Journal of Diabetes and Metabolic Disorders最新文献

Background and objectives: The literature has reported heavy metals might alter the physiological and biochemical functions of body organs and cause several health problems. So, the present systematic review and meta-analysis aimed to investigate the association of blood levels of essential or non-essential metals with metabolic syndrome (MetS).

Methods: In this systematic review, some international databases including PubMed, Embase, Scopus, and Web of Science were searched up to February 2024. All observational studies which assessed the association of three heavy metals (cadmium, mercury, lead) and bio-elements (chromium, iron, manganese, and magnesium, copper) with the risk of MetS were included. There was no limitation in the time of publication and language. A random-effects meta-analysis was performed to estimate the pooled effect sizes. Possible sources of heterogeneity were explored by meta-regression analysis.

Results: Totally, 29 studies were eligible for meta-analysis. Our results showed that increased level of cadmium (pooled OR: 1.24, 95% CI: 1.05, 1.46) and mercury (pooled OR: 1.22, 95% CI: 1.08, 1.38) significantly increased the risk of MetS. In contrast, increased level of chromium significantly reduced the risk of developing MetS (pooled OR: 0.68, 95% CI: 0.56, 0.83). Moreover, association between lead, iron, copper, magnesium, and manganese with MetS was not statistically significant (P > 0.05). However, elevated lead levels in men increased the odds of MetS.

Conclusion: Our results show a significant association between blood levels of some heavy metals, including cadmium, mercury, and lead, with increased odds of MetS. On the other hand, chromium as a biometal decreased the odds of MetS.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-024-01500-9.

Objectives: To evaluate the effectiveness of a Persian Medicine herbal formula and a Traditional Chinese Medicine intervention (acupuncture) on the improvement of weight and anthropometric indices of overweight patients.

Methods: This study was a randomized placebo-controlled double-blind clinical trial. A total of 200 overweight patients were randomly divided into 4 groups receiving either (1) Herbal capsule, (2) placebo capsule, (3) acupuncture, or (4) sham acupuncture. Herbal capsules were filled with hydroethanolic extract of Cuminum cyminum L. seed, Apium graveolens L. seed, Ruta graveolens L. seed, Trachyspermum ammi (L.) Sprague seed, Origanum majorana L. leaf, and sodium tetraborate and placebo capsules with avicel. Patients received two 500mg capsules or 12 acupuncture sessions over 8 weeks. Study outcomes, consisted of weight, body mass index (BMI), anthropometric indices including chest, arm, wrist, waist, hip, and leg circumferences, and waist/hip ratio (WHR), were evaluated 3 times: before treatment, after 4 weeks, and after 8 weeks.

Results: The herbal formula significantly reduced weight, BMI, WHR, and chest and waist circumferences compared to the placebo capsule (P < 0.05). Furthermore, acupuncture improved all study outcomes, except WHR, compared to sham acupuncture (P < 0.05). Despite the effects of herbal formula and acupuncture were the same on WHR and chest, waist, and leg circumferences (P < 0.05), acupuncture reduced weight, BMI, and arm, wrist, and hip circumferences more than herbal formula (P < 0.05).

Conclusion: Complementary and alternative therapeutic methods, such as herbal treatments and acupuncture, show promising effects in improving weight and anthropometric indices of overweight patients.

Background: Abdominal obesity and low muscle strength, known separately as risk factors for mortality, might have a synergistic effect when they co-occur. Dynapenic abdominal obesity (DAO) is a condition defined by the presence of both. However, DAO's independent and combined impact on mortality remains under investigation.

Objective: The objective of the present study was to evaluate the association of dynapenia, abdominal obesity, and dynapenic abdominal obesity with all-cause mortality among community-dwelling older adults.

Methods: This is a longitudinal study with a 5-year follow-up conducted involving 1,354 community-dwelling older adults (≥ 65 years) of the Birjand Longitudinal Aging Study (BLAS). Abdominal obesity and dynapenia were respectively defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), dynapenic/non-abdominal obesity (D/NAO), non-dynapenic/abdominal obesity (ND/AO), and dynapenic/abdominal obesity (D/AO). The outcome was all-cause mortality registered through four methods: 1- telephone interview with the family of the participants during September 2018 and February 2024, 2- hospital information systems, 3- death registry of the deputy of the Health of Birjand University of Medical Sciences 4- in a subject who died at home or out of hospital death registry was verified by a verbal autopsy performed by a clinician. Univariate and multiple Logistic regression models were used to estimate the risk of all-cause mortality as a function of dynapenia and abdominal obesity in competing events controlled by age, sex, multi-morbidity, and frailty.

Results: The mean age of the study participants was 69.77 ± 7.55 years, and about 703 (51.71%) were female. There was a statistical difference between the alive and the deceased groups in terms of sex, age, multimorbidity, and frailty. Mortality was statistically higher among dynapenic participants (P < 0.001). Unadjusted logistic regression analysis explored the relationship between D/NAO and mortality (OR = 2.18; CI 95% 1.25-3.78). In the adjusted models, no significant relationships were observed. Age and frailty had significant associations with mortality.

Conclusion: While our study found an association between dynapenia without abdominal obesity and increased mortality risk, factors like age and frailty might play a stronger role. These require further investigation to understand the independent effect of dynapenia on mortality fully.

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Supplementary information: The online version contains supplementary material available at 10.1007/s40200-024-01501-8.

Abstract: Metabolic syndrome is increasingly recognized as a significant precursor to various chronic diseases, contributing to a growing public health concern. Its complex pathogenesis involves multiple interrelated mechanisms, with oxidative stress identified as a cornerstone that exacerbates other pathogenic pathways. This study elucidates the molecular mechanisms by which oxidative stress intensifies metabolic disturbances, particularly insulin resistance. Some recent research has focused on fisetin, a natural product known for its potential benefits in diabetes and its associated microvascular and macrovascular complications. This paper compiles a comprehensive collection of findings by reviewing studies conducted over the past decade, detailing dosages, investigated markers, and their respective outcomes. Notably, a recurrent finding was fisetin's ability to enhance Nrf2, a principal regulator of antioxidant defense, in both metabolic and non-metabolic diseases. Furthermore, intriguing results suggest that the effects of Nrf2 extend beyond oxidative stress modulation, demonstrating favorable impacts on tissue-specific functions in metabolic regulation. This highlights fisetin not only as an antioxidant but also as a potential therapeutic agent for improving metabolic health and mitigating the effects of metabolic syndrome. In conclusion, fisetin can enhance the body's antioxidant defenses by modulating the Nrf2 pathway while also improving metabolic health through its effects on inflammation, cell survival, and energy metabolism, offering a comprehensive approach to managing metabolic disorders.

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Objectives: It has been shown that growth factors and small molecules play an essential role in the proliferation of β cells and insulin production. In this study, we investigated the effects of small molecules (WS6 and 5-iodotubercidin) and growth factors (TGFβ, HGF, and EGF) on the proliferation of β-like human ipSCs.

Methods: iPSCs derived β cells were treated with small molecules and growth factors. Cytotoxic activity of small molecules and growth factors was determined using MTT assay. Insulin gene expression and secretion were measured by qPCR and ELISA, respectively. The protein expression of insulin was evaluated by western blot as well.

Results: Simltananeous addition of WS6 and Harmine into the culture media increased insulin gene expression compared to treatment by each molecule alone (p < 0.05). It was found that the simultaneous recruitment of EGH, HGF, and TGF-β increased insulin expression compared to treatment by each molecule alone (p < 0.05). Results showed that EGF, HGF, TGF-β growth factors increased insulin gene expression, eventually leading to insulin secretion from β cells (p < 0.05).

Conclusions: Growth factors and small molecules synergistically enhanced the proliferation of β cells and insulin production.

Objectives: The in vivo assay is a key step in the development of a new bioactive compound as a lead drug structure. Based on importance of α-glucosidase inhibitors in the control of blood glucose level (BGL) in diabetes, in the present work, 3-amino-1-(4-chlorophenyl)-12-oxo-11,12-dihydro-1H-benzo[h]pyrano[3,2-c]quinoline-2-carbonitrile (ACODDHBPQC) that showed excellent inhibitory activity on the yeast form of α-glucosidase was selected for in vivo anti-diabetic assay.

Methods: The in vivo anti-diabetic and anti-lipidemic effects of this synthetic compound were evaluated using by a streptozotocin (STZ)-induced diabetic Wistar rat model. In silico docking study of ACODDHBPQC was performed by Atodock tools and absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties of this compound was predicted by PreADMT online software.

Results: The obtained results revealed that selected compound ACODDHBPQC showed a significant anti-diabetic effect on diabetic rats. In vivo anti-lipidemic assay also demonstrated that ACODDHBPQC had favorable effects on cholesterol and LDL levels. Furthermore, in silico studies showed that ACODDHBPQC interacted with key residues of the α-glucosidase active site and had good pharmacokinetic and toxicity properties.

Conclusion: In summary, anti-hyperglycemic effects of ACODDHBPQC was confirmed by in vivo study. However, more evaluations are needed to introduce ACODDHBPQC as a lead drug compound.

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Objectives: This study aimed to assess the prevalence and risk factors associated with sarcopenia among hospitalized elderly Chinese patients with Type 2 Diabetes Mellitus (T2DM) to inform more effective management and prevention strategies.

Methods: We conducted a cross-sectional analysis of 263 elderly T2DM patients in a hospital in Chengdu, China. Sarcopenia was diagnosed using the 2019 criteria from the Asian Working Group for Sarcopenia (AWGS). Multifactorial logistic regression analysis was employed to explore the determinants of sarcopenia among these patients.

Results: The study revealed a sarcopenia prevalence of 42.2% among hospitalized elderly patients with T2DM, with men at 49.44% and women at 38.51%. Patients with sarcopenia were older (72.21 ± 6.841 years vs. 68.55 ± 5.585 years) and had lower Short Physical Performance Battery scores(SPPB), grip strength, and appendicular skeletal muscle mass index(ASMI) compared to non-sarcopenic patients (p < 0.001). Sarcopenia significantly impacted body composition, reducing muscle mass and body water and increasing visceral fat (p < 0.001). Logistic regression identified body mass index (BMI)(OR = 0.476, 95%CI: 0.352-0.642), skeletal muscle (OR = 0.274, 95%CI: 0.183-0.409), being female (OR = 0.001, 95%CI: 0.000-0.007) and handgrip strength (OR = 0.911, 95%CI: 0.842-0.986) as protective factors against sarcopenia, while higher waist circumference (OR = 1.186, 95%CI: 1.057-1.331) was significant risk factors.

Conclusions: Key strategies to manage sarcopenia in elderly T2DM patients include maintaining an optimal BMI, strengthening grip, regular body composition assessments, and controlling waist circumference. These measures improve muscle strength, reduce risks from visceral fat, and enhance patient outcomes and quality of life.

Objectives: People with hypertension are more susceptible to developing cardiometabolic risk factors including overweight, obesity, diabetes mellitus, dyslipidemia, and metabolic syndrome (MetS). We aim to determine the trends in the prevalence of these risk factors among Iranian adults with hypertension from 2007 to 2021.

Methods: We utilized data for adults from 25 to 64 years old from four rounds of the STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) study conducted in Iran in 2007, 2011, 2016, and 2021. Direct standardization by age, sex, and residency area was conducted using the 2016 Iranian census population. Weighted least squares linear regression was performed to assess the statistical changes in the trends.

Results: Overall, 21,088 participants were included in this study. From 2007 to 2021, the standardized prevalence of hypertension among adults did not change significantly (from 24.5 to 22.8%). Dyslipidemia was the most prevalent comorbidity among adults with hypertension (from 83.7 to 85.5%). The standardized prevalence of overweight (39.3-40.4%) did not change significantly among adults with hypertension, while the standardized prevalence of obesity (34.3-38.4%), diabetes (10.3-13.5%), and MetS (64.4-78.3%) increased significantly, with MetS showing the highest annually change (0.9%). Considering changes in specific subgroups, significant increases in obesity were observed in males, the 45-54 age group, and rural subgroups. For MetS and diabetes, all subgroups showed a significant increase, except for diabetes in age groups, where significant increases were limited to the 55-64 age group.

Conclusions: There has been a significant increase in the prevalence of obesity, diabetes, and MetS among adults with hypertension in Iran. The observed disparities in these trends across different subgroups highlight the need for health policymakers to implement targeted strategies that account for age, sex, and area differences to effectively prevent and control these risk factors.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-024-01498-0.

Objectives: The efficacy and safety of drug treatments vary widely due to genetic variations. Pharmacogenomics investigates the impact of genetic variations on patient drug response. This research investigates the frequency of UGT1A1 genetic variations in the Iranian population, comparing them with global data to provide insights into the pharmacogenomic approach in the Iranian population.

Methods: The study was conducted using the data of the Bushehr Elderly Health (BEH) program, a population-based cohort study of the elderly population aged ≥ 60 years. Genotyping of three UGT1A1 variant alleles (UGT1A1*6, UGT1A1*27, and UGT1A1*80) was performed on a group of 2730 elderly Iranian participants with the Infinium Global Screening Array.

Results: The genotyping analysis revealed significant differences compared to major global populations that were addressed in the gnomAD database. UGT1A1*80 was found at a high frequency (32.34%), and followed by UGT1A1*6 (0.76%) and UGT1A1*27 (0.018) at a low frequency in the Iranian group.

Conclusions: The UGT1A1*80 was the more prevalent allele between investigated alleles in the present study which can be considered as an important allele for pharmacogenomic testing.

Type 2 diabetes mellitus (T2DM) is a multifactorial metabolic disorder characterised by impaired insulin secretion and action, often exacerbated by oxidative stress. Recent research has highlighted the intricate involvement of epigenetic mechanisms, particularly DNA methylation, in the pathogenesis of T2DM. This review aims to elucidate the role of DNA methylation as an epigenetic modifier in oxidative stress-mediated beta cell dysfunction, a key component of T2DM pathophysiology. Oxidative stress, arising from an imbalance between reactive oxygen species (ROS) production and antioxidant defence mechanisms, is a hallmark feature of T2DM. Beta cells, responsible for insulin secretion, are particularly vulnerable to oxidative damage due to their low antioxidant capacity. Emerging evidence suggests that oxidative stress can induce aberrant DNA methylation patterns in beta cells, leading to altered gene expression profiles associated with insulin secretion and cell survival. Furthermore, studies have identified specific genes involved in beta cell function and survival that undergo DNA methylation changes in response to oxidative stress in T2DM. These epigenetic modifications can perpetuate beta cell dysfunction by dysregulating key pathways essential for insulin secretion, such as the insulin signalling cascade and mitochondrial function. Understanding the interplay between DNA methylation, oxidative stress, and beta cell dysfunction holds promise for developing novel therapeutic strategies for T2DM. Targeting aberrant DNA methylation patterns may offer new avenues for restoring beta cell function and improving glycemic control in patients with T2DM. However, further research is needed to elucidate the complex mechanisms underlying epigenetic regulation in T2DM and to translate these findings into clinical interventions.