM mice and to explore the possible underlying molecular mechanism involved. MethodsA T2DM mouse model was established by a combination of a high-fat diet (HFD) and streptozotocin (STZ, 100 mg/kg, i.p.), and Mlt (5, 10 or 20 mg/kg) was intragastrically administered for six consecutive weeks. The serum levels of glycolipid metabolism indicators were measured, behavioral performance was tested, and the protein expression of key molecules involved in the regulation of synaptic plasticity, circadian rhythms, and neuroinflammation in the hippocampus was detected. Moreover, the fluorescence intensities of glial fibrillary acidic protein (GFAP), ionized calcium binding adapter molecule 1 (IBA-1), amyloid β-protein (Aβ) and phosphorylated Tau (p-Tau) in the hippocampus were also observed. ResultsTreatment with Mlt not only improved T2DM-related metabolic disorders, as indicated by increased serum concentrations of fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc), insulin (INS), total cholesterol (TC) and triglyceride (TG), improved glucose tolerance and liver and pancreas function but also alleviated AD-like neuropsychiatric injuries in a HFD/STZ-induced mouse model, as indicated by decreased immobility time in the tail suspension test (TST) and forced swimming test (FST), increased preference indices of novel objects or novel arms in the novel object recognition test (NOR) and Y-maze test (Y-maze), and improved platform positioning capability in the Morris water maze (MWM) test. Moreover, treatment with Mlt also improved the hyperactivation of astrocytes and microglia in the hippocampus of mice, accompanied by reduced expression of interleukin 1β (IL-1β), interleukin 6 (IL-6), tumor necrosis factor (TNF-α), Aβ, and p-Tau and increased expression of brain-derived neurotrophic factor (BDNF), Synapsin I, Synaptotagmin I, melatonin receptor 1B (MT1B), brain muscle arnt-like protein 1 (Bmal1), circadian locomotor output cycles kaput (Clock), period 2 (Per2), and cryptochrome 2 (Cry2). ConclusionMlt alleviated T2DM-related metabolic disorders and AD-like neuropsychiatric injuries in a HFD/STZ-induced mouse model, possibly through a mechanism involving the regulation of glial activation and associated neuroinflammation and the balancing of synaptic plasticity and circadian rhythms in the hippocampus.

The effect of hypothyroidism on cardiovascular events and type 2 diabetes mellitus developing in rheumatoid arthritis

To compare the frequency of cardiovascular events (CVE), to assess the risk of cardiovascular death using the mSCORE and the development of type 2 diabetes mellitus (DM) using the FINDRISC in patients with rheumatoid arthritis (RA) with and without hypothyroidism. The study included 149 patients (125 women, 24 men) with RA (median age - 57 [52; 61] years). In all patients, traditional factors of cardiovascular risk and glucose metabolism disorders (age, smoking status, total blood cholesterol, blood pressure, overweight, abdominal obesity - AO, heredity burdened by diabetes, insufficient physical activity, the lack of the necessary amount of berries, fruits and vegetables in the daily diet, history of hyperglycemia episodes), the 10-year risk of death from cardiovascular causes according to the mSCORE and the risk of developing type 2 DM according to the FINDRISС were assessed, a history of CVE (myocardial infarctions, and its revascularization, stroke) was recorded. Hypothyroidism was diagnosed in 17.4% of RA patients. Patients with hypothyroidism (group 1) were more likely to have AO and less likely to consume unsufficient dietary fiber than patients with euthyroidism (group 2). Moderate, high and very high risk of development according to the mSCORE and FINDRISC was detected in 61.5% of hypothyroid patients and 48.8% euthyroid patients, according to mSCORE alone - in 30.8 and 44.7%, according to FINDRISC - in 0 and 2.4%, respectively (p>0.05 in all cases); 11.5% of patients in group 1 and 6.5% in group 2 suffered from CVE (OR 1.875, 95% CI 0.462-7.607; p=0.63). It is necessary to evaluate the thyroid gland function, especially in patients with AO due to the high frequency of hypothyroidism in RA. Hypothyroidism did not have an independent effect on the severe CVЕ rates, as well as risk assessment according to the score and FINDRISC in RA patients. Theses, with and without hypothyroidism, were predominantly in the moderate, high, very high risk groups according to both scales.

Developmental aspects of metabolic syndrome in children under treatment with gastrointestinal lipase inhibitors

Alongside the increasing trends in obesity rates, there is a documented rise in the prevalence of metabolic syndrome (MetS) in children, dictating that each component of MetS should be identified as early as possible;and the treatment goal consists of reducing obesity, managing metabolic complications, insulin resistance, and also addressing hypertension (HTN).Aim of the study. To determine risk factors, the role of certain proinflammatory markers (TNF α, hs-CRP), and adipokines (leptin, adiponectin) in the onset of MetS in children and their evolution under treatment with gastrointestinal lipase inhibitors (GLI). Material and methods. The presented results were obtained as part of a project within the State Program 2020-2023 titled “Evolutionary Aspects of Metabolic Syndrome in Children Under Treatment with Gastrointestinal Lipase Inhibitors”, project number 20.80009.8007.33. The study included 57 children with MS (IDF, 2007). Depending on the pharmacological therapy associated with non-pharmacological treatment, the children in the research were divided into 3 groups: Group I- 23 children who received orlistat (orlip) - GLI, Group II - 15 children who received Angiotensin Converting Enzyme Inhibitors (ACEIs), and Group III - 19 children who received both GLI and ACEIs. The control group consisted of 50 normotensive and normal-weight children of similar age (gender ratio: 1:1). Risk factors, body mass index (BMI), waist circumference (WC), blood pressure values, total cholesterol (TC), LDL-C, HDL-C, triglycerides (TG), basal glycemia (BG), serum insulin, TNFα, hs-CRP, leptin, and adiponectin were analyzed initially and at the 3-month interval.The study protocol was approved by the Medical Ethics Committee of the Institute of Cardiology, Republic of Moldova (minutes no.2 dated February 20, 2020).Results: The majority of children in the study had a history of hereditary aggravated HTN and obesity, were sedentary or moderately sedentary, and had poor dietary habits. Among the components of MetS (IDF, 2007) associated with abdominal obesity, the following predominated: hypertension in 38 (66.7%) children, hypertriglyceridemia - 32 (56.1%%) children, increased basal blood glucose (BG) - 17(29.8%) children and hypo-HDL-C - 11 (19.3%) children. BMI at the 3-month interval from the initiation of medication decreased most significantly in group I (-4.025±1.267 kg/ m2), followed by group II (-3.33±0.972 kg/m2), and III (-3.046±0.840 kg/m2). WC decreased most notably in group III (-10.63±3.732 cm) compared to group II (-9.167±1.783 cm) and group I (-4.700±2.352 cm). Similar trends were observed for blood pressure values: group III (-18.75±1.897 mm Hg) vs group II (-12.167±1.359 mm Hg) vs group I (-3.900±4.613 mm Hg). LDL-C decreased essentially in group II (-0.46±0.211 mmol/l), while TG decreased in group III (-0.77±0.325 mmol/l) and II (-0.53±0.112 mmol/l). HDL-C increased by +0.60±0.274 mmol/l in group I, by +0.15±0.066 mmol/l in group II, and by +0.12±0.031 mmol/l in group III. Serum insulin decreased predominantly in group III (-9.36±4.53 µU/ mL). Similar trends were observed for BG (group III -1.24±0.322 mmol/l). TNF α decreased most significantly in group III (-2.65±0.911 pg/ml) compared to group I (-1.24±0.508 pg/ml) and group II (-1.61±1.018 pg/ml). hs-CRP decreased mainly in group I (-0.69±0.785 mg/l) and group II (-0.74±0.593 mg/l) compared to group III (-0.42±0.617 mg/l). Leptin values decreased significantly in all study groups at the 3-month interval from the initiation of medication (group I by-8.80±3.64 ng/ml, group II by -10.92±4.084 ng/ml, group III by -9.75±6.172 ng/ml). Adiponectin values increased by+1.83±1.087 µg/L in group III of the study.Conclusion: In combination with a calorie-restricted diet, regular physical exercise, and behavioral modifications, treatment with ILG and ACEIs in children with MetS in the study contributed to a decrease in the degree of obesity, blood pressure values, and normalization of the lipid and glucose profile, respectively. Additionally, it highlighted both the importance of prevention, early detection, and management of obesity, as well as the causal link between obesity, hypertension, and chronic inflammation.

Effectiveness of herbs taken concurrently with antihypertensive drugs in managing hypertension and lipid outcomes. A systematic review and meta-analysis.

PurposeHypertension is the primary cause of mortality. Hence globally, there is a growing interest in complementing antihypertensive drugs with herbs to alleviate blood pressure among hypertensive patients. Thus, this review aimed to evaluate the effectiveness of complementing drugs with herbs on blood pressure and lipid profile outcomes, the associated factors and the types of complementary herbs alongside their consumption regimes. MethodsThis review is registered in PROSPERO on the National Institute of Health Database with an ID: CRD42021270481. Using the PICOS (population, intervention, comparison, outcome, study type) mnemonic formula and search strategy, we searched (January 2010 to February 2024) five electronic databases including Pubmed, Scopus, Web of Science, CINAHL (Cumulative Index for Nursing and Allied Health Literature) and Psychology & Behavioral Sciences Collection (PBSC). The inclusion criteria of the review were that all included papers had to be randomised control trials in English among hypertensive adults who complemented antihypertensive drugs with herbs. A Cochrane risk of bias assessment as well as a meta-analysis and narrative synthesis were conducted to answer the objectives. ResultsTwenty-five randomised controlled trials involving 1996 participants from 14 countries were included. The risk of bias among included articles was assessed and presented using the Cochrane risk of bias tool and the graphs were generated. The effects of complementing antihypertensive drugs with different herb regimes on blood pressure and lipid profile outcomes were compared to those solely on antihypertensive drugs and placebo via a random model effects meta-analysis using the Revman manager. Systolic blood pressure (SBP) and triglycerides gave a significant reduction in favour of the intervention group which complemented herbs. The overall pooled systolic blood pressure showed a reduction of (SMD=0.81, 95 % CI 0.14–1.47, p < 0.02, p for heterogeneity=0.00001, I2 =97 %) while triglycerides were (SMD=0.73, 95 % CI 0.17–1.28, p < 0.01, p for heterogeneity=0.00001, I2 =85 %). However, diastolic blood pressure, total cholesterol, HDL and LDL did not exert significant outcomes. ConclusionThe complemented herbs with antihypertensive drugs did show improvement in overall blood pressure management in the majority of the studies compared to the placebo group. Blood pressure and lipid profiles are the health outcomes that enable access to complementing herbs in controlling high blood pressure. Some limitations of this review are attributed to performance, detection and attrition bias in a few included articles alongside the presence of a high heterogeneity overall.

Dietary cooking oils and cardiometabolic measurements in an elderly Chinese population.

To investigate three features of dietary cooking oil intake, namely, the consumption, cooking style, and composition of fatty acids in relation to several cardiometabolic measurements in an elderly Chinese population. The elderly (≥ 65 years) participants for this study were recruited from two community health centers in the urban area of Shanghai. A questionnaire was administered to collect information on dietary oil consumption (low, medium and high) and cooking styles (fry or stir-fry vs. others) and the composition of fatty acids (poly-unsaturated vs. mono-unsaturated). The cardiometabolic measurements included anthropometry, blood pressure, fasting plasma glucose and serum lipids. The 1186 study participants had a mean age of 70.9 ± 5.4 years. The mean dietary oil consumption was 35.0 g/d, being low (< 25 g/d), medium (25-49 g/d) and high (≥ 50 g/d) in 485,467 and 234 participants, respectively. The proportion of the fry or stir-fry cooking style and oils rich in mono-unsaturated fatty acids was 30.4% and 27.4%, respectively. Both before and after adjustment for sex, age, current smoking and alcohol intake, dietary oil consumption was significantly (P ≤ 0.02) and positively associated with the prevalence of treated hypertension and fasting plasma glucose concentration. With similar adjustments as above and additional adjustment for dietary oil consumption, the fry or stir-fry cooking style was significantly (P ≤ 0.048) and positively associated with body mass index, but inversely with systolic and diastolic blood pressure and serum low-density lipoprotein cholesterol, and the dietary intake of oils rich in mono-unsaturated fat acids was significantly (P ≤ 0.02) and positively associated with diastolic blood pressure, serum triglycerides, total cholesterol and low-density lipoprotein cholesterol, and the prevalence of hypertriglyceridemia and hypercholesterolemia. This study showed that both the consumption and composition of fatty acids of the dietary oils mattered with regard to several cardiometabolic measurements in an elderly Chinese population.

Efficacy Assessment of Five Policosanol Brands and Damage to Vital Organs in Hyperlipidemic Zebrafish by Six-Week Supplementation: Highlighting the Toxicity of Red Yeast Rice and Safety of Cuban Policosanol (Raydel®).

Policosanol is a mixture of long-chain aliphatic alcohols (LCAAs) derived from various plant and insect origins that are marketed by various companies with distinct formulations and brand names. Policosanols offer several beneficial effects to treat dyslipidemia and hypertension; however, a comprehensive functionality comparison of various policosanol brands has yet to be thoroughly explored. In the present study five distinct policosanol brands from different origins and countries, Raydel-policosanol, Australia (PCO1), Solgar-policosanol, USA (PCO2), NutrioneLife-monacosanol, South Korea (PCO3), Mothernest-policosanol, Australia (PCO4), and Peter & John-policosanol, New Zealand (PCO5) were compared via dietary supplementation (1% in diet, final wt/wt) to zebrafish for six weeks to investigate their impact on survivability, blood lipid profile, and functionality of vital organs under the influence of a high-cholesterol diet (HCD, final 4%, wt/wt). The results revealed that policosanol brands (PCO1-PCO5) had a substantial preventive effect against HCD-induced zebrafish body weight elevation and hyperlipidemia by alleviating total cholesterol (TC) and triglycerides (TG) in blood. Other than PCO3, all the brands significantly reduced the HCD's elevated low-density lipoprotein cholesterol (LDL-C). On the contrary, only PCO1 displayed a significant elevation in high-density lipoprotein cholesterol (HDL-C) level against the consumption of HCD. The divergent effect of PCO1-PCO5 against HCD-induced hepatic damage biomarkers, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), was observed. PCO1, PCO2, and PCO4 efficiently curtailed the AST and ALT levels; however, PCO3 and PCO5 potentially aggravated the HCD's elevated plasma AST and ALT levels. Consistently, the hepatic histology outcome revealed the least effectiveness of PCO3 and PCO5 against HCD-induced liver damage. On the contrary, PCO1 exhibited a substantial hepatoprotective role by curtailing HCD-induced fatty liver changes, cellular senescent, reactive oxygen species (ROS), and interleukin-6 (IL-6) production. Likewise, the histological outcome from the kidney, testis, and ovary revealed the significant curative effect of PCO1 against the HCD-induced adverse effects. PCO2-PCO5 showed diverse and unequal results, with the least effective being PCO3, followed by PCO5 towards HCD-induced kidney, testis, and ovary damage. The multivariate interpretation based on principal component analysis (PCA) and hierarchical cluster analysis (HCA) validated the superiority of PCO1 over other policosanol brands against the clinical manifestation associated with HCD. Conclusively, different brands displayed distinct impacts against HCD-induced adverse effects, signifying the importance of policosanol formulation and the presence of aliphatic alcohols on the functionality of policosanol products.

Time-course atherogenic blood lipid response to statin discontinuation in dyslipidemic adults

Background and aimsHalf of dyslipidemic patients sometimes discontinue statin medication. It is unclear if blood atherogenic risk increases right after statin discontinuation or if there is a lingering protective effect. We sought to determine if a legacy effect prevented blood lipid increases during the first stages of statin cessation. Methods and resultsAtherogenic blood lipid profile was measured in 10 overweight (BMI 31 ± 3 kg m−2) middle-aged males (62 ± 7 years old), statin users, while fasted and postprandially. Trials were conducted before (i.e., Day 0) and after 4, 7, 15, and 30 days of statin withdrawal and 20 days after statins reloading (Day 50).Four days after statin discontinuation, blood fasting LDL-c, total cholesterol (CHOL), and triglyceride (TG) concentrations increased by 30%, 18%, and 17%, respectively (P < 0.05). The increases in LDL-c, CHOL, and TG peaked after 7–15 days at 79%, 48%, and 34% of basal levels (P < 0.001), respectively. There were no significant correlations between the increases in blood lipids and the dose or years under statin treatment (P = 0.156–0.575). Twenty days after resuming statins, blood LDL-c (2.79 ± 1.06 vs 2.20 ± 0.50 mmol L−1; P = 0.568), CHOL (4.85 ± 1.41 vs 4.25 ± 0.83 mmol L−1; P = 0.747), and TG (1.47 ± 0.60 vs 1.50 ± 0.68 mmol L−1; P = 0.782), returned to basal levels. ConclusionsOur data does not support a statin lingering/legacy effect in blood lipids since they dangerously increased after only 4 days of statin withdrawal in every patient, regardless of dose and years under treatment. Reloading statins restored blood lipids, evidencing a reproducible biological effect at the whole-body level.

Predictors for diabetes and hypertension among bus drivers and conductors in South India.

Bus drivers and conductors are facing various health hazards due to stressful working conditions. They are exposed to various occupational hazards which lead to deterioration of their health over a period of time. Therefore, it is of interest to evaluate the prevalence of diabetes and hypertension among bus drivers and conductors and to determine the factors associated with diabetes and hypertension. This cross-sectional study was done among 293 bus drivers and 157 conductors during March 2018 to December 2018 and the data was collected using a semi structured questionnaire after obtaining informed consent. Each individual was investigated for Blood sugar and Blood Pressure. Out of 450 study participants, about 6.9% were diabetic and 50.2% were hypertensive. Transport workers with single marital status, those who belong to rural areas and drivers were significant predictors for diabetes. Overweight was significantly associated with the Diabetes in negative direction. Marital status, years of experience and anxiety were significantly associated with hypertension. Hemoglobin level, total cholesterol level and blood urea level also emerged as predictors for Hypertension. Non-communicable diseases like diabetes and hypertension have surpassed the communicable diseases in affecting the health of people with distinct occupations like bus drivers and conductors.

Eruptive Xanthomas – A Case Report with a Review of the Literature

Eruptive xanthomas are most often the result of impaired lipid metabolism. They can be caused by a primary dysregulation in lipid metabolism (familial hyperlipoproteinemias) or by an increase in serum lipids from concomitant diseases (diabetes mellitus, obesity, chronic renal failure, nephrotic syndrome, pancreatitis, hypothyroidism, rarely hyperthyroidism, alcohol abuse, cholestasis or biliary cirrhosis, monoclonal gammopathy, multiple myeloma and leukemia) or from the use of certain medications (beta-blockers, estrogens, retinoids, protease inhibitors, cyclosporine, the antimycotic Miconazole and the antipsychotic Olanzapine (secondary hyperlipoproteinemias). Early diagnosis and adequate therapy of the skin changes and the comorbid underlying disease prevent serious life-threatening complications. A case of a 34-year-old man with papular yellowish lesions on the elbows is presented. The patient has accompanying diseases of diabetes mellitus, alcohol addiction, liver cirrhosis, chronic acute pancreatitis and chronic cholecystitis. The clinical diagnosis of eruptive xanthomas was confirmed by histopathological examination revealing foam cells in the dermis. Laboratory blood tests revealed an accelerated ESR and elevated blood glucose, transaminases, uric acid, total cholesterol, and triglycerides. Hepatoprotective and antidiabetic therapy combined with a dietary regimen improved the patient&amp;apos;s condition and laboratory parameters. A partial reversal of skin lesions occurred. An overview of the epidemiology, etiopathogenesis, clinical picture, laboratory tests, differential diagnosis, dietary regimen, and treatment of eruptive xanthomas are presented.

SCORE2 Screening Tool for Cardiovascular Risk Assessment in Psoriasis-A Case-Control Study.

Background: Psoriasis is a common, T-cell-mediated inflammatory and immune-mediated skin disease. Numerous studies confirmed that patients with psoriasis have a significant frequency of cardiovascular (CV) risk factors and CV diseases (CVDs). Risk stratification is helpful in light of the elevated risk of CVD in psoriasis patients. SCORE2 and SCORE2-OP, a new algorithm derived, calibrated and validated to predict the 10-year risk of first-onset CVD in European populations, enhances the identification of individuals at higher risk of developing CVD across Europe. Objective: Using the SCORE2 and SCORE2-OP scoring systems, the current study objective was to evaluate CV risk in Slovak psoriasis patients and the relationship between CV risk and psoriasis features in a real-world setting. Results: A case-control study was conducted involving 115 outpatients with plaque psoriasis and 66 age- and gender-matched controls with skin conditions other than psoriasis. Patients with psoriasis had significantly higher mean SCORE2 values. In the age group up to 50 years, more psoriasis patients were classified as moderate risk than controls (33.8% vs. 13.6%, p = 0.010); the high-risk category was dominated by psoriasis patients. Analysing the relationship between CV risk and selected variables, we determined, using linear regression, the dependence of the SCORE2 risk score on gender in the age group up to 50 years, on age in both age groups, on waist circumference (WC) in the category up to 50 years and on the duration and severity of psoriasis in both age groups using linear regression. For individuals older than 70, we estimated the SCORE2-OP risk score, with the average risk score being 19.5 ± 4.95. We did not observe controls with a high risk score. Psoriasis patients were more likely to be smokers and had significantly higher mean values for body mass index (BMI), WC, total cholesterol (TC), low-density lipoprotein (LDL) and systolic blood pressure (BP). Conclusions: Because CV risk factors and psoriasis are strongly related, the importance of CV risk stratification is growing, and initiating preventive lifestyle changes or therapeutic interventions in patients with psoriasis is warranted.

The Effect of Therapeutic Doses of Culinary Spices in Metabolic Syndrome: A Randomized Controlled Trial.

Non-communicable diseases (NCDs) place a significant burden on global health and the healthcare systems which support it. Metabolic syndrome is a major risk factor for a large number of NCDs; however, treatments remain limited. Previous research has shown the protective benefits of edible dietary spices on key components of metabolic syndrome. Therefore we performed a 12-week double-blind, placebo-controlled, randomized, clinical trial to evaluate the effect of ginger (Zingiber officinale), cinnamon (Cinnamomum), and black seed (Nigella sativa) consumption on blood glucose, lipid profiles, and body composition in 120 participants with, or at risk of, metabolic syndrome. Each participant consumed 3 g/day of powder (spice or placebo). Data related to different parameters were collected from participants at the baseline, midpoint, and endpoint of the intervention. Over the 12-week interventions, there was an improvement in a number of biochemical indices of metabolic syndrome, including fasting blood glucose, HbA1c, LCL, and total cholesterol associated with supplementation with the spices when compared to a placebo. This study provides evidence to support the adjunct use of supplementation for those at risk of metabolic syndrome and its sequelae.

Metabolomic and Physiological Effects of a Cardiorenal Protective Diet Intervention in African American Adults with Chronic Kidney Disease.

Chronic kidney disease (CKD) impacts 14% of adults in the United States, and African American (AA) individuals are disproportionately affected, with more than 3 times higher risk of kidney failure as compared to White individuals. This study evaluated the effects of base-producing fruit and vegetables (FVs) on cardiorenal outcomes in AA persons with CKD and hypertension (HTN) in a low socioeconomic area. The "Cardiorenal Protective Diet" prospective randomized trial evaluated the effects of a 6-week, community-based FV intervention compared to a waitlist control (WL) in 91 AA adults (age = 58.3 ± 10.1 years, 66% female, 48% income ≤ USD 25K). Biometric and metabolomic variables were collected at baseline and 6 weeks post-intervention. The change in health outcomes for both groups was statistically insignificant (p > 0.05), though small reductions in albumin to creatinine ratio, body mass index, total cholesterol, and systolic blood pressure were observed in the FV group. Metabolomic profiling identified key markers (p < 0.05), including C3, C5, 1-Met-His, kynurenine, PC ae 38:5, and choline, indicating kidney function decline in the WL group. Overall, delivering a directed cardiorenal protective diet intervention improved cardiorenal outcomes in AA adults with CKD and HTN. Additionally, metabolomic profiling may serve as a prognostic technique for the early identification of biomarkers as indicators for worsening CKD and increased CVD risk.

Association between two novel anthropometric measures and type 2 diabetes in a Chinese population.

To investigate the associations of conicity index (C-index) and relative fat mass (RFM) with incident type 2 diabetes mellitus (T2DM) among adults in China. A total of 10 813 participants aged over 18 years in Shenzhen Longhua district were enrolled in a follow-up study conducted from 2018 to 2022. The participants were categorized based on quartiles (Q) of C-index and RFM. The Cox proportional hazards model was performed to examine the relationships between C-index, RFM and the risk of T2DM. After adjusting for potential confounding factors, including age, sex, occupation, marital status, education level, smoking status, alcohol consumption, physical exercise, hypertension status, fasting blood glucose (FBG) and total cholesterol (TC), both C-index and RFM showed positive and independent associations with risk of T2DM. The multivariable-adjusted hazard ratios (95% confidence intervals) for T2DM risk in participants in C-index Q3 and Q4 compared with those in C-index Q1 were 1.50 (1.12, 2.02) and 1.73 (1.29, 2.30), and 1.94 (1.44, 2.63), 3.18 (1.79, 5.64), 4.91 (2.68, 9.00) for participants in RFM Q2, Q3 and Q4 compared with RFM Q1. These differences were statistically significant (all p < 0.05). C-index and RFM are strongly associated with new-onset T2DM and could be used to identify the risk of diabetes in large-scale epidemiological studies.

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

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

#1526 Effects of dietary intervention on diabetic nephropathy: an umbrella review of systematic review and meta-analysis of randomized controlled trials

Abstract Background and Aims To evaluate the quality of evidence, potential biases, and validity of all available studies on dietary intervention and diabetic nephropathy (DN). Method We conducted an umbrella review of existing meta-analyses of randomized controlled trials (RCTs) that focused on the effects of dietary intervention on DN. Literature searching was performed via PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and hand searching of the reference lists. Systematic reviews and meta-analyses of RCTs that evaluated the effects of any dietary intervention on clinical outcomes of DN were included. Two reviewers evaluated the methodological quality of the included articles through AMSTAR score. In addition, according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE), evidence of each outcome was evaluated and graded as “high”, “moderate”, “low” or “very low” quality to draw conclusions. Additionally, we classified evidence of outcomes into 4 categories (class I to IV and non-significant (NS)). Results We identified 36 meta-analyses of RCTs and 55 clinical outcomes of DN from 395 unique articles (Fig. 1). Moderate quality evidence suggested that probiotics supplementation could significantly improve blood urea nitrogen (BUN), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in DN patients. Low quality evidence indicated that probiotics supplementation significantly improved serum creatinine, urinary albumin creatinine ratio (UACR), fasting blood glucose (FBG), HbA1c and high-density lipoprotein cholesterol (HDL-C) in DN patients. In addition, low quality evidence suggested that a salt restriction diet could significantly improve creatinine clearance rate (CrCl) in patients with DN. Low quality evidence suggested that vitamin D supplementation could significantly improve UACR in patients with DN. Besides, low quality evidence indicated that soy isoflavone supplementation could significantly improve BUN, FBG, TC, triglycerides (TG) and LDL-C in patients with DN. Furthermore, low quality evidence suggested that coenzyme Q10 supplementation could significantly improve HbA1c, TC and HDL-C in patients with DN, and dietary polyphenols also significantly improved HbA1c in patients with DN. Finally, low quality evidence suggested supplementation of antioxidant vitamins could significantly improve serum creatinine, systolic blood pressure, and HbA1c in patients with DN. The remaining outcomes were rated as very low quality due to significant risk of bias, significant heterogeneity, imprecision, and publication bias. Given the small sample size, all significantly associated outcomes were evaluated as class IV evidence (Fig. 2). Conclusion Moderate to low evidence suggests that supplementation with probiotics, vitamin D, soy isoflavones, coenzyme Q10, dietary polyphenols, antioxidant vitamins, and salt-restricted diets may significantly improve clinical outcomes in patients with DN.

#1756 Development and internal validation of machine learning algorithms for mortality prediction model of people with DM and CKD

Abstract Background and Aims Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) are leading causes of morbidity and mortality, presenting challenges in patient management. The aim of this study is to develop a machine learning-based predictive model for mortality in DM and CKD patients, improving early intervention and treatment personalization. Method 3,637 participants with DM and CKD from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were included. All-cause mortality was ascertained by linkage to National Death Index records through 31 December 2019 in NHANES. The dataset included clinical profiles, demographic details, and laboratory results of patients with DM and CKD. We performed 100 random groupings, dividing the data into a 75% training set and a 25% validation set each time. We then visualized the results of 100 AUC measurements using a boxplot. The objective was to forecast patient survival over 1, 3, 5, and 10-year horizons using a variety of machine learning algorithms. The algorithms tested included Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), K-Nearest Neighbors (KNN), Gaussian Naive Bayes (GNB), Multinomial Naive Bayes (MNB), Bayesian Network Classifier (BNC), AdaBoost (Ada), Gradient Boosting (Gradient), and Extreme Gradient Boosting (XG). The performance of each algorithm was evaluated based on the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC), with the results visualized in boxplot format. Results Upon result shown as the boxplots, it becomes evident that the Random Forest (RF) algorithm consistently exhibits one of the highest AUCs on average across all prediction intervals, suggesting a strong and stable predictive capacity. In the 1-year survival prediction, the RF algorithm demonstrates a highest AUC, implying consistent performance. The 3 and 5-year predictions reveal a slight dip in AUC for most models, including RF, but it still remains one of the top-performing algorithms with fewer outliers than XG and Gradient Boosting. The mean AUC of RF is particularly noteworthy at the 10-year mark, where most algorithms struggle with prediction accuracy, as indicated by lower median AUCs and greater variability. Notably, the RF algorithm identified six major factors for 1-year survival prediction: systolic blood pressure, uric acid, blood urea nitrogen, lactate dehydrogenase, lymphocyte count and total cholesterol, as well as three major factors for 10-year survival prediction: age, lymphocyte and gamma-glutamyl transferase. Conclusion Overall, the study indicates that while machine learning can be a powerful tool for survival prediction in patients with DM and CKD, the choice of algorithm is crucial, with RF standing out for its consistent and reliable performance.

A Tailored Intervention for Improving Diabetes Self-care Among Adults With Visual Impairment: A Pilot Study

ObjectivesOur aim in this study was to develop and evaluate a tailored intervention for improving diabetes self-care among people with visual impairment (TID-VI) in South Korea. MethodsThe TID-VI program was designed around the barriers, resources, and perceptual factors to promote diabetes self-care in those with visual impairment (VI). A single-arm pilot study was conducted to evaluate the feasibility and preliminary effects of the intervention. Diabetes self-efficacy, self-care behaviours, depression, health-related quality of life, and clinical outcomes (fasting blood glucose, glycated hemoglobin [A1C], lipids, and blood pressure) were measured before and up to 2 months after the 12-week intervention. ResultsAll 14 participants completed TID-VI. Diabetes self-efficacy, diabetes self-care behaviours, depression, and health-related quality of life showed improvement from baseline that was sustained at 2 months. Although high- and low-density lipoprotein also improved, there were no differences in blood glucose, A1C, total cholesterol, or blood pressure at 2 months. ConclusionsA theory-driven, tailored intervention specific to the needs of adults with VI can produce substantial improvements in patient-reported quality of life and health status outcomes, although the benefits are yet to be confirmed in a controlled study.

#1294 The impact of plant-based diet on renal function and metabolic profile in kidney transplant recipients

Abstract Background and Aims Controlling and reducing protein intake is the most used approach to preserve renal function in CKD patients. Compared to protein restriction alone, plant-based diets have received particular attention. However, data on the potential risks and benefits of a plant-based diet in kidney transplant patients remains sparse, and evidence in this population is indirect. The primary purpose of this study was to evaluate if a plant-based diet affects proteinuria and eGFR in renal transplant patients. Establishing whether it influences acid load, glycolipid profile, nutritional status, and performance status were secondary objectives. Method 26 renal transplant recipients with eGFR &amp;gt;20 ml/min/1.73 m², urinary protein excretion &amp;gt;0.5 g/day, and transplant age &amp;gt;1 year were considered eligible for the study. Enrolled subjects underwent dietary assessment and biochemical tests at baseline, three and six months after starting the plant-based diet. All subjects underwent performance tests: sit-to-stand and handgrip tests. Results Only 18 patients were included in the statistical analysis. After six months, no significant changes in levels of proteinuria, urinary anion gap, triglycerides, and grip strength were detected. However, there was a statistically significant reduction in total cholesterol (p=0.03), LDL (p=0.04), and fasting blood sugar levels (p=0.001). A statistically significant reduction in eGFR (p=0.033) was observed, likely the regression of the previous hyperfiltration caused by the animal protein diet. A significant improvement was found in sit-to-stand test performance (p=0.037). Finally, a direct relationship between azoturia and urinary anion gap was observed. Conclusions The work carried out has highlighted how some of the potential benefits of the plant-based diet may also be relevant among kidney transplant patients. The plant-based diet is also associated with improved performance tests.

Prevalence of metabolic syndrome and its associated factors in first-treatment drug-naïve schizophrenia patients: A large-scale cross-sectional study.

Metabolic syndrome (MetS), a condition that includes several risk factors specific for cardiovascular disease, is commonly detected among patients with schizophrenia (SCZ). This study elucidated the factors contributing to the development and severity of MetS in first-treatment drug-naïve (FTDN) patients with SCZ. The study enrolled 668 individuals with FTDN SCZ, aged 18-49 years, who had no exposure to antipsychotic medications and been hospitalized between February 2017 and June 2022 at the largest psychiatric specialty institution in central China. Patient sociodemographic and general clinical data were collected, and their psychopathology scores and illness severity were assessed using the Positive and Negative Symptom Scale (PANSS) and Clinical Global Impression Scale-Severity of Illness (CGI-SI), respectively. MetS score was calculated to determine the disease severity. The prevalence of MetS among this study population was 10.93%. Binary logistic regression analysis revealed onset age, female sex, total cholesterol, and red blood and white blood cell counts as risk factors for MetS, and deemed free tetraiodothyronine (FT4) and CGI-SI score as protective factors. Multiple linear regression analysis result confirmed older SCZ onset age as a risk factor for elevated MetS score. This study determined the prevalence of MetS in patients with FTDN SCZ and revealed the factors that influence the occurrence and severity of the disease. These findings will allow development of specific prevention and treatment strategies in clinical practice.

Characterization of Green Synthesized Nanoparticles with Anti-diabetic Properties. A Systematic Review.

Plants are used in medicine because they are low-cost, widely available, and have few side effects (compared to pharmacological treatment). Plants have phytocompounds with antidiabetic properties that can be delivered using nanoparticles (NPs). To describe the antidiabetic properties of green synthesized NPs (GSNPs) and their characterization methods. Three databases were searched using the terms "type 2 diabetes mellitus," "antidiabetic effects," "phytochemicals," "plants," and "nanoparticles." Studies describing the antidiabetic effects (in vitro or animal models) of NPs synthesized by plant extracts and characterizing them through UV-Vis spectroscopy, FTIR, XRD, SEM, TEM, and DLS were included. 16 studies were included. In vitro studies reported enzyme inhibition values between 11% (H. polyrhizus) and 100% (A. concinna) for alfa-amylase and between 41.1% (M. zapota) and 100% (A. concinna) for alfa-glucosidase. Animal studies with Wistar Albino rats having diabetes (induced by alloxan or streptozotocin) reported improved blood glucose, triglycerides, total cholesterol, LDL, and HDL after treatment with GSNPs. Regarding characterization, NP sizes were measured with DLS (25-181.5 nm), SEM (52.1-91 nm), and TEM (8.7-40.6 nm). The surface charge was analyzed with zeta potential (-30.7 to -2.9 mV). UV-Vis spectroscopy was employed to confirm the formations of AgNPs (360-460 nm), AuNPs (524-540 nm), and ZnONPs (300-400 nm), and FTIR was used to identify plant extract functional groups. GSNP characterization (shape, size, zeta potential, and others) is essential to know the viability and stability, which are important to achieve health benefits for biomedical applications. Studies reported good enzyme inhibition percentages in in vitro studies, decreasing blood glucose levels and improving lipid profiles in animal models with diabetes. However, these studies had limitations in the methodology and potential risk of bias, so results need careful interpretation.