International Journal of Endocrinology and Metabolism最新文献

Background: Neonatal hypoglycemia is a common and serious condition in infants born to diabetic mothers (IDMs), particularly those with gestational diabetes mellitus (GDM).

Objectives: This study aimed to explore neonatal glycemic status and its associated maternal and neonatal factors in babies born to diabetic mothers.

Methods: A prospective cohort study was conducted in the Neonatal Intensive Care Unit of Dr. Jamal Ahmad Rashid Pediatrics Teaching Hospital and Sulaimani Maternity Teaching Hospital on 105 neonates born to mothers with type 1, type 2, or GDM. Neonatal blood glucose levels were measured at multiple time intervals (0, 1, 3, and 6 hours). Maternal and neonatal characteristics, including sociodemographic data, clinical characteristics, and delivery outcomes, were analyzed and correlated to neonatal glycemic status.

Results: Most pregnant women (61%) were aged 30 - 39 years, Kurdish (92.4%), had completed high school (33.3%), lived in urban areas (69.5%), had > 3 children (58.1%), were diagnosed with GDM (87.6%), used oral medications (54.3%), had well-controlled blood sugar levels (64.8%), and experienced cesarean section (81.9%). Type 1 diabetes mellitus (T1DM) was significantly associated with neonatal blood glucose levels over time (P = 0.003). Glycemic control demonstrated a non-significant rise in blood glucose from birth to 6 hours in all patterns. Fetal weight was inversely and significantly correlated with blood glucose at birth and at 1 hour, but not at 3 or 6 hours. Gestational age showed no significant correlation with blood glucose at birth, 1, or 3 hours, but exhibited a significant correlation at 6 hours (P = 0.030).

Conclusions: Maternal T1DM, more specifically, and fetal weight with gestational age were directly correlated to neonatal glycemic status in infants of diabetic mothers, but in different time periods. Thus, early monitoring and intervention for neonatal hypoglycemia are crucial, especially for neonates with poor maternal glycemic control.

Background and objective: The prevalence of type 2 diabetes in Saudi Arabia is steadily rising, resulting in multiple complications that negatively influence patients' quality of life (QOL) and further add to the worldwide burden of chronic diseases. This study aimed to evaluate the QOL of individuals with diabetes and to determine the effect of structured health education programs on improving their QOL.

Methods: A quasi-experimental study was carried out after obtaining ethical approval. A total of 232 diabetic patients were recruited from King Fahad Medical city and Prince Sultan Military Medical city. During the initial phase, sociodemographic and baseline clinical data were collected. Each patient then participated in 20 - 30-minute health education sessions every two weeks for a period of three months. After the intervention, follow-up assessments were performed using the same World Health Organization Quality of Life (WHOQOL) questionnaire to measure changes in QOL. Data were analyzed using Microsoft Excel for descriptive statistics, frequency distributions, and cross-tabulations, while Student's t-test was applied to assess statistical significance, with P < 0.05 considered significant.

Results: Among the participants, 117 (51%) were male and 115 (49%) were female; 25 (11%) were under 40 years old, while 207 (89%) were above 40 years. Most patients (198; 85%) had been receiving antidiabetic treatment for more than 10 years, whereas 44 (15%) had less than 10 years of treatment history. The average random blood sugar at baseline was 8.3 mmol/L. 206 (89%) patients were compliant to treatment and 216 (93%) had complications of diabetes. Post-intervention findings showed improvements across all four WHOQOL domains, with notable gains in the physical and psychological domains, and modest improvements in social and environmental aspects. Statistical analysis confirmed a significant difference between baseline and post-intervention scores in all domains (P < 0.05).

Conclusions: Structured health education significantly enhances the QOL of diabetic patients across multiple domains. Strengthening patient awareness and self-care not only helps prevent serious complications and premature mortality but also reduces the burden on families, healthcare institutions, and the broader healthcare system.

Background: Type 2 diabetes mellitus (T2DM) is a prevalent disorder with significant complications and mortality. Gut microbiota plays a role in metabolic homeostasis, and dysbiosis may contribute to inflammation and insulin resistance (IR).

Objectives: This study aimed to investigate the effect of Bacteroides thetaiotaomicron on glycemic and IR markers, lipid profiles, and the expression of diabetes- and inflammation-related genes, as well as the abundance of targeted gut microbiota in a rat model of T2DM.

Methods: Thirty-two male Wistar rats were randomly assigned to normal control groups or a high-fat diet/streptozotocin-induced T2DM group. Each group received 5-week oral B. thetaiotaomicron (1×10⁹ CFU/mL) or phosphate-buffered saline (PBS). Anthropometric and metabolic measures were compared pre- and post-intervention. Expression of diabetes-related genes (PI3K, Akt) in the liver, inflammation-related genes (IL-6, IL-10, IL-1β, IL-4) in the colon, cannabinoid receptors (CB1, CB2) in both tissues, and changes in gut microbiota composition were evaluated using quantitative PCR.

Results: Compared to the T2DM-PBS group, administration of B. thetaiotaomicron to T2DM rats led to significant reductions in body weight (BW) (8%), Body Mass Index (BMI) (21%), Lee index (10%), fasting blood glucose (FBG) (16%), insulin (46%), homeostatic model assessment of IR (HOMA-IR) (56%), triglycerides (TG) (34%), total cholesterol (TC) (29%), and low-density lipoprotein cholesterol (25%) (all P ≤ 0.012). This intervention was associated with reduced expression of CB1 (1.81-fold) and increased expression of PI3K (4.91-fold), Akt (3.55-fold), and CB2 (2.26-fold) (all P < 0.0001). Furthermore, expression of IL-1β (1.76-fold), IL-6 (2.10-fold), and CB1 (1.64-fold) was significantly down-regulated, whereas expression of other inflammation-related genes including IL-4 (2.43-fold), CB2 (1.47-fold), and IL-10 (4.6-fold) was up-regulated (all P ≤ 0.0009). Moreover, significant changes in targeted gut microbiota were observed (a reduction in the abundance of Bacillota and Actinomycetota and an increase in Bacteroidota, Faecalibacterium prausnitzii, B. thetaiotaomicron, and Clostridium cluster IV).

Conclusions: Bacteroides thetaiotaomicron improved anthropometric measures, glycemic indices, IR, lipid profiles, and regulated the expression of diabetes- and inflammation-related genes, along with modification of gut microbiota composition in a T2DM rat model.

Context: Prediabetes (Pre-DM) is an intermediate state between normoglycemia and type 2 diabetes (T2D), encompassing heterogeneous phenotypes, including isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT), and combined iIFG-impaired glucose tolerance (IFG-IGT). This review aimed to synthesize evidence from the Tehran Lipid and Glucose Study (TLGS) on modifiable and non-modifiable determinants of Pre-DM transition.

Evidence acquisition: Relevant TLGS publications were identified through PubMed and Scopus up to September 2025 using keywords including "prediabetes," "impaired fasting glucose," "impaired glucose tolerance," "diabetes," "regression," "progression," "determinants," and "Tehran Lipid and Glucose Study." Eligible studies included prospective analyses of Pre-DM regression and progression.

Results: Evidence from the Tehran Lipid and Glucose Study indicates that both non-modifiable and modifiable factors influence the Pre-DM transition. Regression to normoglycemia (NGR) was associated with younger age, lower fasting glucose, higher physical activity, and adherence to healthy diets, whereas progression to T2D was associated with obesity, central adiposity, the combined IFG-IGT phenotype, and unhealthy dietary patterns. Specifically, high adherence to the Alternate Healthy Eating Index (AHEI), higher intakes of low-fat dairy, certain minerals, and coffee facilitate regression to NGR, while Western-style diets increase the risk of progression to T2D. Across the phenotypes, regression to NGR was most likely in individuals with IGT, particularly those with ≥ 5% weight loss and adherence to healthy dietary patterns. Combined IFG-IGT benefited from high adherence to the AHEI. The iIFG phenotype appears particularly susceptible to excessive exposure to nitrate/nitrite, zinc, and diets high in cholesterol, saturated, and trans fats, which may attenuate reversion to NGR and facilitate progression to T2D.

Conclusions: Findings from the TLGS cohort show that healthy lifestyle factors favor regression to NGR, whereas obesity and poor dietary habits accelerate progression to T2D.

Background: Although numerous studies have demonstrated that plant-based diets can reduce the risk of cardiometabolic diseases, their applicability and health benefits within Iran remain unconfirmed.

Objectives: This systematic review aimed to clarify the findings from the Tehran Lipid and Glucose Study (TLGS) regarding the benefits of these recommended diets against cardiometabolic diseases in the Iranian population.

Methods: A systematic literature search was conducted in PubMed/Medline, Web of Science, and Scopus until September 2025. Studies that assessed the association between plant-based diets, including the Mediterranean diet (MeDi), dietary approaches to stop hypertension (DASH), Mediterranean-DASH intervention for neurodegenerative delay (MIND), Nordic, and Portfolio diets, and cardiometabolic diseases [i.e., cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM)] or their risk factors [i.e., overweight/obesity, hyperglycemia or insulin resistance (IR), dyslipidemia, and hypertension (HTN)] within the TLGS framework were included.

Results: From the 1,293 articles, 13 studies were included. Nine studies were identified on the MeDi score and cardiometabolic diseases; most found no significant associations. Five studies were conducted on the DASH score, which revealed an inverse association with risk of IR but no other outcomes. Two studies assessed the link between the MIND and Nordic diets and CVD with protective associations. There was one study on the Portfolio diet that showed no association with T2DM risk.

Conclusions: Within the TLGS, the MeDi and DASH diet scores have been studied more than other plant-based diets, yet most findings show no beneficial association with cardiometabolic diseases. Conversely, recent findings regarding the MIND and Nordic diets indicate a significant inverse association with CVD incidence. Given the scarcity of research in this area, further investigation into plant-based diets and cardiometabolic health within the TLGS is warranted.

Context: This scoping review investigates the association between ambient air pollution and cardiometabolic outcomes using data from the Tehran Lipid and Glucose Study (TLGS), a population-based cohort initiated in 1999.

Evidence acquisition: Five TLGS studies were included, each examining associations between ambient air pollutants and cardiometabolic outcomes such as hypertension (HTN), dyslipidemia, diabetes, cardiovascular morbidity, and mortality. Due to overlapping populations but differing outcome measures across studies, a meta-analysis was not feasible. Instead, a narrative synthesis was conducted, with results organized into a comparative matrix to facilitate cross-study evaluation.

Results: The findings reveal heterogeneous effects of ambient air pollutants on cardiometabolic health across both short- and long-term pathways. Short-term exposures to nitrogen dioxide (NO₂) and particulate matter ≤ 10 µm in diameter (PM₁₀) were linked to higher systolic blood pressure (SBP), while sulfur dioxide (SO₂) was associated with elevated diastolic pressure. For lipid parameters, carbon monoxide (CO) and SO₂ corresponded with higher total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) levels. Cardiovascular outcomes also worsened, as increases in the Air Quality Index (AQI), PM₁₀, SO₂, and CO were associated with higher risks of cardiovascular disease (CVD) hospitalization and mortality. Long-term exposures to ozone (O₃), PM₁₀, and SO₂ predicted incident HTN (strongest for PM₁₀), while CO was associated with elevated TC, TG, and adverse dyslipidemia phenotypes but not high LDL-C. Sulfur dioxide, O₃, and PM₁₀ also increased risks of dysglycemia, though no consistent associations with type 2 diabetes incidence or long-term mortality were observed.

Conclusions: This review underscores the substantial influence of ambient air pollution on metabolic and cardiovascular health in Tehran. Short-term exposure to pollutants such as PM₁₀, SO₂, and CO is associated, either immediately or with lagged effects, with increased blood pressure, adverse lipid changes, and heightened cardiovascular risk, while long-term exposure to PM₁₀ and SO₂ exacerbates HTN and impairs glucose metabolism. These findings highlight the need for stricter air quality regulations and further investigation into the cumulative, long-term effects of air pollution in the metropolitan city of Tehran.

Background: Obesity and type 2 diabetes (T2D) are associated with nitric oxide (NO) deficiency. L-citrulline (Cit), a substrate for NO synthesis, has been suggested as a treatment for obesity and T2D.

Objectives: This study aims to determine the effects of Cit on body weight, food intake, and water consumption in obese T2D male and female rats.

Methods: The T2D was induced using a high-fat diet (HFD) and a low dose of streptozotocin (STZ). Obese male (n = 30) and female (n = 30) rats with T2D were divided into five groups (n = 6/group) that received Cit (0, 1, 4, 7, and 10 g/L in drinking water for 8 weeks). Body weight, food intake, and water consumption were measured every week. Serum Cit and nitrite+nitrate (NOx) concentrations were measured at weeks 0, 4, and 8, and serum fasting glucose was measured at week 8.

Results: Compared to non-treated T2D rats, Cit-treated male rats had lower body weight (11.3%, 13.0%, and 11.6% at doses of 4, 7, and 10 g/L), lower food intake (4.7% and 5.5% at doses of 4 and 7 g/L), and water consumption (7% at dose 7 g/L). In female rats, Cit decreased body weight (7.2%, 8%, and 7.3% at doses of 4, 7, and 10 g/L), food intake (4.0% and 5.0% at doses of 4 and 7 g/L), and water consumption (5% and 6.6% at doses of 4 and 7 g/L; all P < 0.001). The body weight and food intake-lowering effects of Cit were higher in T2D male rats than females (all P < 0.05), but decreased water consumption was comparable between sexes. A Cit dose of 7 g/L was most effective in reducing all measured parameters in both sexes.

Conclusions: The Cit decreased body weight, food intake, and water consumption in obese T2D male and female rats. These effects were sex- and dose-dependent.

Context: The community readiness (CR) level is a critical factor affecting the success and sustainability of prevention programs.

Objectives: This study systematically reviews research utilizing the community readiness model (CRM) to assess CR for childhood obesity prevention programs, identifying readiness levels and summarizing their characteristics and outcomes.

Methods: A comprehensive electronic and manual search was performed across multiple databases, including PubMed, Scopus, Web of Science, PsycINFO, Pub Psych, ERIC, ProQuest, and CINAHL, as well as two key journals: Preventing chronic disease and health education and behavior. The search adhered to predetermined inclusion and exclusion criteria. Studies evaluating CR for obesity prevention in children and adolescents aged 0 to 19 years were included, with no restrictions based on gender, race, ethnicity, or language. Three reviewers conducted data extraction and assessed the risk of bias using two appraisal forms from the Joanna Briggs Institute.

Results: A total of 27 studies were included, with 24 conducted in high-income countries. Readiness levels across studies ranged from the first to the fifth stages. Communities generally reached the highest stage in the community effort dimension but were at the lowest stage regarding community climate and knowledge about the issue. The heterogeneity of the studies made it challenging to compare CR levels among different communities.

Conclusions: This study provides an overview of CR levels and objectives of CR assessments, highlighting the significance of bottom-up interventions in childhood obesity prevention. It emphasizes the necessity of conducting context-specific readiness assessments before implementing interventions.