Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy最新文献

Purpose: To examine how coping style mediates the relationship between risk perception of diabetic complications and self-management, so as to provide evidence for improving the self-management level of patients with type 2 diabetes.

Patients and methods: We recruited patients with type 2 diabetes mellitus and conducted a cross-sectional survey using a general information questionnaire, the risk perception survey-diabetes mellitus (RPS-DM), the medical coping modes questionnaire (MCMQ), and the summary of Diabetes Self-Care Activities (SDSCA). Descriptive analysis and Pearson correlation analysis were carried out with SPSS 25.0 software, and a structural equation model was constructed with AMOS 24.0 software to verify the mediating effect.

Results: A total of 343 valid questionnaires were collected. Diabetes patients' risk perception of complications has a positive impact on self-management behavior. Cope style was analyzed in three dimensions: confrontation, avoidance and acceptance-resignation, where the confrontation dimension is positively correlated with risk perception of complications and self-management behavior, and the acceptance-resignation dimension is negatively correlated with risk perception of complications and self-management behavior. These two dimensions have partial mediating effects (β=0.115, 95% CI = 0.041-0.225; β = 0.147, 95% CI = 0.056-0.283) between risk perception of complications and self-management behaviors, accounting for 15.9% and 20.3% of the total effects, respectively.

Conclusion: Our study discovered that the risk perception of complications can affect self-management behavior via various coping styles, suggesting that clinical medical staff should assist patients with type 2 diabetes in facing the perceived risk of complications positively, and thus improve their self-management behavior.

Objective: This study aims to evaluate the efficacy of acupuncture as an adjunct to lifestyle interventions on weight loss in simple obesity.

Methods: Potentially eligible studies that assessed anthropometric outcomes as well as glucose and lipid metabolism following acupuncture combined with lifestyle interventions in simple obesity patients were searched from eight databases from inception to October 2023. All analyses were performed using the Review Manager software v5.4 and Stata software v17.0.

Results: Herein, 25 randomized controlled trials (RCTs) involving 2018 patients were included. Generally, acupuncture combined with lifestyle interventions outperformed lifestyle interventions alone in terms of body weight (MD = -4.73, 95% CI [-6.32, -3.13], p < 0.00001), body mass index (BMI) (MD = -2.11, 95% CI [-2.75, -1.48], p < 0.00001), waist circumference (WC) (MD = -4.96, 95% CI [-6.89, -3.03], p < 0.00001), body fat percentage (BF %) (MD = -2.61, 95% CI [-4,51, -0.71], p = 0.007), fasting plasma glucose (FPG) (SMD = -0.66, 95% CI [-1.02, -0.31], p = 0.0002), fasting serum insulin (FINS) (SMD = -1.12, 95% CI [-1.44, -0.81], p < 0.00001), homeostasis model assessment-insulin resistance (HOMA-IR) (MD = -1.22, 95% CI [-1.50, -0.94], p < 0.00001), total cholesterol (TC) (SMD = -1.14, 95% CI [-1.83, -0.45], p = 0.001), triglyceride (TG) (SMD = -1.31, 95% CI [-2.07, -0.56], p = 0.0006), and low-density lipoprotein cholesterol (LDL-C) (SMD = -1.81, 95% CI [-3.11, -0.51], p = 0.006). Subgroup analysis based on three subgroup variables (types of acupuncture and lifestyle interventions as well as treatment durations) could partially explain the heterogeneity of the results.

Conclusion: Acupuncture demonstrated an enhancing effect on the benefits of lifestyle interventions for weight loss in patients with simple obesity, including reducing body weight and improving glucose and lipid metabolism. This finding suggests its potential value as a complementary therapy alongside lifestyle interventions in a clinical setting. However, further validation with rigorously designed and high-quality RCTs is still needed in the future.

Purpose: To compare the levels of cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in apparently non-COVID-19 (COVID-19-) and post-COVID-19 (COVID-19+) persons with metabolic syndrome (MetS+) and without metabolic syndrome (MetS-).

Methods: The descriptive correlational study was carried out in 275 inhabitants of the city of Trujillo in 2023. Cardiac markers were determined by time-resolved immunofluorescence.

Results: It was determined that 58.2% of the participants presented COVID-19 and 46.5% presented a diagnosis of MetS according to the harmonized ATP III criteria. Levels of cTnI greater than 0.05 ng/mL were found in low percentages in the COVID-19-/MetS-, COVID-19-/MetS+, and COVID-19+/MetS- groups at 0.7% each, and in the COVID-19+/SM+ group, it was 0.4%. NT-proBNP concentrations higher than 125 pg/mL were found in 2.9% of participants, of which 1.1% were in the COVID-19+/MetS+ group, a slightly higher proportion compared to the other groups.

Conclusion: The proportion of individuals with normal or elevated cTnI and NT-ProBNP levels does not differ significantly in both healthy individuals, with MetS only, and those with mild Post COVID-19 with or without MetS; however, longitudinal studies are required to detect possible myocardial events in either group for adequate treatment, especially in those with COVID-19+/MetS+.

Diabetic kidney disease (DKD) is a significant complication of diabetes and a major cause of end-stage renal disease. Affecting around 40% of diabetic patients, DKD poses substantial economic burdens due to its prevalence worldwide. The primary clinical features of DKD include the leakage of proteins into the urine, altered glomerular filtration, and an increased risk of cardiovascular diseases. Current treatments focus on managing hypertension and hyperglycemia to slow the progression of DKD. These include the use of SGLT2 inhibitors to control blood sugar and ACE inhibitors to reduce blood pressure. Despite these measures, current treatments do not cure DKD and fail to address its underlying causes. Emerging research highlights mitochondrial dysfunction as a pivotal factor in DKD progression. The kidneys' high energy requirements make them particularly susceptible to disturbances in mitochondrial function. In DKD, mitochondrial damage leads to reduced energy production and increased oxidative stress, exacerbating tissue damage. Mitochondrial DNA (mtDNA) damage is a key aspect of this dysfunction, with studies suggesting that changes in mtDNA copy number can serve as biomarkers for the progression of the disease. Efforts to target mitochondrial dysfunction are gaining traction as a potential therapeutic strategy. This includes promoting mitochondrial health through pharmacological and lifestyle interventions aimed at enhancing mitochondrial function and reducing oxidative stress. Such approaches could lead to more effective treatments that directly address the DKD.

Background and aim: There is noticeable heterogeneity in weight loss outcomes following intragastric balloon (IGB) treatment, with average weight loss ranging between 11% to 15% of total body weight. Genetic variations associated with obesity have been found to influence weight loss response, however such variations are limited. Therefore, the aim of this study is to investigate the impact of the obesity associated brain-derived neurotrophic factor (BDNF) gene polymorphism rs11030104 with weight loss outcomes following IGB treatment.

Methods: In this cross-sectional study, BDNF rs11030104 was analysed in 106 individuals who underwent intragastric balloon treatment. Weight loss metrics were evaluated at the three-month follow-up: percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and percentage of body mass index loss (%EBMIL). The effects of additive and dominant genetic models were evaluated. Both linear and logistic regression were applied to assess associations between rs11030104 genotypes and weight loss metrics.

Results: A total of 71 participants completed the 3-month follow-up assessment (loss to follow-up: 33%). This study found a significant association between the BDNF rs11030104 polymorphism and weight loss. A-allele carriers showed a better response to IGB treatment. Individuals carrying the AA genotype were found to have a greater %TWL than those carrying the GG genotype at 3 months post-IGB treatment (11.05% vs 5.09%, p=0.003).

Conclusion: Our results suggest that BDNF rs11030104 influences the response to weight loss after IGB treatment and therefore could be added to the growing list of genetic variants that predict greater weight loss response.

With changes in lifestyle, sedentary behavior or lack of physical exercise increases the risk of various glycolipid metabolic disorders. Glycolipid metabolic dysregulation refers to abnormalities in the metabolism of carbohydrates and lipids, including diseases such as diabetes, obesity, and metabolic syndrome. In-depth research into the molecular mechanisms of glycolipid metabolic dysregulation can help develop more effective treatment strategies and preventive measures to prevent the occurrence of long-term complications such as cardiovascular diseases. Alternative polyadenylation (APA) is an important form of RNA modification that helps regulate gene expression and generate protein diversity. This modification can affect processes such as RNA stability, post-transcriptional modification, and translational regulation. Recent studies have confirmed that APA can influence the expression of genes involved in glucose and lipid metabolism, increasing the probability of developing immune, endocrine, and metabolic diseases. The review explains the research progress of APA involvement in various metabolic diseases and explores these mechanisms, providing new insights and directions for novel metabolic disorder treatment strategies.

Aim: To explore the physicians' knowledge, awareness, and perspectives on HRQoL and mental health aspects of people with T2DM in Jeddah, Saudi Arabia.

Methods: A cross-sectional survey study was conducted over a three-month period (October to December 2022) on 54 physicians. Physicians were requested to respond to a 12-item researcher-designed, self-administered survey questionnaire that explored their perspectives regarding the importance of their patients' general, physical, and mental health aspects using the 12-item Short Form Health Survey Version 2 (SF-12v2).

Results: Overall, 85.2% of physicians were male, with almost two-thirds (64.8%) practising in one medical and more than two-thirds (35%.2%) in the surgical specialties. Most physicians (57.4%) were consultants, which was also reflected in both subgroup specialties (54.3% versus 63.2%, respectively). The majority of physicians (83.3%) asked their patients about their general health; however, only 18.5% responded positively to questions about emotional problems. There was a low positive response to questions relating to the emotional component, such as feeling "calm and peaceful" (38.9%) and "feeling a lot of energy" (35.2%). This was even lower (25.9%) for questions related to mental health.

Conclusion: Our study is a "call for action" for future well-designed, multidimensional, and multisectoral research studies that will help broaden knowledge about the magnitude of the current problem. This may improve overall general, physical, and mental health by enhancing patient level of care, adherence to health care plans, and reducing long-term complications.

Background: Thyroid dysfunction is more common in other endocrine disorders such as diabetes mellitus (DM). Carcinoembryonic antigen (CEA), a common tumor biomarker, is found elevated in patients with thyroid dysfunction. However, the relationship between thyroid hormone levels and CEA levels remains unclear.

Methods: In total, 663 patients with type 2 diabetes at the Tongzhou Branch of Dongzhimen Hospital were enrolled in this retrospective study. Data were collected from inpatient electronic files between December 2011 and December 2019. Laboratory indices were statistically analyzed using logistic regression and Spearman correlation analyses.

Results: In our study, total triiodothyronine (TT3), free triiodothyronine (FT3), serum albumin(ALB), total protein (TP), and triglyceride (TG) levels were significantly higher in the T2DM patients with normal values of CEA than T2DM patients who had abnormal values of CEA, whereas alkaline phosphatase (ALP), Glucose (GLU), and HbA1c levels were significantly increased in the T2DM patients with abnormal CEA level. Binary logistic regression analysis demonstrated that FT3, GLU, HbA1c, and TG levels remained as independent risk factors for CEA in patients with T2DM (β=-0.907, P =0.004; β =-1.009, P=0.004; β =0.090, P = 0001; β= 0.336, P <0.001; β= -0.293, P =0.009, resp). Spearman correlation analysis showed that CEA level was significantly positively correlated with HbA1c and GLU (r_s value: 0.265, P <0.001; r_s value: 0.270, P <0.001, resp.) and negatively correlated with FT3 and TG levels (r_s value: -0.139, P <0.001; r_s value: -0.103 P =0.008, resp). Furthermore, multivariate logistic regression analysis indicated that the FT3 quartiles were significantly associated with CEA levels before and after adjusting for confounding factors.

Conclusion: Our study determined that FT3 remained an independent risk factor for CEA in patients with T2DM and was significantly negatively correlated with CEA levels.

Background: Dietary patterns that lower postprandial glycemia have been effective in preventing type 2 diabetes. Consuming macronutrients in a specific sequence within a meal has been considered as a novel strategy to reduce post-meal glucose spikes. Therefore, this study aimed to investigate the effect of meal sequence on postprandial glucose and insulin response among healthy adults in the United Arab Emirates.

Methods: Eighteen healthy adults participated in a cross-over randomized controlled trial. Two isocaloric meals were consumed separately in a different order: a standard mixed meal (SMM) vs vegetables and protein first followed by carbohydrates (VPF) meal. The postprandial glucose and insulin levels were determined at Fasting, 30, 60, and 120 min. Visual Analog Scale (VAS) rating was used to assess hunger at similar frequencies.

Results: The mean glucose and insulin levels significantly reduced (p = 0.001) following VPF meal compared to SMM at 30 min. The incremental area under the curve (iAUC0-120) for glucose following the VPF meal sequence was 40.9% lower (p = 0.03) compared with the SMM (572.83; 95% CI 157.3 to 988.2) vs (968.5; 95% CI 692.4 to 1244.8 mg/dL). Furthermore, the iAUC0-120 for insulin following the VPF meal sequence was 31.7% lower than the SMM meal sequence. (2184; 95% CI 1638.30 to 2729) vs (3196.94; 95% CI 2328.19 to 4065.69) mIU/mL × 120 min, P = 0.023). The feeling of fullness measured by the hunger scale showed that the feeling of fullness was higher after 60 and 120 minutes (p = 0.05, p = 0.04) with the VPF meal sequence compared to the SMM sequence. Although, there is no significant difference in the Area under the curve (AUC) for hunger rating between the two meals.

Conclusion: The VPF meal sequence could significantly reduce postprandial glucose and insulin levels and sustain fullness after a meal. Meal sequencing could be an effective dietary strategy for improving the postprandial glucose and insulin response in healthy adults.

Purpose: To study the expression and diagnostic ability of the long noncoding RNAs (lncRNAs) MIAT, HOTTIP, and SNHG16 in serum of patients with diabetic retinopathy.

Methods: A total of 70 healthy controls and 195 patients with Type 2 Diabetes (T2D) were collected. T2D patients include 65 patients with Nondiabetic retinopathy (NDR), 65 patients with Nonproliferative diabetic retinopathy (NPDR) and 65 patients with Proliferative diabetic retinopathy (PDR). The relative expression of MIAT, HOTTIP and SNHG16 in participant serum was measured through Real-time fluorescence quantitative polymerase chain reaction to compare the differential expression between the groups. t test, Mann‒Whitney U-test, Pearson's chi-square test and the receiver operating characteristic (ROC) curve were used to analyze the expression of these LncRNAs and their diagnostic ability for DR.

Results: We compare the healthy control group with T2D group, healthy control group with NDR group, NDR group with DR (NPDR+PDR) group, and NPDR group with PDR group. When NDR group was compared with the healthy control group, there was no difference between MIAT (p>0.05)and HOTTIP (p>0.05), only the relative expression of SNHG16(p<0.05) was different and it's ROC curve had identification significance. In the remaining inter-group comparisons, the differences in the expression of MIAT (p<0.05), HOTTIP (p<0.05) and SNHG16 (p<0.05) were statistically significant, and their ROC curves were all had identification significance.

Conclusion: These findings prove that serum LncRNA MIAT, HOTTIP and SNHG16 may be used as potential markers to monitor the progress of DR.