Low skeletal muscle mass and high visceral adiposity are associated with recurrence of acute cholecystitis after conservative management:A propensity score-matched cohort study

Background:Recurrent acute cholecystitis(RAC)can occur after non-surgical treatment for acute cholecystitis(AC),and can be more severe in comparison to the first episode of AC.Low skeletal muscle mass or adiposity have various effects in several diseases.We aimed to clarify the relationship between RAC and body parameters.Methods:Patients with AC who were treated at our hospital between January 2011 and March 2022 were enrolled.The psoas muscle mass and adipose tissue area at the third lumbar level were measured using computed tomography at the first episode of AC.The areas were divided by height to obtain the psoas muscle mass index(PMI)and subcutaneous/visceral adipose tissue index(SATI/VATI).According to median VATI,SATI and PMI values by sex,patients were divided into the high and low PMI groups.We performed propensity score matching to eliminate the baseline differences between the high PMI and low PMI groups and analyzed the cumulative incidence and predictors of RAC.Results:The entire cohort was divided into the high PMI(n=81)and low PMI(n=80)groups.In the propensity score-matched cohort there were 57 patients in each group.In Kaplan-Meier analysis,the low PMI group and the high VATI group had a significantly higher cumulative incidence of RAC than their counterparts(log-rank P=0.001 and 0.015,respectively).In a multivariate Cox regression analysis,the hazard ratios of low PMI and low VATI for RAC were 5.250(95%confidence interval 1.083-25.450,P=0.039)and 0.158(95%confidence interval:0.026-0.937,P=0.042),respectively.Conclusions:Low skeletal muscle mass and high visceral adiposity were independent risk factors for RAC.

Anthropometric indicators of visceral adiposity as predictors of non-alcoholic fatty liver disease: A review

The objective was to critically analyze studies that evaluated the predictive capacity of indicators of visceral adiposity in non-alcoholic fatty liver disease(NAFLD). The bibliographic research was carried out using the electronic database PubMed, LILACS and SciELO, references of selected articles. Although we found few studies, they have already used several indicators of visceral adiposity as waist circumference, waist-to-hip ratio, waist-to-height ratio, Lipid accumulation product, Body Shape Index, Body Roundness Index and most them were good predictors of NAFLD. Thus, the anthropometric indicators may contribute for the diagnosis of NAFLD in a simple, low-cost and noninvasive way, allowing early therapeutic measures to prevent the evolution to non-alcoholic steatohepatitis.

Adiposity and spinal cord injury

The drastic changes in body composition following spinal cord injury(SCI) have been shown to play a significant role in cardiovascular and metabolic health. The pattern of storage and distribution of different types of adipose tissue may impact metabolic health variables similar to carbohydrate, lipid and bone metabolism. The use of magnetic resonance imaging provides insights on the interplay among different regional adipose tissue compartments and their role in developing chronic diseases. Regional adipose tissue can be either distributed centrally or peripherally into subcutaneous and ectopic sites. The primary ectopic adipose tissue sites are visceral, intramuscular and bone marrow. Dysfunction in the central nervous system following SCI impacts the pattern of distribution of adiposity especially between tetraplegia and paraplegia. The current editorial is focused primarily on introducing different types of adipose tissue and establishing scientific basis to develop appropriate dietary, rehabilitation or pharmaceutical interventions to manage the negative consequences of increasing adiposity after SCI. We have also summarized the clinical implications and future recommendations relevant to study adiposity after SCI.

Measures of Abdominal Adiposity and Risk of Stroke:A Dose-Response Meta-analysis of Prospective Studies

Objective Waist circumference, waist-to-hip ratio and waist-to-height ratio, which are the indicators or measures of abdominal adiposity, have long been hypothesized to increase the risk of stroke; yet evidence accumulated till date is not conclusive. Here, we conducted a dose-response meta-analysis to summarize evidences of the association between these measures of abdominal adiposity and the risk of stroke. Methods PubMed and Web of Science databases were searched from inception to May 2015. Two investigators independently conducted the study selection and data extraction. Dose-response relationships were assessed by the generalized least squares trend estimation, while the summary effect estimates were evaluated by the use of fixed- or random-effect models. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Publication bias of the literature was evaluated using Begg＇s and Egger＇s test. Results Altogether 15 prospective cohort studies were identified in this study. The summary of relative risks （95% confidence intervals） of stroke for the highest versus the lowest categories was 1.28 （1.18-1.40） for waist circumference, 1.32 （1.21-1.44） for waist-to-hip ratio, and 1.49 （1.24-1.78） for waist-to-height ratio. For a 10-cm increase in waist circumference, the relative risk of stroke increased by 10%; for a 0.1-unit increase in waist-to-hip ratio, the relative risk increased by 16%; and for a 0.05-unit increase in waist-to-height ratio, the relative risk increased by 13%. There was evidence of a nonlinear association between waist-to-hip ratio and stroke risk, Pnonlinearity=0.028, Conclusion Findings from our meta-analysis indicated that waist circumference, waist-to-hip ratio, and waist-to-height ratio were positively associated with the risk of stroke, particularly ischemic stroke.

Relationship between abdominal adiposity, cardiovascular fitness, and biomarkers of cardiovascular risk in British adolescents

Background:Puberty is a critical time in the development of overweight and obesity.The aim of this study was to examine relationships between measures of adiposity,cardiovascular fitness,and biomarkers of cardiovascular disease risk in adolescents.Methods:In a cross-sectional study design,129 girls and 95 boys aged 12.9-14.4 years at various stages of puberty were included,along with their mothers(n=217)and fathers(n=207).Anthropometric assessments of adiposity were made,along with cardiovascular physical fitness,using the 20-m shuttle run test,and biomarkers associated with cardiovascular risk,including glucose,insulin,triglyceride,fibrinogen,and C-reactive protein(CRP)concentrations.Results:Waist-to-height ratio values were similar in boys and girls and correlated positively with diastolic blood pressure,insulin,triglyceride,fibrinogen,and CRP concentrations,and inversely with cardiovascular fitness scores.Skinfold thickness measurements were higher in girls.High-molecular-weight adiponectin concentrations were lower in boys than girls,particularly in late puberty,and CRP levels were higher.Cardiovascular fitness,maternal body mass index(BMI),and paternal BMI contributed independently to the variance in waist measurements in girls and boys.Gender,triceps skinfold thickness,and weight-to-height ratio,but not parental BMI,contributed independently to the variance in cardiovascular fitness.Conclusion:There is a relationship between measures of adolescent adiposity and parental weight that involves factors other than cardiovascular fitness.Adolescent boys have relatively more abdominal fat than girls and a tendency to have a proinflammatory profile of biomarkers.These observations suggest that family and social environmental interventions are best undertaken earlier in childhood,particularly among boys.

Two male study groups with adiposity and hypertriglyceridemia were at risk for hypertension and alcohol use declined renal endothelium

Men who attended a Bavarian General Medicine Practice were confidentially invented here. Two male study groups were enrolled to characterize adiposity or hypertriglyceridemia showing that these men were at baseline risk for hypertension [1]. Adverse alcohol consumption mediated dysfunction of renal endothelium as shown here and before [1]. This study found that alcohol use aggravated dyslipidemia, fatty liver disease and critical fasting blood glucose of obese men predicting then late hepatorenal disorders. Overall, two male study groups showed a relevant proportion of men who reported alcohol consumption showing then critical morning urines indicating dysfunction of renal endothelium. The present report looked also at healthy men who reported positive lifestyle behaviour and at men with nonalcohol adiposity and nonalcohol hypertriglyceridemia who then showed normal morning urines indicating functional renal endothelium. Relatively young men at risk were motivated to replace adverse alcohol use by healthy liquids without alcohol and by higher quality of food.

Energy Balance-related Behaviors Are Related to Cardiometabolic Parameters and Predict Adiposity in 8-14-year-old Overweight Chinese Children One Year Later

To identify target energy balance-related behaviors（ERBs）,baseline data from 141overweight or obese schoolchildren（aged 8-14years old）was used to predict adiposity[body mass index（BMI）and fat percentage]one year later.The ERBs included a modified Dietary Approach to Stop Hypertension diet score（DASH score）,leisure-time physical activity（PA,days/week）,and leisure screen time（minutes/day）.Several cardiometabolic variables were measured in the fasting state, including systolic blood pressure （SBP）, diastolic blood pressure （DBP）, blood glucose （GLU）, total cholesterol （TC）, triglycerides （TG）, low-density lipoprotein （LDL-C）, and high-density lipoprotein （HDL-C）.

Occupation, Physical Fitness and Adiposity Markers among Security Guards and Students of Delhi University

Physical fitness and health are reciprocal to each other and examining adiposity is an important parameter to assess physical fitness. The present study examines the relationship between different adiposity markers and physical fitness based on occupation. A cross sectional sample of 82 security guards (mean age: 36.86 ± 8.72) and 43 students (mean age: 23.4 ± 3.86) of Delhi University were studied. Anthropometric measurements (height, body weight, waist and hip circumference) and socio-demographic characteristics were ascertained. Body composition parameters (body fat percentage, fat mass, fat free mass, muscle mass, total body water, bone mass and visceral fat) were assessed by bioelectric-impedance method using Tanita Body Composition Analyzer (BCA). Harvard step test was performed to test the physical fitness using Rapid Fitness Index. Student’s t test was used to compare the physical fitness and adiposity markers between the security guards and the students. ANOVA was used to categorize the level of physical fitness with adiposity markers amongst the two groups. As RFI scores decreased, mean value of body weight, waist circumference, hip circumference, MUAC, fat mass, visceral fat and BMI increased among the security guards showing a trend which indicates that with an increase in adiposity, the tendency to perform physical work decreases. However, no consistent trend as such was observed amongst the students between the RFI categories. Nevertheless, Delhi University students were found to be more physically fit than the security guards that may be attributable to the differences in their leisure time physical activity preferences and occupational workloads besides the underlying genetic, metabolic or dietary influences. Workplace interventions to reduce occupational sitting among the university security guards may boost cardiorespiratory fitness in the long run.

The Association of Visceral Adiposity Index with Insulin Resistance in Adults with Prediabetes

Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m2] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.

The effect of age, gender, level of adiposity and diabetes duration on glycated hemoglobin reduction after anti-diabetic therapy in type-2 diabetic patients

Background: It is established that glycemic control measures involving diet and oral medication reduce glycated hemoglobin concentration (HbA1c) in type-2 diabetic patients. Aim: We aimed to determine whether HbA1c reduction after diabetic treatment is affected by age, gender, level of adiposity and diabetes duration in type-2 diabetic patients. Methods: One hundred and four type-2 diabetic patients participated in a 20-week diabetic control therapy involving oral medication (metformin) and lifestyle intervention (diet). We compared the HbA1c reduction after treatment between the elderly and non-elderly;males and females;overweight/obese and non-overweight/obese;and long-standing and newly diagnosed patients. Results: After the treatment, participants had mean HbA1c reduction of 1.1 ± 1.31% and weight loss of 2.46 ± 1.79 kg. Forty-six (44.2%) of the patients had acceptable HbA1c level of p p p < 0.001), respectively. HbA1c reduction did not indicate significant sex differences. Conclusion: The present findings suggest that treatment criteria for type-2 diabetes should account for the age, level of adiposity and diabetes duration of the patient in order to make optimal therapeutic decisions for the treatment of diabetes mellitus in adults.

Optimal Adiposity Measurement and Risk Stratification in Established Ischaemic Stroke

Background: Prevention strategies post-stroke should target risk factor reduction which includes consideration of weight, diet and lipoprotein profiles. Limited data informs the optimal adiposity measurement post-stroke to target those at highest recurrent risk. This study aims to identify adiposity measurement/s post-stroke that best predict cardiovascular and co-morbid risk. Subjects and Methods: 142 stroke patients (100 males, 42 females;mean age 63 years) participated. Adiposity and metabolic profiles included BMI, waist circumference, waist to height ratio (WHR), triglyceride levels and hypertriglyceridemic waist. The predictive ability of these measures with indices of cardiovascular risk (Cardiovascular Risk Score) and co-morbidity (Charlson’s co-morbidity index) were examined. Results: In hierarchical multiple regression models, age and gender controlled, waist (p = 0.002), triglyceride levels (p = 0.006), BMI and WHR (p = 0.014), uniquely and significantly contributed to the variance in cardiovascular risk, in their models. Only one combination of measures (waist and triglyceride levels) improved the predictive ability of waist in cardiovascular risk stratification (p = 0.001). In men, waist (p = 0.013) and in women triglyceride levels (p = 0.012) performed as the best predictors of cardiovascular risk respectively. No combination of measures was superior to triglyceride levels in women or waist circumference measures in men in predicting cardiovascular risk. With Charlson’s co-morbidity index as the dependent variable, triglyceride levels significantly contributed to variance of the model with age and gender influences controlled (p = 0.047). No combination of measures improved the predictive ability of triglyceride levels for co-morbidity. Conclusion: Waist circumference and triglyceride levels should form a minimum dataset for adiposity when considering cardiovascular and comorbid risk post-stroke.

Effects of Cryofrequence on Localized Adiposity: Case Study

Cryofrequence is the combination of cryotherapy with radiofrequency, which promotes a “thermal shock” to the tissue, working simultaneously to skin flaccidity and localized adiposity. The efficacy of dermatological and hypodermic cryofrequency treatment was evaluated. This study reports the case of a 45-year-old woman with complaints of flaccidity and fat located in the infra-umbilical region in the preoperative period of abdominoplasty. The evaluation was performed before and after treatment through evaluation protocols, ultrasound examinations and histological findings through optic microscopy, microfocal and immunohistochemical analysis. The treatment was performed in 4 sessions, with a weekly application, using the BHS 156 FULL&reg;—BODY HEALTH BRASIL&reg;apparatus, the parameters were temperature of -10&deg;C, power in 70%, duration of 8 minutes. After the surgical procedure, parts of treated and untreated abdominal tissues were removed for evaluation. In the tests performed, significant destruction of adipocytes was detected, with consequent reduction of fat and greater expression of caspase-3 in the treated tissue, being constated the macrophage increase by CD68 expression. There was improvement in flaccidity, evidenced by the significant increase in the number of fibroblasts and inflammatory cells positive for Ki67, bringing more quantity and better quality to the collagen.

Treatment of Edematofibrosclerotic Panniculitis (Cellulite) and of Localised Adiposity with Extracts of Birch, Melilotus, Orthosiphon, Bromelin and Red Vine Leukocyanidine: Results from a Single-Centre Observational Prospective Study

The Edematofibrosclerotic Panniculitis (EFP) and the Localised Adiposity (LA) have controversial pathogenesis and therapy. A single-centre observational study has been performed to assess the potential efficacy, the limitations and the side effects of the medical treatment of EFP and AL by means of a multicomponent nutraceutical product. Fifty female subjects have been enrolled, mean age and BMI of the patients were 46 years and 24.18 respectively. The subjects have been submitted to a two-month treatment with two tablets of a nutraceutical based on extracts of Birch (100 mg), Orthosiphon (100 mg), Red Vine Leukocyanidines (100 mg), Melilotus (5 mg) and Bromelin (150 mg). The patients have been investigated before the treatment and during the treatment (at 30 and 60 days) by means of: a) volumetry of the lower limbs with tape measurement;b) visual analogue scale assessment (VAS) of symptoms such as pain paresthesia/dysesthesia, heaviness, and of the daily diuresis;c) duplex ultrasound evaluation of the thickness of the adipose tissue at the peri-trochanteric level;d) multifrequency segmental bioimpedance (MSB) analysis for the tissue liquid component. Forty-five of the 50 enrolled subjects have completed the study and five patients have discontinued the treatment, four of which due to unexpected personal problems or health problems not related to the treatment itself and one for reporting gastrointestinal disorders (such as constipation/diarrhea) with the nutraceutical intake. At the end of the therapeutical cycle, volumetry of the limbs decreased of 7% (right) and of 6% (left). Pre/post treatment VAS assessment of symptoms showed the following mean figures: heaviness from 5.10 to 0.88;paresthesia/dysesthesia from 0.90 to 0.00;pain from 2.03 to 0.12. Diuresis increased of 31%. Duplex-ultrasound assessment of the subcutaneous adipose layers at the trochanteric level showed a reduction of slightly more than 20% at the end of the treatment in both limbs. L-Dex bioimpedance values have been as follows: 3.97 at the enrolment;1.17 at the end of the treatment (reduction of the subcutaneous tissue fluid content). The present single-centre observational study proved that the tested nutraceutical multicomponent is effective and free of relevant side effects in the treatment of EFP and AL of the lower limbs. Larger cohort studies may possibly confirm the results of this preliminary experience.

Relationship between Adiposity, Low-Density Lipoprotein Particles Size and Cardiovascular Risk among Adult Obese Cameroonians

Background: Despite the evidence about the increasing prevalence of dyslipidemia among adult obese Cameroonians, little is known about the Low-Density Lipoprotein (LDL) particles which influence lipid metabolism and affect cardiovascular status. The present study aims to assess the relationship between adiposity, LDL particles size and cardiovascular risk (CVR) among adult obese Cameroonians. Methods: A cross-sectional study was conducted from September 2015 to March 2016 on apparently healthy adults (n = 1006), aged 20 - 70 years and living in the West and North-West regions of Cameroon. Anthropometric measurements, blood pressure (BP), fasting blood glucose (FBG) and lipid profile markers were analyzed and LDL particle phenotypes (LDL phenotype A;LDL phenotype I;LDL phenotype B) were characterized using small, dense LDL-cholesterol (sdLDL-c) levels. Abdominal fat accumulation (AFA) was defined as waist circumference (WC) ≥ 88 cm (men) and ≥90 cm (women) and the CVR was assessed using Framingham score method. Results: In the overall population, 36.6% were overweight, 33.1% were obese and 69.1% were overweight/obese with AFA. The prevalence of LDL phenotype B was 19.8%, 37.5% and 42.8% respectively in normal-weight, overweight and obese. Among the obese, sdLDL and triglycerides levels correlated significantly with WC (r = 0.768;p Conclusion: Among obese Cameroonians, anthropometric markers of adiposity (BMI and WC) were strongly correlated to LDL phenotype B which was associated with high CVR dependently of AFA. SdLDL particles could exacerbate the CVR in obese Cameroonians subjects.

Association between Chinese visceral adiposity index and risk of cardiometabolic multimorbidity in middle-aged and elderly Chinese population:Evidence from a national longitudinal study

Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.

鼻咽通气管在重度阻塞性睡眠呼吸暂停肥胖儿童术后应用的临床观察

目的探讨鼻咽通气管在重度阻塞性睡眠呼吸暂停(OSA)肥胖儿童术后管理中的临床疗效。方法选取53例扁桃体肥大伴腺样体肥大的重度OSA儿童作为研究对象,随机分为A组38例和B组15例,均使用低温等离子射频消融术切除肥大的扁桃体和腺样体,A组留置鼻咽通气管,B组不留置鼻咽通气管,术后均转至SICU监护观察。记录患儿术后24 h内的最低血氧饱和度(lowest oxygen saturation,LSaO_(2))、SICU留观时间、脱氧时间及血气分析结果等指标并进行分析。结果术后24 h,A组LSaO_(2)为(91.66±1.77)%,B组为(89.8±2.93)%;A组SICU留观时间为(60.97±15.49)h,B组为(80.93±24.26)h;A组脱氧时间为(42.32±10.21)h,B组为(55.8±18.35)h,以上指标差异比较均有统计学意义(t=2.29、2.96、2.69,P均<0.05)。术后12 h、24 h,PO_(2)及PCO_(2)比较,A组异常率低于B组,差异有统计学意义(P均<0.05);术后36 h、48 h,A组异常率低于B组,差异无统计学意义(P均>0.05)。结论重度OSA肥胖儿童术后留置鼻咽通气管,可有效预防呼吸道阻塞或窒息的发生,缩短患儿SICU留观时间,是重度OSA肥胖儿童术后气道管理的有效措施之一。

Nε-carboxymethyl-lysine and inflammatory cytokines,markers and mediators of coronary artery disease progression in diabetes

This editorial refers to the article“Comparative analysis of Nε-carboxymethyllysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients”,published in the recent issue of the World Journal of Diabetes 2023 is based on glucose metabolism,advanced glycation end products(AGEs),inflammation and adiposity on diabetes and coronary artery disease(CAD).This study has included CAD patients who were stratified according to glycosylated hemoglobin higher than 6.5 and sex-matched.A higher prevalence of hypertension,dyslipidemia,and non-vegetarian diet were found in the diabetic group.These risk factors might influence body weight and adiposity and explain the increment of the left atrium.Although this data was not supported by the study.The diet can also explain the non-enzymatic reactions on lipids,proteins,or nucleic acids and consequently an increment of AGEs.These molecules can emit fluorescence.However,one of the non-fluorescent and most abundant AGEs is Nε-carboxymethyl-lysine(CML).Its association with coronary artery stenosis and severity in the diabetic group might suggest its role as a player in CAD progression.Thus,CML,after binding with its receptor(RAGE),can induce calcification cascade through reactive oxygen species and mitogen-activated protein kinase.Moreover,this interaction AGE-RAGE can cause activation of the transcription nuclear factor-kb and induce inflammatory cytokines.It might explain the relationship between CML and pro-inflammatory cytokines in diabetic and CAD patients.Although this is a population from one center,the determination of CML and inflammatory cytokines might improve the diagnosis of severe and progressive CAD.Future and comparative studies among glycosylated hemoglobin,CML,and other AGE levels according to diagnosis and prognosis value might modify the clinical practice.Although these molecules are irreversible,they can act through a specific receptor inducing a signal transduction that might be modulated by inhibitors,antibodies,or siRNA.Further mechanistic studies might improve the development of future preventive therapies for diabetic patients.

Estrogen restores disordered lipid metabolism in visceral fat of prediabetic mice

BACKGROUND Visceral obesity is increasingly prevalent among adolescents and young adults and is commonly recognized as a risk factor for type 2 diabetes.Estrogen[17β-estradiol(E2)]is known to offer protection against obesity via diverse me-chanisms,while its specific effects on visceral adipose tissue(VAT)remain to be fully elucidated.AIM To investigate the impact of E2 on the gene expression profile within VAT of a mouse model of prediabetes.METHODS Metabolic parameters were collected,encompassing body weight,weights of visceral and subcutaneous adipose tissues(VAT and SAT),random blood glucose levels,glucose tolerance,insulin tolerance,and overall body composition.The gene expression profiles of VAT were quantified utilizing the Whole Mouse Genome Oligo Microarray and subsequently analyzed through Agilent Feature Extraction software.Functional and pathway analyses were conducted employing Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses,respectively.RESULTS Feeding a high-fat diet(HFD)moderately increased the weights of both VAT and SAT,but this increase was mitigated by the protective effect of endogenous E2.Conversely,ovariectomy(OVX)led to a significant increase in VAT weight and the VAT/SAT weight ratio,and this increase was also reversed with E2 treatment.Notably,OVX diminished the expression of genes involved in lipid metabolism compared to HFD feeding alone,signaling a widespread reduction in lipid metabolic activity,which was completely counteracted by E2 adminis-tration.This study provides a comprehensive insight into E2's local and direct protective effects against visceral adiposity in VAT at the gene level.CONCLUSION In conclusion,the present study demonstrated that the HFD-induced over-nutritional challenge disrupted the gene expression profile of visceral fat,leading to a universally decreased lipid metabolic status in E2 deficient mice.E2 treatment effectively reversed this condition,shedding light on the mechanistic role and therapeutic potential of E2 in combating visceral obesity.

Team players in the pathogenesis of metabolic dysfunctionsassociated steatotic liver disease:The basis of development of pharmacotherapy

Nutrient metabolism is regulated by several factors.Social determinants of health with or without genetics are the primary regulator of metabolism,and an unhealthy lifestyle affects all modulators and mediators,leading to the adaptation and finally to the exhaustion of cellular functions.Hepatic steatosis is defined by presence of fat in more than 5%of hepatocytes.In hepatocytes,fat is stored as triglycerides in lipid droplet.Hepatic steatosis results from a combination of multiple intracellular processes.In a healthy individual nutrient metabolism is regulated at several steps.It ranges from the selection of nutrients in a grocery store to the last step of consumption of ATP as an energy or as a building block of a cell as structural component.Several hormones,peptides,and genes have been described that participate in nutrient metabolism.Several enzymes participate in each nutrient metabolism as described above from ingestion to generation of ATP.As of now several publications have revealed very intricate regulation of nutrient metabolism,where most of the regulatory factors are tied to each other bidirectionally,making it difficult to comprehend chronological sequence of events.Insulin hormone is the primary regulator of all nutrients’metabolism both in prandial and fasting states.Insulin exerts its effects directly and indirectly on enzymes involved in the three main cellular function processes;metabolic,inflammation and repair,and cell growth and regeneration.Final regulators that control the enzymatic functions through stimulation or suppression of a cell are nuclear receptors in especially farnesoid X receptor and peroxisome proliferator-activated receptor/RXR ligands,adiponectin,leptin,and adiponutrin.Insulin hormone has direct effect on these final modulators.Whereas blood glucose level,serum lipids,incretin hormones,bile acids in conjunction with microbiota are intermediary modulators which are controlled by lifestyle.The purpose of this review is to overview the key players in the pathogenesis of metabolic dysfunction-associated steatotic liver disease(MASLD)that help us understand the disease natural course,risk stratification,role of lifestyle and pharmacotherapy in each individual patient with MASLD to achieve personalized care and target the practice of precision medicine.PubMed and Google Scholar databases were used to identify publication related to metabolism of carbohydrate and fat in states of health and disease states;MASLD,cardiovascular disease and cancer.More than 1000 publications including original research and review papers were reviewed.

Visceral adipose tissue predicts severity and prognosis of acute pancreatitis in obese patients

Acute pancreatitis is a common systemic inflammatory disease, manifested by a spectrum of severity, ranging from mild in the majority of patients to severe acute pancreatitis. Patients with severe acute pancreatitis suffer from severe local and systemic complications and organ failure, leading to a poor prognosis. The early recognition of the severe condition is important to improve prognosis. Obesity has risen in tandem with an increase in the severity of acute pancreatitis in recent years. Studies have revealed that adipose tissue, particularly visceral adipose tissue is associated with the prognosis of acute pancreatitis. This review discussed the role of visceral adipose tissue in obese patients with acute pancreatitis and explored the possible mechanism involved.