Anti-Obesity Effects of Dietary d-Allulose and Medium-Chain Triglycerides in High-Fat Diet-Fed Rats

d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycerol. MCTs have been extensively investigated for their ability to reduce body fat accumulation. We previously investigated the anti-obesity effects of a combination of dietary d-allulose and MCT (5% - 13%) in rats;however, we could not confirm the anti-obesity effects of MCT or observed synergetic effects between d-allulose and MCT on body fat loss. We speculated that our previous studies were influenced by the excessive amount of MCT in the diets. Therefore, in this study, we aimed to investigate the anti-obesity effects of the simultaneous intake of d-allulose and MCT in rats fed an obesity-inducing high-fat diet with a low amount of MCTs (2%). Thirty-two male Wistar rats (3-week-old) were randomly divided into four groups: control, d-allulose, MCT, and d-allulose + MCT groups. Rats in each group were fed ad libitum on a control (no d-Allulose or MCT), 5% d-allulose, 2% MCT, or 5% d-allulose + 2% MCT diets for 16 weeks. Abdominal adipose tissue weights were significantly lower in the d-allulose diet group than in the control group, whereas no differences were observed between results of the MCT-supplemented groups. The total body fat mass was significantly lower in the d-allulose and MCT diet groups than in the control group, but no differences were observed between the MCT-supplemented groups. These results suggested that anti-obesity effects of dietary d-allulose were observed, and the effects of dietary MCTs were weaker than those of d-allulose. Moreover, we confirmed the interaction between dietary d-allulose and MCT on indicators of obesity. Interestingly, their effects were not synergistic, as MCT supplementation offset the anti-obesity effects of dietary d-allulose. However, the specific mechanisms underlying those effects remain unknown, warranting further investigation.

Effect of medium-chain triglycerides on growth performance, nutrient digestibility,plasma metabolites and antioxidant capacity in weanling pigs

The aim of this study was to investigate the effect of medium-chain triglycerides(MCTs) on growth performance, nutrient digestibility, plasma metabolites and antioxidant capacity in weanling pigs. A total of 160 weanling(Duroc × Landrace x Yorkshire) pigs(age: 21 ± 1 d; body weight: 7.50 ± 0.28 kg) were randomly allotted to 4 treatments, receiving the following diets for 28 d: control diet [containing 3.5%soybean oil(SO)], MCT1 diet(containing 0.7% MCTs and 2.8% SO), MCT2 diet(containing 1.4% MCTs and2.1% SO) and MCT3 diet(containing 2.1% MCTs and 1.4% SO). Dietary inclusion of MCTs improved the average daily gain and feed efficiency(FE) of pigs compared with the control during the first 2 weeks post-weaning(P < 0.05). A similar positive effect was also observed for the overall FE in MCT2 group(P < 0.05). Compared with the control, apparent total tract digestibility(ATTD) of ether extract was improved by MCT2 and MCT3 treatment from day 12-14 post-weaning(P < 0.05). In addition, MCT2 treatment also exerted a beneficial effect on the ATTD of dry matter(P < 0.05). The increased total protein concentration and decreased urea nitrogen and malondialdehyde levels of plasma were observed in both MCT2 and MCT3 groups on day 14 post-weaning(P < 0.05). In conclusion, MCTs could improve growth performance, nutrients utilization, and antioxidant ability of weanling piglets.

Chemical structures,analytical approaches and toxicological effects of oxidative derivatives of triglycerides as potential hazards in lipid thermal processing:A review

There is an increasing attention on oxidative derivatives of triglycerides,a group of potential thermal processing induced food toxicants,which are formed during the thermal processing of food lipids.This review aims to summarize current knowledge about their formation mechanisms,detection approaches,and toxicology impacts.Oxidative derivatives of triglycerides are generated through the oxidation,cyclization,polymerization,and hydrolysis of triglycerides under high-temperature and abundant oxygen.The analytical techniques,including GC,HPSEC,MS,^(1)H-NMR were discussed in analyzing these components.In addition,their toxic effects on human health,including effects on the liver,intestines,cardiovascular system,immune system,and metabolism were elucidated.Information in this review could be used to improve the understanding of oxidative derivatives of triglycerides and ultimately improve academic and industrial strategies for eliminating these compounds in thermal processing food systems.

Medium-Chain Triglyceride Activated Brown Adipose Tissue and Induced Reduction of Fat Mass in C57BL/6J Mice Fed High-fat Diet

Objective To investigate activation of brown adipose tissue （BAT） stimulated by medium-chain triglyceride （MCT）. Methods 30 Male C57BL/6J obese mice induced by fed high fat diet （HFD） were divided into 2 groups, and fed another HFD with 2% MCT or long-chain triglyceride （LCT） respectively for 12 weeks. Body weight, blood biochemical variables, interscapular brown fat tissue （IBAT） mass, expressions of mRNA and protein of beta 3-adrenergic receptors （β3-AR）, uncoupling protein-1 （UCP1）, hormone sensitive lipase （HSL）, protein kinase A （PKA）, and adipose triglyceride lipase （ATGL） in IBAT were measured. Results Significant decrease in body weight and body fat mass was observed in MCT group as compared with LCT group （P〈O.05） after 12 weeks. Greater increases in IBAT mass was observed in MCT group than in LCT group （P〈O.05）. Blood TG, TC, LDL-C in MCT group were decreased significantly, meanwhile blood HDL-C, ratio of HDL-C/LDL-C and norepinephrine were increased markedly. Expressions of mRNA and protein of β3-AR, UCP1, PKA, HSL, ATGL in BAT were greater in MCT group than in LCT group （P〈O.05）. Conclusion Our results suggest that MCT stimulated the activation of BAT, possible via norepinephrine pathway, which might partially contribute to reduction of the body fat mass in obese mice fed high fat diet.

The Ability of Baseline Triglycerides and Total Cholesterol Concentrations to Predict Incidence of Type 2 Diabetes Mellitus in Chinese Men and Women:A Longitudinal Study in Qingdao, China

Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aimed to evaluate the ability of TG and TC to predict T2DM incidence.Methods Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012–2015.TG,TC,and T2DM status were measured.Cox proportional hazards models were used to estimate the association between TG,TC,and T2DM incidence.The receiver operating characteristic(ROC)curve was used to evaluate the ability of TG and TC to identify T2DM participants.Results The incidence of T2DM significantly increased with TG in women and TC in both men and women(Ptrend<0.05).Univariate Cox regression indicated that higher TG{borderline high TG[hazards ratio(HR):2.05;95%confidence interval(CI):1.40,3.00]and hypertriglyceridemia[HR:2.64;95%CI:1.68,4.15]}and TC[hypercholesterolemia(HR:2.05;95%CI:1.43,2.95)]were significantly associated with increased risk of T2DM incidence in women but not in men.Multivariate Cox regression showed that hypertriglyceridemia in women(HR:1.78,95%CI:1.07,2.97),borderline high TC in men(HR:1.61,95%CI:1.04,2.48),and hypercholesterolemia in women(HR:1.68,95%CI:1.81,2.61)had a higher significant risk of T2DM incidence.The optimal cutoff values of TG were>1.15 and>1.23 mmol/L in men and women,respectively.For TC,they were>5.17 and>5.77 mmol/L in men and women,respectively.The area under the ROCs of TG and TC were 0.54(0.51–0.57)and 0.55(0.52–0.58),respectively,in men,and 0.60(0.58–0.62)and 0.59(0.56–0.61),respectively,in women.Conclusion Elevated TG and TC were risk factors for T2DM incidence.However,no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women.Hence,TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.

The Importance of Systemic Balance in Safeguarding Health: A Randomized Double-Blind Clinical Trial on VLDL, Triglycerides, Free T3, Leptin, Ghrelin, Cortisol and Visceral Adipose Tissue

The purpose of this clinical trial was to delineate some of the negative consequences of high BMI on health and explore the possibility of a solution. We analysed the blood test results of nine overweight adults with sedentary lifestyles, and an average BMI of 32.23. Results revealed a statistically significant reduction of visceral adipose tissue, very-low density lipoprotein (VLDL), and triglycerides. Testosterone, leptin, IGF-1 and Free T3 increased within the normal range, juxtaposed by cortisol and ghrelin that declined, but without dipping into abnormality. These findings have important implications during the COVID-19 pandemic, where optimal immunity is deemed necessary in limiting susceptibility to the virus. Recent research indicates that weight gain often escalates vulnerability to respiratory track disturbances, cardiovascular disease (CVD) and diabetes. Consequently, pre-existing conditions increase COVID-19 mortality rates. CVD and diabetes emerge out of hormonal imbalances that involve Free T3, leptin, ghrelin, testosterone, and cortisol. Physical training is decidedly the most acclaimed solution, yet, the least implemented one, due to procrastination, or demoralization after investing constant exhaustive effort with no immediately visible physical change. COVID-19 confinement exacerbates the tendency for inactivity, and promotes stress-eating behaviours. Moreover, strenuous exercise, necessary for visceral fat reduction, results in a negative cortisol/testosterone relationship that provokes caloric consumption and inflammation. Offering an alternative to exercise that effectively improves health, boosts metabolism, and controls appetite, may serve as a proactive, and preventive method that can safeguard health.

Z-SCAN TECHNIQUE FOR MEASUREMENT OF TOTAL CHOLESTEROL AND TRIGLYCERIDES IN BLOOD

The measurement of cholesterol and triglycerides in blood by Z-scan technique is proposed.The nonlinear refractive index of cholesterol and triglycerides was found to vary linearly with concentration.Hence by calculating the nonlinear refractive index it is possible to measure their concentration in the sample.These measured values are found in equivalence with conventional colorimetric method.

Rapid Decrease and Subsequent Increase in the Serum Triglycerides Accompanied by CD36 Transcript Increase in an Acute Stress Mice Model

In this article, we report the changes in serum triglyceride (TG) levels that occurred during repeated tail blood sampling using a mouse restrainer. We used three groups of mice, namely, “PBS-restrained” “PBS-unrestrained” and “mock-restrained”. The mice in the PBS-restrained and PBS-unrestrained groups were intraperitoneally (i.p.) injected with 100 mL PBS and tail blood sampling was performed at 1, 5, 8, 24, and 48 h after i.p. injection. For the mock-restrained group, no i.p. injection was performed whereas the subsequent tail blood sampling was similarly performed. During the tail blood sampling, the mice of the two “restrained” groups were placed inside the restrainer designed from an open-ended 50 mL conical tube. The blood from the mice in the PBS-unrestrained group mice was sampled from the tail held by the operator’s hands while being allowed to move on a stage. Strikingly, in all of the three groups, the serum TG level initially decreased to remarkably low levels (approximately 30 mg/dL) after several blood samplings were performed over 8 h. This decrease was followed by a 2 - 3-fold increase in the levels relative to that in the control mice in the subsequent 24 - 48 h time period. We concluded that the acute stress associated with blood sampling caused alterations in TG levels. Serum levels of free fatty acid showed only modest changes. Changes in TG levels were not associated with serum corticosterone levels but with a dramatic increase in CD36 transcript levels in the liver. The relevance of this finding to the previously reported release of lipoprotein lipase (LPL) from white fatty tissue into the plasma during acute stress is also discussed.

Triglycerides Isolated from <i>Streptomyces</i>sp. ZZ035 and Their Nuclear Magnetic Resonance Spectroscopic Characters

Streptomyces sp. ZZ035 isolated from a folk medicinal soil sample in China showed remarkable antimicrobial activities. During the isolation of secondary metabolites, a white crystal powder (1) was isolated from the broth of this strain. Its nuclear magnetic resonance (NMR) and infrared (IR) spectra indicated that it was a complex composed of triglycerides. Next, six C15-17 long- chain fatty acids derived from these triglycerides were respectively identified as n-pentadecanoyl, 12-methyltetradecanoyl, 14-methyl pentadecanoyl, palmitoyl, 15-methyl hexadecanoyl and 14-methyl hexadecanoyl using the gas chromatography-mass spectroscopy (GC-MS) technology. Finally, the 13C and 1H assignments of 1 were achieved through the analyses of NMR data. Based on above, their detailed NMR spectroscopic elucidation and meticulous 13C, 1H assignments, especially the split peaks and coupling correlation of protons attached on the glycerol carbons, were performed for distinguishing triglycerides from other glycerides and for the identification of the long-chain fatty acids, and which would be helpful to the qualitative and quantitative analyses of tri-, di-and mono-glycerides.

Production of mono-, di-, and triglycerides from waste fatty acids through esterification with glycerol

Currently monoglyceride and diglyceride are representing important products, as they have numerous applications such as modifying agents in food and pharmaceutical industries. In this work, the production of these economically value added compounds by estrifying the fatty acids with the glycerol is presented. Effects of various reaction parameters were optimized to obtain high yield of mono, di- and triglycerids. The effects of temperature (180℃ to 260℃), ZnCl2 catalyst concentration (0.1%, 0.2%, 0.3%), glycerol to fatty acids molar ratio (1:1, 1:2, 1:3, 3:1), agitation speeds (200, 500, 1000 rpm), type of reaction system (opened and closed) and type of fatty acids including oleic and palmatic acids on esterification efficiency of fatty acids were investigated. The optimum conditions of esterification reaction were at temperature 195℃, molar ratio 1:1, amount of catalyst 0.3% Zncl2, and agitation 500 rpm. Analysis of yield showed that at the optimum conditions mondi and triglycerids were produced in high purity, up to 99%. Infrared spectroscopy IR and thin layer chromatograph TLC proved that the final product contains mono, di- and triglycerides.

A Study of Correlation of Serum Chromium Level with Glycosylated Haemoglobin (HbA1c), Total Cholesterol and Triglycerides, among Type 2 Diabetes Patients

Background: Diabetes mellitus is a common disease and it is a major cause of morbidity;several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to control diabetes mellitus and metabolism of carbohydrate, lipid and protein. Objective: The purpose of this study was to understand the relationship between serum chromium, with HbA1c, Total cholesterol and Triglycerides among type 2 diabetes patients among diabetic patients. Methodology: This is cross-sectional study done in Jabber Abu Ezz Centre for treatment and care of diabetics in Khartoum—Sudan. Four hundred subjects were enrolled in this study;one hundred subjects were normal healthy as control group, and three hundred subjects diabetic patient type 2 as test group;demographic and biochemical data were collected;serum chromium, Glycosylated Haemoglobin (HbA1c), Total cholesterol Triglycerides, were determined by using NYCOCARD READER II, spectrophotometer (Biosystem 310) and spectrophotometer 210-VGP. Result: In this study there is significant parameters level means of FBS HbA1c, Total Cholesterol, Triglycerides and Chromium of the test groups when compared with healthy control groups subjects (P = 0.001, 0.018, 0.01, 0.011, 0.004), respectively. Significant negative correlation is between FBS, HbA1c, Total Cholesterol, Triglycerides and Chromium (r = ?0.555, P value = 0.003), (r = ?0.668, P value = 0.002), (r = ?0.335, P value = 0.004) and (r = ?0.774, P value = 0.002) respectively. Conclusion: There was significant correlation between serum Chromium level with fasting blood sugaer, Glycosylated Haemoglobin (HbA1c), Total cholesterol and Triglycerides among type 2 diabetes patients.

Fatty Acids and Triglycerides Composition in Uruguayan Cow, Sheep and Goat Cheeses

Adverse health consequences are associated with consumption of so-called trans fatty acids （FAs） generated during chemical hydrogenation processes. Naturally-occurring trans fats, including trans vaccenic acid （TVA） derived from a conjugated isomer of linoleic acid （18：2 cis-9, trans-11）, （CLA） in contrast, are recognized as having potentially beneficial effects on human health. These natural trans FAs are found in fat from dairy products and meat of ruminants, and have distinct effects compared with trans FAs industrially produced. The lipid composition of cheeses depends on the milk used. In this work was determined CLA and TVA content in milk fat of sheep and cow to be 1.4% and 3.2%, respectively, and from goat, 0.7% and 1.8%. Also, differences in CLA and TVA content were found in fat extracted from samples of the same cheese type made from cow＇s milk from the same company but with different production dates during a year. The levels of CLA and TVA found in Uruguayan cheeses were generally higher than levels reported in previous studies with comparable cheeses produced in other countries. Milk fat is well-known to confer specific properties to foods. This in turn will affect the rheology and sensory attributes as food. For this reason, it is of interest to determine the triglyceride （TAG） composition in milk-derived foods. Results show that there are characteristic differences in the TAG composition of the different cheeses. We found minimal differences between cheeses from goat and sheep but found distinct characteristics for TAGs from cow milk-derived cheese.

Progress of Triglyceride Glucose Index in Lesion Severity and Prognosis of Acute Coronary Syndromes

Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of morbidity and mortality. The pivotal role of insulin resistance in the pathogenesis of atherosclerosis, independent of traditional risk factors, has garnered significant interest. Objective: This review aims to synthesize the recent advancements in the utilization of the triglyceride glucose index (TyG index) as a biomarker for assessing the severity and predicting the prognosis of ACS lesions. Methods: A systematic search was conducted across PubMed, Embase, and Scopus databases, incorporating keywords such as “triglyceride glucose index”, “TyG index”, “acute coronary syndrome”, “cardiovascular disease”, “insulin resistance”, “coronary artery calcification”, “SYNTAX score”, “Gensini score”, and “major adverse cardiac events”. Studies were included from the inception of each database up to July 2024. Selection criteria encompassed observational studies, case-control studies, and randomized controlled trials, with a particular emphasis on evaluating the diagnostic and prognostic value of the TyG index in patients with acute coronary syndromes. Ultimately, 46 publications met the inclusion criteria. Data extraction and quality assessment were performed in accordance with established guidelines. Results: Evidence suggests that the TyG index, reflecting insulin resistance, blood glucose, and lipid levels, is significantly associated with lesion severity in ACS, including coronary artery calcification, SYNTAX score, and Gensini score. Moreover, it demonstrates predictive power for major adverse cardiovascular events, underscoring its potential as a valuable tool in clinical decision-making. Conclusion: The review highlights the emerging role of the TyG index in the assessment and prognosis of ACS, advocating for its incorporation into clinical practice as a complement to existing diagnostic modalities. However, the establishment of standardized reference ranges and further validation across diverse populations are warranted to refine its applicability in personalized medicine. The interdisciplinary approach is essential to advance our understanding of the complex interplay between insulin resistance and cardiovascular disease, paving the way for the development of more effective prevention and treatment strategies.

Chaiqin Chengqi Decoction as an adjuvant treatment for mild/moderately severe hypertriglyceridemic acute pancreatitis: A retrospective study

Hypertriglyceridemia is the third leading cause of acute pancreatitis(AP),and its incidence is increasing.Due to its relatively insidious etiology,it is easy to be ignored in the early stages.In China,Chaiqin Chengqi Decoction(CQCQD)has long been employed for treating AP.AIM To evaluate the effectiveness of CQCQD in patients diagnosed with mild/moderately severe hypertriglyceridemic AP(HTG-AP).METHODS In this study,the clinical data of 39 patients with HTG-AP admitted from January 2019 to November 2022 were collected.The changes of blood lipids,gastrointestinal symptoms,and abdominal pain before and after treatment were analyzed and compared between the two groups.RESULTS Twenty patients were treated with the conventional HTG-AP regimen,and 19 patients were additionally treated with CQCQD.After receiving treatment,the triglycerides(TG)level of the CQCQD group was lower than that of the CQCQD group(3.14±0.25 mmol/L vs 4.96±0.47 mmol/L,P<0.01).After 3 d of treatment,the patients in the CQCQD group had more bowel movements than the control group(2.51±0.25 times vs 1.00±0.17 times,P=0.01).The gastrointestinal function of most patients returned to normal,and the acute gastrointestinal injury score was significantly lower than that of the control group(0.11±0.07 vs 0.42±0.11,P<0.01).CONCLUSION In patients with HTG-AP,CQCQD can significantly reduce the TG level,shorten the recovery time of defecation,significantly improve the gastrointestinal function.

On the Impairment of Stress-Induced Changes in Triglyceride Levels via a Sub-Toxic Dose of Unmethylated Cytidine Phosphate Guanosine Oligodinucleotide (a Toll-Like Receptor 9 Ligand)

Changes in lipid metabolism have been implicated in protection against infectious diseases. In the first experiment of this study, we measured clinical lipid parameters in a murine model where the unmethylated cytidine phosphate guanosine (CpG) oligodinucleotide (ODN1826), a Toll-like receptor 9 (TLR9) agonist was administered in combination with D-galactosamine (GalN) that caused relatively liver-specific inflammation and toxicity. In the control mice group injected with phosphate-buffered saline (PBS) (acute psychological stress model associated with blood sampling), the serum triglyceride (TG) levels showed a rapid decrease followed by a rebound at 24 h as we have recently reported. However, such a TG rebound was impaired in the CpG/GalN- and solely CpG-treated groups of mice despite an absence of liver injury based on serum alanine aminotransferase levels in the latter group. Thus, the stress-associated serum TG rebound was abrogated by the injection of a sub-hepatotoxic CpG dose. In the second experiment, we simply measured the hepatic CD36 and SACRB1 (the gene for scavenger receptor B1 (SR-B1)) transcripts after the i.p. administration of PBS, CpG or CpG/GalN. There was a remarkable elevation of hepatic CD36 transcript expression in both the CpG- and CpG/GalN-treated mice at 8 h post-CpG injection whereas the increase in the PBS-treated mice was slower than the former two groups, suggesting that hepatic CD36 transcript expression is more pronounced in the combined stress models than under psychological stress alone. The individual mice data showed that the increase in CD36 expression was accompanied by a reduction in SCARB1 mRNA, showing reciprocal regulation between these two genes. Together with our previously reported findings, these data suggest that, in a murine model combining psychological stress with TLR-triggered hepatic inflammation, the psychological stress facilitates liver uptake of plasma TG (and its components fatty acids), but the subsequent re-esterification and/or release of TG-rich lipoproteins from the liver is impaired due to the concomitant TLR-signaling. We hypothesize that lipid metabolism during acute stress shifts toward an elevated hepatic uptake of lipids due to concomitant TLR signaling, facilitating the clearance of bacterial lipids by the liver.

Assessment of the triglyceride glucose index in adult patients with chronic diarrhea and constipation

BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.

基于三酰甘油葡萄糖指数联合血管弹性指标的绝经后女性高血压患者冠心病发生风险模型开发研究

背景绝经后女性高血压患者是冠心病易发人群,其冠心病患病率与死亡率较绝经前显著升高。本研究在团队前期研究基础上进一步联合糖脂代谢、血管弹性等相关指标诊断绝经后女性高血压患者发生冠心病,以期为临床识别绝经后女性高血压患者的冠心病风险提供新思路。目的探讨三酰甘油葡萄糖(TyG)指数、踝肱指数(ABI)、臂踝脉搏波传导速度(baPWV)、脉压指数(PPI)、动脉硬化指数(AI)联合与绝经后女性高血压患者发生冠心病的相关性及预测价值,构建绝经后女性高血压患者冠心病发生风险的预测模型。方法本研究选取2019—2022年就诊于中日友好医院中西医结合心内科的首次行冠状动脉造影检查的绝经后女性高血压患者,根据冠状动脉造影结果分为冠心病组与非冠心病组。收集患者入院时的TyG指数、ABI、baPWV、PPI、AI等临床资料,采用多因素Logistic回归分析构建绝经后女性高血压患者冠心病发生风险预测模型,并绘制列线图实现模型可视化。采用受试者工作特征(ROC)曲线、校准曲线、临床决策曲线分析(DCA)评价诊断效能。结果本研究共纳入首次行冠状动脉造影的绝经后女性高血压患者300例,其中非冠心病组141例、冠心病组159例。多因素Logistic回归分析结果显示,ABI、baPWV、TyG指数、PPI、AI是绝经后女性高血压患者发生冠心病的影响因素(P<0.05),并根据预测方程绘制列线图。ROC曲线分析结果显示,ABI、baPWV、TyG指数、PPI、AI和联合预测模型预测绝经后女性高血压患者发生冠心病的ROC曲线下面积(AUC)分别为0.662、0.687、0.659、0.700、0.612、0.808(P<0.001),预测模型预测绝经后女性高血压患者冠心病发生风险的灵敏度为0.7806,特异度为0.7410。校准曲线显示预测结果与实际结果具有较好的一致性。DCA曲线表明列线图具有较好的临床实用价值。结论ABI、baPWV、TyG指数、PPI、AI是绝经后女性高血压患者发生冠心病的影响因素,新开发模型可对冠心病风险进行有效预警。

Mechanisms of intrahepatic triglyceride accumulation

Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol intake are the most frequent causes of hepatic steatosis. However, steatosis also often occurs with chronic hepatitis C virus(HCV) infection and is also found in rare but potentially life-threatening liver diseases of pregnancy. Clinical significance and outcome of hepatic triglyceride accumulation are highly dependent on etiology and histological pattern of steatosis. This review summarizes current concepts of pathophysiology of common causes of hepatic steatosis, including non-alcoholic fatty liver disease(NAFLD), alcoholic fatty liver disease, chronic HCV infections, drug-induced forms of hepatic steatosis, and acute fatty liver of pregnancy. Regarding the pathophysiology of NAFLD, this work focuses on the close correlation between insulin resistance and hepatic triglyceride accumulation, highlighting the potential harmful effects of systemic insulin resistance on hepatic metabolism of fatty acids on the one side and the role of lipid intermediates on insulin signalling on the other side. Current studies on lipid droplet morphogenesis have identified novel candidate proteins and enzymes in NAFLD.

Mechanisms of triglyceride metabolism in patients with bile acid diarrhea

Bile acids(BAs) are essential for the absorption of lipids. BA synthesis is inhibited through intestinal farnesoid X receptor(FXR) activity. BA sequestration is known to influence BA metabolism and control serum lipid concentrations. Animal data has demonstrated a regulatory role for the FXR in triglyceride metabolism. FXR inhibits hepatic lipogenesis by inhibiting the expression of sterol regulatory element binding protein 1c via small heterodimer primer activity. Conversely, FXR promotes free fatty acids oxidation by inducing the expression of peroxisome proliferator-activated receptor α. FXR can reduce the expression of microsomal triglyceride transfer protein, which regulates the assembly of very low-density lipoproteins(VLDL). FXR activation in turn promotes the clearance of circulating triglycerides by inducing apolipoprotein C-Ⅱ, very low-density lipoproteins receptor(VLDL-R) and the expression of Syndecan-1 together with the repression of apolipoprotein C-Ⅲ, which increases lipoprotein lipase activity. There is currently minimal clinical data on triglyceride metabolism in patients with bile acid diarrhoea(BAD). Emerging data suggests that a third of patients with BAD have hypertriglyceridemia. Further research is required to establish the risk of hypertriglyceridaemia in patients with BAD and elicit the mechanisms behind this, allowing for targeted treatment.

Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease

Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.However the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.