BACKGROUND The small intestine is known to play a crucial role in the development and remission of diabetes mellitus(DM).However,the exact mechanism by which mid-small intestinal bypass improves glucose metabolism in ...BACKGROUND The small intestine is known to play a crucial role in the development and remission of diabetes mellitus(DM).However,the exact mechanism by which mid-small intestinal bypass improves glucose metabolism in diabetic rats is not fully understood.AIM To elucidate the mechanisms by which mid-small intestinal bypass improves glucose metabolism.METHODS Streptozotocin(STZ)was used to induce DM in Sprague-Dawley(SD)rats at a dose of 60 mg/kg.The rats were then randomly divided into two groups:The mid-small intestine bypass(MSIB)group and the sham group(underwent switch laparotomy).Following a 6-wk recovery period post-surgery,the rats underwent various assessments,including metabolic parameter testing,analysis of liver glycogen levels,measurement of key gluconeogenic enzyme activity,characterization of the gut microbiota composition,evaluation of hormone levels,determination of bile acid concentrations,and assessment of the expression of the intestinal receptors Takeda G protein-coupled receptor 5 and farnesoid X receptor.RESULTS The MSIB group of rats demonstrated improved glucose metabolism and lipid metabolism,along with increased hepatic glycogen content.Furthermore,there was a decrease in the expression of the key gluconeogenic enzymes phosphoenolpyruvate carboxykinase 1 and glucose-6-phosphatase.Importantly,the MSIB group exhibited a substantial increase in the abundances of intestinal Lactobacillus,Clostridium symbiosum,Ruminococcus gnavus,and Bilophila.Moreover,higher levels of secondary bile acids,such as intestinal lithocholic acid,were observed in this group.Remarkably,the changes in the gut microbiota showed a significant correlation with the expression of key gluconeogenic enzymes and glucagon-like peptide 1(GLP-1)at 6 wk postoperatively,highlighting their potential role in glucose regulation.These findings highlight the beneficial effects of mid-small intestine bypass on glucose metabolism and the associated modulation of the gut microbiota.CONCLUSION The findings of this study demonstrate that the introduction of postoperative intestinal Clostridium symbiosum in the mid-small intestine contributes to the enhancement of glucose metabolism in nonobese diabetic rats.This improvement is attributed to the increased inhibition of hepatic gluconeogenesis mediated by GLP-1,resulting in a favorable modulation of glucose homeostasis.展开更多
AIM:To determine if subclinical abnormal glucose tolerance(SAGT)has influence on survival of non-diabetic patients with liver cirrhosis.METHODS:In total,100 patients with compensatedliver cirrhosis and normal fasting ...AIM:To determine if subclinical abnormal glucose tolerance(SAGT)has influence on survival of non-diabetic patients with liver cirrhosis.METHODS:In total,100 patients with compensatedliver cirrhosis and normal fasting plasma glucose were included.Fasting plasma insulin(FPI)levels were measured,and oral glucose tolerance test(OGTT)was performed.According to OGTT results two groups of patients were formed:those with normal glucose tolerance(NGT)and those with SAGT.Patients were followed every three months.The mean follow-up was932 d(range of 180-1925).Survival was analyzed by the Kaplan-Meyer method,and predictive factors of death were analyzed using the Cox proportional hazard regression model.RESULTS:Of the included patients,30 showed NGT and70 SAGT.Groups were significantly different only in age,INR,FPI and HOMA2-IR.Patients with SAGT showed lower 5-year cumulated survival than NGT patients(31.7%vs 71.6%,P=0.02).Differences in survival were significant only after 3 years of follow-up.SAGT,Child-Pugh B,and high Child-Pugh and Model for EndStage Liver Disease(MELD)scores were independent predictors of death.The causes of death in 90.3%of cases were due to complications related to liver disease.CONCLUSION:SAGT was associated with lower survival.SAGT,Child-Pugh B,and high Child-Pugh and MELD scores were independent negative predictors of survival.展开更多
We recently described the training of the passage from scheduled to demanded meals in infants and adults. Subjects reduced energy intake by subjectively abolishing conditioned meals and by allowing intake only after d...We recently described the training of the passage from scheduled to demanded meals in infants and adults. Subjects reduced energy intake by subjectively abolishing conditioned meals and by allowing intake only after demand by the infant or after hunger perception by the adult (Initial Hunger Meal Pattern;IHMP). Conditioned meals were those scheduled and/or presented to the infant as well to the adult by sight, smell, mentioning, gesturing or simply at a fixed mealtime. During IHMP instead, meals were suspended until the first infant’s demand or until an adult’s self-noticing arousal of hunger. IHMP was checked by measuring blood glucose before three meals per day (MBG) and was associated with significant decreases in diary-reported energy-intake, MBG, glycated hemoglobin, body weight, insulin AUC in glucose tolerance tests and in days with diarrhea as compared to randomized control subjects who maintained conditioned meals. Although generalized, conditioned eating is a modern aberration that is associated with development of insulin resistance and overall inflammation. These associations are well demonstrated independently from the implicated mechanism. A state of Overall Subclinical Inflammation greatly increases cell and DNA replications and replication errors. After decades of DNA errors, oncogenic cells arise and cumulate. A prevention of malignancies is possible by interrupting the development of conditioned eating, insulin resistance and associated overall inflammation.展开更多
AIM:To study frequency of blood groups,prevalence of sickle-cell anemia trait and glucose-6-phosphate dehydrogenase deficiency(G6PD),among consanguineous Yansi tribe.METHODS:A total of 525 blood samples were collected...AIM:To study frequency of blood groups,prevalence of sickle-cell anemia trait and glucose-6-phosphate dehydrogenase deficiency(G6PD),among consanguineous Yansi tribe.METHODS:A total of 525 blood samples were collected,of which 256 among the Yansi population,and269 for the unrelated control group in the Bandunduprovince of Democratic Republic of Congo.Blood group antigens were determined in the following systems:ABO,Rh,Kell,Duffy,Kidd and MNS.Blood grouping and extended phenotype tests were performed according to standard immunohematological procedures.Spot tests and tandem mass spectrometry were used respectively for the assessment of G6PD and sickle-cell anemia trait.RESULTS:The frequency of ABO phenotypes conformed to the following order O>A>B>AB with notably 62.5%,23.8%,12.1%and 1.6%for the Yansi,and 54.6%,27.5%,14.1%and 3.7%for the unrelated control group,respectively(P=0.19).As for the Rh phenotypes,the most frequent were cc D.ee,cc D.Ee,Cc D.ee,corresponding to 71.5%,12.1%and 12.1%for the Yansi,and 70.6%,15.6%and 8.2%,for the unrelated control group(P=0.27).The frequency of MN and Ss phenotypes were statistically different between groups(P=0.0021 and P=0.0006).G6PD was observed in 11.3%of subjects in the Yansi group,and in 12.4%of controls(P=0.74).The sickle-cell anemia trait was present in 22.4%of Yansi subjects and 17.8%in the control group(P=0.24).Miscarriages and deaths in young age were more common among Yansi people.CONCLUSION:This study shows a significant difference in MNS blood group distribution between the Yansi tribe and a control population.The distribution of other blood groups and the prevalence of hemoglobinopathies did not differ in the Yansi tribe.展开更多
This study aims to enhance the healthcare services for diabetic patients in the administrative region of Kindia by suggesting dietary interventions to assist diabetics in better managing their condition. Conducted ove...This study aims to enhance the healthcare services for diabetic patients in the administrative region of Kindia by suggesting dietary interventions to assist diabetics in better managing their condition. Conducted over a period of six months, from February 18 to July 18, 2021, this prospective and descriptive cross-sectional study involved 220 diabetic patients. Among these, 48 patients (22%) maintained balanced glucose levels (2 g/l). Positive glycosuria was observed in 54% of the patients, whereas 46% demonstrated normal glycosuria. An analysis of urinary parameters revealed that 15% of the patients had abnormal Ketone Bodies. Normal HbA1c levels (9%) HbA1c levels. Hematological assessments indicated significant variation: 56% of the patients had low hemoglobin levels, 4% suffered from hyper-eosinophilia, and 1% each from hyper-basophilia and hyper-hemoglobinemia. The anemic profile was characterized as mild anemia in 75%, moderate anemia in 20%, and severe anemia in 5%. Furthermore, 25% of patients were affected by Microcytic anemia and 75% by Normocytic anemia. Demographically, women constituted 65% of the study group compared to 35% of men. The most represented age bracket was 41 to 60 years, accounting for 52% of the patients, while those between 61 and 80 years comprised 36%. Every district in Kindia was impacted by diabetes.展开更多
Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World H...Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World Health Organization (WHO) has estimated that, at the end of 2022, 1 out of every 8 individuals were obese, and that the global adult obesity rates have over doubled since 1990, even as the adolescent obesity rates have quadrupled. Thus, as of 2022, nearly 2.5 billion adults, aged 18 years and above, were overweight, with 890 million being obese. Obesity and overweight incidence rate has been gradually increasing over the years, presenting significant challenges to the healthcare systems throughout the globe. In this regard, the objective of this systematic review was to evaluate the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. Methodology: To attain the above stated study objective, a systematic evaluation of previous studies was carried out, particularly studies that assessed the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. The authors have used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the selection of eligible studies for inclusion in the study. Results: The findings indicate that lifestyle interventions resulted in 5% - 10% weight reduction and significant improvements in metabolic indicators, while pharmacotherapy (GLP-1 receptor agonists) achieved up to 15% weight reduction and considerable metabolic health benefits. Further, comparative studies show lifestyle modifications provide overall health benefits, while medication is necessary for non-responders. Conclusion: Individualized treatment strategies are crucial, and further research is needed on long-term consequences and combination therapies.展开更多
“健康和疾病的发育起源”(Developmental Origins of Health and Disease,DOHaD)学说认为,体内外环境可以通过影响胚胎/胎儿的遗传和表观遗传影响其发育轨迹,并对远期健康和疾病风险产生深远影响,其研究窗口目前已进一步扩展到配子发...“健康和疾病的发育起源”(Developmental Origins of Health and Disease,DOHaD)学说认为,体内外环境可以通过影响胚胎/胎儿的遗传和表观遗传影响其发育轨迹,并对远期健康和疾病风险产生深远影响,其研究窗口目前已进一步扩展到配子发生期。配子发生和成熟需要数十年的时间,因此与胚胎和胎儿发育相比更容易受到较长暴露时间的潜在损害。糖尿病是威胁人类健康的重大慢性病,本文阐述了糖尿病的配子起源性,包括精子源性和卵子源性糖代谢异常的临床和基础研究进展,重点关注了表观遗传学机制在其中的作用,并展望了未来的研究方向。展开更多
基金National Natural Science Foundation of China,No.82060161,81960154,and 81760156Jiangxi Provincial Youth Science Foundation,No.2018ACB21040+1 种基金Natural Science Foundation of Jiangxi Province,No.20212BAB206020and Foundation of Health commission of Jiangxi Province,No.SKJP220225830.
文摘BACKGROUND The small intestine is known to play a crucial role in the development and remission of diabetes mellitus(DM).However,the exact mechanism by which mid-small intestinal bypass improves glucose metabolism in diabetic rats is not fully understood.AIM To elucidate the mechanisms by which mid-small intestinal bypass improves glucose metabolism.METHODS Streptozotocin(STZ)was used to induce DM in Sprague-Dawley(SD)rats at a dose of 60 mg/kg.The rats were then randomly divided into two groups:The mid-small intestine bypass(MSIB)group and the sham group(underwent switch laparotomy).Following a 6-wk recovery period post-surgery,the rats underwent various assessments,including metabolic parameter testing,analysis of liver glycogen levels,measurement of key gluconeogenic enzyme activity,characterization of the gut microbiota composition,evaluation of hormone levels,determination of bile acid concentrations,and assessment of the expression of the intestinal receptors Takeda G protein-coupled receptor 5 and farnesoid X receptor.RESULTS The MSIB group of rats demonstrated improved glucose metabolism and lipid metabolism,along with increased hepatic glycogen content.Furthermore,there was a decrease in the expression of the key gluconeogenic enzymes phosphoenolpyruvate carboxykinase 1 and glucose-6-phosphatase.Importantly,the MSIB group exhibited a substantial increase in the abundances of intestinal Lactobacillus,Clostridium symbiosum,Ruminococcus gnavus,and Bilophila.Moreover,higher levels of secondary bile acids,such as intestinal lithocholic acid,were observed in this group.Remarkably,the changes in the gut microbiota showed a significant correlation with the expression of key gluconeogenic enzymes and glucagon-like peptide 1(GLP-1)at 6 wk postoperatively,highlighting their potential role in glucose regulation.These findings highlight the beneficial effects of mid-small intestine bypass on glucose metabolism and the associated modulation of the gut microbiota.CONCLUSION The findings of this study demonstrate that the introduction of postoperative intestinal Clostridium symbiosum in the mid-small intestine contributes to the enhancement of glucose metabolism in nonobese diabetic rats.This improvement is attributed to the increased inhibition of hepatic gluconeogenesis mediated by GLP-1,resulting in a favorable modulation of glucose homeostasis.
基金Supported by Gastroenterology and Endocrinology Services of the University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México
文摘AIM:To determine if subclinical abnormal glucose tolerance(SAGT)has influence on survival of non-diabetic patients with liver cirrhosis.METHODS:In total,100 patients with compensatedliver cirrhosis and normal fasting plasma glucose were included.Fasting plasma insulin(FPI)levels were measured,and oral glucose tolerance test(OGTT)was performed.According to OGTT results two groups of patients were formed:those with normal glucose tolerance(NGT)and those with SAGT.Patients were followed every three months.The mean follow-up was932 d(range of 180-1925).Survival was analyzed by the Kaplan-Meyer method,and predictive factors of death were analyzed using the Cox proportional hazard regression model.RESULTS:Of the included patients,30 showed NGT and70 SAGT.Groups were significantly different only in age,INR,FPI and HOMA2-IR.Patients with SAGT showed lower 5-year cumulated survival than NGT patients(31.7%vs 71.6%,P=0.02).Differences in survival were significant only after 3 years of follow-up.SAGT,Child-Pugh B,and high Child-Pugh and Model for EndStage Liver Disease(MELD)scores were independent predictors of death.The causes of death in 90.3%of cases were due to complications related to liver disease.CONCLUSION:SAGT was associated with lower survival.SAGT,Child-Pugh B,and high Child-Pugh and MELD scores were independent negative predictors of survival.
文摘We recently described the training of the passage from scheduled to demanded meals in infants and adults. Subjects reduced energy intake by subjectively abolishing conditioned meals and by allowing intake only after demand by the infant or after hunger perception by the adult (Initial Hunger Meal Pattern;IHMP). Conditioned meals were those scheduled and/or presented to the infant as well to the adult by sight, smell, mentioning, gesturing or simply at a fixed mealtime. During IHMP instead, meals were suspended until the first infant’s demand or until an adult’s self-noticing arousal of hunger. IHMP was checked by measuring blood glucose before three meals per day (MBG) and was associated with significant decreases in diary-reported energy-intake, MBG, glycated hemoglobin, body weight, insulin AUC in glucose tolerance tests and in days with diarrhea as compared to randomized control subjects who maintained conditioned meals. Although generalized, conditioned eating is a modern aberration that is associated with development of insulin resistance and overall inflammation. These associations are well demonstrated independently from the implicated mechanism. A state of Overall Subclinical Inflammation greatly increases cell and DNA replications and replication errors. After decades of DNA errors, oncogenic cells arise and cumulate. A prevention of malignancies is possible by interrupting the development of conditioned eating, insulin resistance and associated overall inflammation.
文摘AIM:To study frequency of blood groups,prevalence of sickle-cell anemia trait and glucose-6-phosphate dehydrogenase deficiency(G6PD),among consanguineous Yansi tribe.METHODS:A total of 525 blood samples were collected,of which 256 among the Yansi population,and269 for the unrelated control group in the Bandunduprovince of Democratic Republic of Congo.Blood group antigens were determined in the following systems:ABO,Rh,Kell,Duffy,Kidd and MNS.Blood grouping and extended phenotype tests were performed according to standard immunohematological procedures.Spot tests and tandem mass spectrometry were used respectively for the assessment of G6PD and sickle-cell anemia trait.RESULTS:The frequency of ABO phenotypes conformed to the following order O>A>B>AB with notably 62.5%,23.8%,12.1%and 1.6%for the Yansi,and 54.6%,27.5%,14.1%and 3.7%for the unrelated control group,respectively(P=0.19).As for the Rh phenotypes,the most frequent were cc D.ee,cc D.Ee,Cc D.ee,corresponding to 71.5%,12.1%and 12.1%for the Yansi,and 70.6%,15.6%and 8.2%,for the unrelated control group(P=0.27).The frequency of MN and Ss phenotypes were statistically different between groups(P=0.0021 and P=0.0006).G6PD was observed in 11.3%of subjects in the Yansi group,and in 12.4%of controls(P=0.74).The sickle-cell anemia trait was present in 22.4%of Yansi subjects and 17.8%in the control group(P=0.24).Miscarriages and deaths in young age were more common among Yansi people.CONCLUSION:This study shows a significant difference in MNS blood group distribution between the Yansi tribe and a control population.The distribution of other blood groups and the prevalence of hemoglobinopathies did not differ in the Yansi tribe.
文摘This study aims to enhance the healthcare services for diabetic patients in the administrative region of Kindia by suggesting dietary interventions to assist diabetics in better managing their condition. Conducted over a period of six months, from February 18 to July 18, 2021, this prospective and descriptive cross-sectional study involved 220 diabetic patients. Among these, 48 patients (22%) maintained balanced glucose levels (2 g/l). Positive glycosuria was observed in 54% of the patients, whereas 46% demonstrated normal glycosuria. An analysis of urinary parameters revealed that 15% of the patients had abnormal Ketone Bodies. Normal HbA1c levels (9%) HbA1c levels. Hematological assessments indicated significant variation: 56% of the patients had low hemoglobin levels, 4% suffered from hyper-eosinophilia, and 1% each from hyper-basophilia and hyper-hemoglobinemia. The anemic profile was characterized as mild anemia in 75%, moderate anemia in 20%, and severe anemia in 5%. Furthermore, 25% of patients were affected by Microcytic anemia and 75% by Normocytic anemia. Demographically, women constituted 65% of the study group compared to 35% of men. The most represented age bracket was 41 to 60 years, accounting for 52% of the patients, while those between 61 and 80 years comprised 36%. Every district in Kindia was impacted by diabetes.
文摘Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World Health Organization (WHO) has estimated that, at the end of 2022, 1 out of every 8 individuals were obese, and that the global adult obesity rates have over doubled since 1990, even as the adolescent obesity rates have quadrupled. Thus, as of 2022, nearly 2.5 billion adults, aged 18 years and above, were overweight, with 890 million being obese. Obesity and overweight incidence rate has been gradually increasing over the years, presenting significant challenges to the healthcare systems throughout the globe. In this regard, the objective of this systematic review was to evaluate the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. Methodology: To attain the above stated study objective, a systematic evaluation of previous studies was carried out, particularly studies that assessed the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. The authors have used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the selection of eligible studies for inclusion in the study. Results: The findings indicate that lifestyle interventions resulted in 5% - 10% weight reduction and significant improvements in metabolic indicators, while pharmacotherapy (GLP-1 receptor agonists) achieved up to 15% weight reduction and considerable metabolic health benefits. Further, comparative studies show lifestyle modifications provide overall health benefits, while medication is necessary for non-responders. Conclusion: Individualized treatment strategies are crucial, and further research is needed on long-term consequences and combination therapies.
文摘“健康和疾病的发育起源”(Developmental Origins of Health and Disease,DOHaD)学说认为,体内外环境可以通过影响胚胎/胎儿的遗传和表观遗传影响其发育轨迹,并对远期健康和疾病风险产生深远影响,其研究窗口目前已进一步扩展到配子发生期。配子发生和成熟需要数十年的时间,因此与胚胎和胎儿发育相比更容易受到较长暴露时间的潜在损害。糖尿病是威胁人类健康的重大慢性病,本文阐述了糖尿病的配子起源性,包括精子源性和卵子源性糖代谢异常的临床和基础研究进展,重点关注了表观遗传学机制在其中的作用,并展望了未来的研究方向。
