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Screen Time and Hours of Sleep Influence the Estimate Risk of Diabetes Mellitus and Metabolic Syndrome in Healthy Young Males. 屏幕时间和睡眠时间影响健康年轻男性罹患糖尿病和代谢综合征的估计风险。
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-01 Epub Date: 2024-06-07 DOI: 10.1089/met.2024.0065
Carolina Costa-Santos, Gabriella Guarilha Costa Dias Mattar, Ronan Antonio Fuziwara, Jorge Alexandre de Araújo Peres, Márcia Silva Queiroz

Objective: Screen time (ST) has shown negative effects on physical and mental health, with an increase in the prevalence of overweight, metabolic syndrome (MetS), and obesity. The time spent in front of the screens was also associated with higher odds of selecting indicators of cardiometabolic disease in adulthood. In view of this, the aim of this study was to identify the risk of MetS and type 2 diabetes mellitus (T2DM) in healthy young males and relate it to ST and sleep time. Methods: We evaluated physical and laboratory characteristics, dichotomous diagnosis criteria, and continuous scores to assess MetS and Finnish Diabetes Risk Score questionnaire to measure the T2DM risk. Results: The means of MetS dichotomous and continuous severity criteria, among individuals with <7 hr of sleep, were higher than those with adequate sleep. We did not observe a direct impact of ST on the risk of MetS; nevertheless, >8 hr of ST increased 1.22 points in the T2DM risk. Conclusion: Excessive ST increased the risk of T2DM, but not of MetS. Moreover, sleeping <7 hr was associated with a higher mean of dichotomous and continuous severity criteria for MetS.

目的屏幕时间(ST)对身心健康有负面影响,会增加超重、代谢综合征(MetS)和肥胖的发病率。在屏幕前花费的时间还与成年后选择心脏代谢疾病指标的几率增加有关。有鉴于此,本研究旨在确定健康年轻男性患 MetS 和 2 型糖尿病(T2DM)的风险,并将其与 ST 和睡眠时间联系起来。研究方法我们评估了身体和实验室特征、二分法诊断标准和连续性评分,以评估 MetS 和芬兰糖尿病风险评分问卷,以测量 T2DM 风险。结果MetS 二分法和连续性严重程度标准的平均值,在 8 小时 ST 的人中,T2DM 风险增加了 1.22 分。结论是睡眠时间过长会增加 T2DM 风险,但不会增加 MetS 风险。此外,睡眠
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引用次数: 0
Structural Brain Alterations in Metabolic Syndrome: A Comprehensive MRI Volumetric Analysis of Subcortical and Associated Structures. 代谢综合征的脑结构改变:皮层下及相关结构的全面核磁共振成像容积分析
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-01 Epub Date: 2024-06-17 DOI: 10.1089/met.2024.0048
Hatice Cakir, Mukadder Sunar, Sonay Aydın, Osman Kagan Cakir, Ersan Gursoy

Objective: This study aims to elucidate the comprehensive effects of metabolic syndrome (MetS) on the structural integrity of subcortical brain regions and associated structures through high-resolution magnetic resonance imaging (MRI) volumetric analysis, thereby contributing to a deeper understanding of the neuroanatomical dimensions of MetS and its potential implications for cognitive functions and overall brain health. Methods: A cross-sectional design was implemented, involving 25 individuals diagnosed with MetS for at least one year and a healthy control group of 15 individuals at a tertiary hospital's family medicine clinic in Eastern Turkey. Participants underwent a high-resolution MRI scan using a 1.5T Siemens Aera scanner. The MRICloud platform was employed for comprehensive segmentation and quantitative analysis of various brain structures. Results: The study revealed significant volumetric reductions in all measured subcortical brain regions among individuals with MetS compared to the control group (all P < 0.05). Notable differences were observed in key structures such as the substantia nigra, corpus callosum, and thalamus. In subcortical structures, the largest volumetric differences were noted in the basal ganglia L (1322.4 mm³), while the most significant percentage differences were seen in the substantia nigra R (25.24%) and caudate nucleus L (21.02%). Conclusion: The findings from this study underscore the significant neuroanatomical changes associated with MetS, manifesting as volumetric reductions in critical subcortical brain areas. These alterations underscore the necessity for further research into the comprehensive influence of MetS on cognitive processes and the potential for early therapeutic interventions.

研究目的本研究旨在通过高分辨率磁共振成像(MRI)容积分析,阐明代谢综合征(MetS)对皮层下脑区及相关结构完整性的综合影响,从而有助于深入了解代谢综合征的神经解剖学维度及其对认知功能和大脑整体健康的潜在影响。研究方法采用横断面设计,在土耳其东部一家三甲医院的家庭医学诊所对 25 名确诊 MetS 至少一年的患者和 15 名健康对照组患者进行研究。参与者使用 1.5T 西门子 Aera 扫描仪进行了高分辨率磁共振成像扫描。MRICloud 平台用于对各种大脑结构进行全面分割和定量分析。研究结果研究显示,与对照组相比,MetS 患者所有测量到的皮层下脑区的体积都明显缩小(所有 P < 0.05)。在黑质、胼胝体和丘脑等关键结构中观察到明显差异。在皮层下结构中,体积差异最大的是基底节 L(1322.4 mm³),而百分比差异最显著的是黑质 R(25.24%)和尾状核 L(21.02%)。结论这项研究的结果强调了与 MetS 相关的重大神经解剖学变化,表现为大脑皮层下关键区域的体积减少。这些变化突出表明,有必要进一步研究 MetS 对认知过程的全面影响以及早期治疗干预的潜力。
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引用次数: 0
Changes in Transient Elastography with Glucagon-Like Peptide-1 Receptor Agonist Use in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Real-World Retrospective Analysis. 代谢功能障碍相关性脂肪肝患者使用胰高血糖素样肽-1 受体激动剂后瞬时弹性成像的变化:真实世界的回顾性分析
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-01 Epub Date: 2024-06-13 DOI: 10.1089/met.2024.0115
Nazar Akhverdyan, Amanda Wieland, Shelby Sullivan, Mark Lindsay, Sheila Swartwood, Gretchen Arndt, Laura Katherine Kaizer, Thomas Jensen

Introduction: Current guidelines recommend the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD), especially in patients with comorbid diabetes and obesity. This study investigated the effects of GLP-1RAs on hepatic steatosis and fibrosis in patients with MASLD, as measured by changes in vibration-controlled transient elastography (VCTE) and other clinical parameters in a real-world clinical setting. Methods: We conducted a single-center, retrospective analysis of 96 patients with MASLD from a multidisciplinary care clinic who completed VCTE at baseline and follow-up within 6-24 months to compare changes in controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), as well as other metabolic markers, between GLP-1RA users and nonusers using two-sample t-tests and Wilcoxon rank-sum tests. We also assessed whether improvements in hepatic steatosis, defined as a change in CAP >38 dB/m as previously described in the literature, were associated with improvement in fibrosis. Results: GLP-1RA use resulted in significant improvements in weight (-8.1 kg vs. -3.5 kg, P = 0.009), body mass index (BMI) (-2.9 kg/m2 vs. -1.3 kg/m2, P = 0.012), alanine aminotransferase (-15.0 IU/L vs. -4.0 IU/L, P = 0.017), aspartate aminotransferase (-5.0 IU/L vs. -1.0 IU/L, P = 0.021), glycated hemoglobin (HbA1c) (-0.7% vs. 0.1%, P = 0.019), and CAP (-59.9 dB/m vs. -29.1 dB/m, P = 0.016). Responders also had significant improvements in weight (-9.2 kg vs. -1.9 kg, P < 0.001), BMI (-3.3 kg/m2 vs. -0.7 kg/m2, P < 0.001), diastolic blood pressure (-6.1 mmHg vs. -0.7 mmHg, P = 0.028), HbA1c (-0.8% vs. 0.3%, P < 0.001), and LSM (-1.5 kPa vs. 0.1 kPa, P < 0.001). Conclusions: Patients with MASLD treated with GLP-1RAs showed significant improvements in hepatic steatosis and multiple other metabolic parameters, with weight loss as the proposed mechanism for this liver improvement. In addition, change in CAP >38 dB/m was associated with improvements in LSM and other metabolic parameters, suggesting the clinical utility of VCTE in the surveillance of MASLD.

简介:现行指南建议使用胰高血糖素样肽-1受体激动剂(GLP-1RA)治疗代谢功能障碍相关性脂肪性肝病(MASLD),尤其是合并糖尿病和肥胖症的患者。本研究调查了 GLP-1RA 对 MASLD 患者肝脏脂肪变性和纤维化的影响,这些影响是通过实际临床环境中振动控制瞬时弹性成像(VCTE)和其他临床参数的变化来测量的。研究方法我们对96名来自多学科护理诊所的MASLD患者进行了单中心回顾性分析,这些患者在基线时完成了VCTE,并在6-24个月内进行了随访,我们使用双样本t检验和Wilcoxon秩和检验比较了GLP-1RA使用者和非使用者之间受控衰减参数(CAP)和肝脏硬度测量(LSM)以及其他代谢指标的变化。我们还评估了肝脏脂肪变性的改善(定义为 CAP >38 dB/m 的变化,如之前文献中所述)是否与肝纤维化的改善相关。结果:使用 GLP-1RA 后,体重(-8.1 千克 vs. -3.5 千克,P = 0.009)、体重指数 (BMI)(-2.9 千克/平方米 vs. -1.3 千克/平方米,P = 0.012)、丙氨酸氨基转移酶(-15.0 IU/L vs. -4.0 IU/L,P = 0.012)均有显著改善。-4.0 IU/L,P = 0.017)、天冬氨酸氨基转移酶(-5.0 IU/L vs. -1.0 IU/L,P = 0.021)、糖化血红蛋白(HbA1c)(-0.7% vs. 0.1%,P = 0.019)和 CAP(-59.9 dB/m vs. -29.1 dB/m,P = 0.016)。应答者的体重(-9.2 千克 vs. -1.9 千克,P < 0.001)、体重指数(-3.3 千克/平方米 vs. -0.7 千克/平方米,P < 0.001)、舒张压(-6.1 毫米汞柱 vs. -0.7 毫米汞柱,P = 0.028)、HbA1c(-0.8% vs. 0.3%,P < 0.001)和 LSM(-1.5 千帕 vs. 0.1 千帕,P < 0.001)也有明显改善。结论接受 GLP-1RAs 治疗的 MASLD 患者的肝脏脂肪变性和其他多个代谢指标均有显著改善,体重减轻是肝脏改善的机制之一。此外,CAP >38 dB/m 的变化与 LSM 和其他代谢参数的改善有关,这表明 VCTE 在监测 MASLD 方面具有临床实用性。
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引用次数: 0
Association Between Metabolic Syndrome and Health-Related Quality of Life in Older Adults: Findings from the IRanian Longitudinal Study on Ageing. 代谢综合征与老年人与健康相关的生活质量之间的关系:爱尔兰老龄化纵向研究的发现
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-01 Epub Date: 2024-07-03 DOI: 10.1089/met.2023.0049
Ali Gholami, Azam Doustmohammadian, Seyed Morteza Shamshirgaran, Nayyereh Aminisani, Mohsen Azimi-Nezhad, Hamid Abasi, Mitra Hariri

Objectives: There are some studies without consensus on the association between metabolic syndrome (MetS) and health-related quality of life (HRQoL) and few studies among elderly participants; therefore, the aim of this study is evaluating the association between MetS and HRQoL between elderly participants after adjusting for possible confounding factors. Methods: A cross-sectional analysis was conducted with the data from baseline phase of the IRanian Longitudinal Study on Ageing. The MetS diagnosis was conducted based on the National Cholesterol Education Program Adult Treatment Panel III guidelines. The participants were 3452 subjects aged ≥60 years with and without MetS. The Prospective Epidemiological Research Studies in Iran version of the SF-12 questionnaire was used to examine subjects' perspectives on their well-being and general health level. The association between MetS and HRQoL was evaluated through multivariable linear regression model after adjusting for possible covariates. Results: MetS independently had an inverse association with subscales of HRQoL including physical functioning, physical problems, general health, social functioning, and emotional problems, even after fully adjusting for studied confounding factors. An inverse association was also observed between MetS and both mental component summary and physical component summary in the fully adjusted model. Conclusion: Older adults with MetS had a relatively worse physical and mental HRQoL in comparison with individuals without MetS. Independent of any underlying factors, the inverse association of MetS with HRQoL emphasizes the necessity of routine screening and treatment of MetS in older populations.

研究目的关于代谢综合征(MetS)与健康相关生活质量(HRQoL)之间的关系,一些研究尚未达成共识,而针对老年参与者的研究也很少;因此,本研究的目的是在调整可能的混杂因素后,评估代谢综合征与老年参与者的 HRQoL 之间的关系。研究方法利用爱尔兰老龄化纵向研究基线阶段的数据进行横断面分析。MetS 诊断是根据美国国家胆固醇教育计划成人治疗小组 III 指南进行的。研究对象包括 3452 名年龄≥60 岁、患有和未患有 MetS 的受试者。研究采用了伊朗前瞻性流行病学研究的 SF-12 问卷来考察受试者对其幸福感和总体健康水平的看法。在对可能的协变量进行调整后,通过多变量线性回归模型评估 MetS 与 HRQoL 之间的关系。结果显示MetS 与 HRQoL 的子量表(包括身体机能、身体问题、总体健康、社会机能和情绪问题)之间存在独立的反向关系,即使在完全调整了所研究的混杂因素之后也是如此。在完全调整模型中,还观察到 MetS 与精神部分摘要和身体部分摘要之间存在反向关系。结论与没有 MetS 的人相比,患有 MetS 的老年人的身体和精神 HRQoL 相对较差。与任何潜在因素无关,MetS 与 HRQoL 的反向关系强调了对老年人群进行 MetS 常规筛查和治疗的必要性。
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引用次数: 0
Effect of Real-Time Continuous Glucose Monitoring Versus Flash Glucose Monitoring on Glycemic Control in Adults with Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis. 实时连续葡萄糖监测与闪存葡萄糖监测对 1 型糖尿病成人血糖控制的影响:系统回顾与元分析》。
IF 2.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-11 DOI: 10.1089/met.2024.0025
Danrui Chen,Beisi Lin,Zhigu Liu,Mengyun Lei,Yanling Yang,Bin Yao,Jinhua Yan,Daizhi Yang,Wen Xu
Objective: This meta-analysis aimed to compare the effect of the real-time continuous glucose monitoring (rt-CGM) and flash glucose monitoring (FGM) on glycemic control in adults with type 1 diabetes mellitus (T1DM). Methods: A systematic literature search of all relevant studies comparing the clinical effectiveness of rt-CGM and FGM in adults with T1DM on Cochrane Library, PubMed, Embase, Web of Science, and Scopus from January 2015 to June 2023 was performed. The primary endpoints were glycated hemoglobin (HbA1c) and TIR (time in range). Secondary endpoints included time below range [TBR (<3.9 mmol/L) and (<3.0 mmol/L)], time above range [TAR (>10.0 mmol/L) and (>13.9 mmol/L)], mean glucose, and glycemic variability (GV) [standard deviations (SD) and coefficient of variation (CV)]. Results: Six studies with 1516 TIDM patients, including three randomized controlled trials and three observational studies, were enrolled in this meta-analysis. Compared to FGM, rt-CGM led to greater glycemic control, represented by higher TIR (%, 3.9 ∼ 10 mmol/L) (SMD = 0.59, 95%CI: 0.37 ∼ 0.81, p < 0.001), decreased TBR (%, <3.9 mmol/L) (SMD = -1.45, 95%CI: -2.33 ∼ -0.57, p = 0.001), decreased TAR [(%, >10.0 mmol/L) (SMD = -0.38, 95%CI: -0.71 ∼ -0.04, p = 0.03) and (%, >13.9 mmol/L) (SMD = -0.42, 95%CI: -0.79 ∼ -0.04, p = 0.03), respectively], lower mean glucose (SMD = -0.18, 95%CI: -0.31 ∼ -0.06, p = 0.003), decreased SD (SMD = -0.70, 95%CI: -1.09 ∼ -0.31, p < 0.001), and decreased CV (SMD = -0.76, 95%CI: -1.05 ∼ -0.47, p < 0.001). However, there was no difference in lowering HbA1c and TBR (%, <3.0 mmol/L) between groups. Conclusion: The rt-CGM outperformed FGM in improving several key CGM metrics among adults with T1DM, but there is no significant difference in HbA1c and TBR (<3.0 mmol/L).
目的:本荟萃分析旨在比较实时连续血糖监测(rt-CGM)和闪光血糖监测(FGM)对 1 型糖尿病(T1DM)成人患者血糖控制的影响。研究方法对 2015 年 1 月至 2023 年 6 月期间在 Cochrane Library、PubMed、Embase、Web of Science 和 Scopus 上比较 rt-CGM 和 FGM 对成年 T1DM 患者临床疗效的所有相关研究进行了系统性文献检索。主要终点是糖化血红蛋白(HbA1c)和TIR(在范围内的时间)。次要终点包括低于范围时间[TBR(10.0 mmol/L)和(>13.9 mmol/L)]、平均血糖和血糖变异性(GV)[标准差(SD)和变异系数(CV)]。结果:本次荟萃分析共纳入了六项研究,共 1516 名 TIDM 患者,其中包括三项随机对照试验和三项观察性研究。与 FGM 相比,rt-CGM 能更好地控制血糖,表现为更高的 TIR(%,3.9 ∼ 10 mmol/L)(SMD = 0.59,95%CI:0.37 ∼ 0.81,p < 0.001),TBR 下降(%,10.0 mmol/L)(SMD = -0.38,95%CI:-0.71 ∼ -0.04,p = 0.03)和(%,>13.9 mmol/L)(SMD = -0.42,95%CI:-0.79 ∼ -0.04,p = 0.03)],降低平均血糖(SMD = -0.18,95%CI:-0.31 ∼ -0.06,p = 0.003),降低 SD(SMD = -0.70,95%CI:-1.09 ∼ -0.31,p < 0.001),降低 CV(SMD = -0.76,95%CI:-1.05 ∼ -0.47,p < 0.001)。然而,在降低 HbA1c 和 TBR(%,<3.0 mmol/L)方面,组间没有差异。结论rt-CGM在改善T1DM成人患者的几项关键CGM指标方面优于FGM,但在HbA1c和TBR(<3.0 mmol/L)方面没有显著差异。
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引用次数: 0
Using Cluster Analysis to Identify Metabolic Syndrome Components and Physical Fitness in Patients with Metabolic Syndrome. 利用聚类分析确定代谢综合征患者的代谢综合征成分和体能。
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-01 Epub Date: 2024-05-09 DOI: 10.1089/met.2024.0041
Şafak Yiğit, Buket Akıncı, Büşra Ülker Ekşi, Damla Korkmaz Dayıcan, Fulya Çalıkoğlu, Yusuf Çelik, İpek Yeldan, İlhan Satman

Background: Metabolic syndrome (MetS) comprises a cluster of cardiovascular risk factors. Physical inactivity and reduced physical fitness are associated with one or more components of MetS. However, MetS has many components, and the unclear relationship between the components and physical fitness parameters can provide a plain and straightforward understanding of the clustering method. Aim: To identify the relationship between physical fitness parameters, physical activity levels, and components of MetS using hierarchical cluster analysis. Methods: One hundred twenty-one patients (mean age = 51.4 ± 7.1/years, F:90, M:31) who were diagnosed as having MetS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria were included in the study. Fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were analyzed. Systolic and diastolic blood pressures, (SBP and DBP), were evaluated. Body composition (waist and hip circumference, (WC and HC), waist-to-hip ratio (WHR), body mass index (BMI), percent body fat, and visceral fat), upper and lower extremity muscle strength (dynamometer), and functional exercise capacity [6-minute walk test (6MWT)] were assessed as physical fitness parameters. Physical activity levels were assessed using a pedometer and number of steps (NS) was determined. Results: Of the patients, 45.5% were diagnosed as having MetS based on four components. The dendrogram consisted of two main clusters and four subclusters. The main cluster I composed of BMI, HC, WC, visceral fat, HDL-C, percent fat, SBP, DBP, and percent quadriceps. The main cluster II comprised FPG, TG, WHR, handgrip strength, 6MWT, and NS. Conclusion: MetS components clustered with different physical fitness parameters. The clusters in the dendrogram can provide substantial implications for heterogeneous MetS components and physical fitness parameters. Future studies are needed to elucidate the effectiveness of dendrogram-derived exercise programs in MetS.

背景:代谢综合征(MetS代谢综合征(MetS)由一组心血管风险因素组成。缺乏运动和体能下降与 MetS 的一个或多个组成部分有关。然而,MetS 有许多组成部分,而这些组成部分与体能参数之间的关系并不明确,因此可以对聚类方法进行简单明了的理解。目的:采用分层聚类分析确定体能参数、体力活动水平和 MetS 组成部分之间的关系。方法:对 121 名患者(平均年龄为 45 岁)进行分组:研究纳入了 121 名根据美国国家胆固醇教育计划-成人治疗小组 III(NCEP-ATP III)标准被诊断为 MetS 的患者(平均年龄 = 51.4 ± 7.1/岁,女:90,男:31)。对空腹血浆葡萄糖(FPG)、高密度脂蛋白胆固醇(HDL-C)和甘油三酯(TG)进行了分析。评估了收缩压和舒张压(SBP 和 DBP)。身体成分(腰围和臀围(WC 和 HC)、腰臀比(WHR)、体重指数(BMI)、体脂百分比和内脏脂肪)、上下肢肌力(测力计)和功能锻炼能力[6 分钟步行测试(6MWT)]作为体能参数进行了评估。使用计步器评估身体活动水平,并确定步数(NS)。结果显示根据四个组成部分,45.5% 的患者被诊断为 MetS 患者。树枝图由两个主簇和四个子簇组成。主簇 I 由体重指数(BMI)、心率(HC)、腹围(WC)、内脏脂肪、高密度脂蛋白胆固醇(HDL-C)、脂肪百分比、SBP、DBP 和股四头肌百分比组成。主群 II 由 FPG、TG、WHR、手握力、6MWT 和 NS 组成。结论是MetS成分与不同的体能参数聚类。树枝图中的聚类可为异质性 MetS 成分和体能参数提供实质性意义。今后还需要进行研究,以阐明树枝图衍生的锻炼计划对 MetS 的有效性。
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引用次数: 0
Heterogeneous Pathological Changes in Liver Lobes During Liver Disease: A Perspective Review. 肝病期间肝叶的异质性病理变化:透视回顾
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-01 Epub Date: 2024-07-22 DOI: 10.1089/met.2023.0311
Carla Cristina de Oliveira Bernardo, Guilherme Godoy, Wilson Eik Filho, Rui Curi, Roberto Barbosa Bazotte

Liver diseases have a global prevalence of 25%, accounting for 4% of all deaths worldwide, and are associated with a 36% increased risk of fatal and nonfatal cardiovascular events. Metabolic dysfunction-associated steatotic liver disease constitutes the liver expression of metabolic syndrome and represents the primary type of liver disease. Microscopical analysis of biopsies, which allows the evaluation of a small portion of tissue with inferences made to the entire organ, is considered the gold standard for determining the presence of liver diseases. However, potential sampling errors in liver biopsies are conceivable because the obtained tissue represents only a tiny fraction of the entire liver mass and may not accurately reflect the true pathological state. Studies have demonstrated the existence of sampling errors in liver biopsies, particularly concerning the severity of inflammation, degree of fibrosis, and the presence of cirrhosis. Also, clinical studies have shown that histopathological abnormalities are better detected in humans when liver samples are collected from both the right and the left lobes. However, a gap exists in clinical investigation to clarify the role of differences between these lobes in improving the diagnostic and prognostic for liver diseases. Building upon the heterogeneous nature of pathological alterations observed in liver lobes, this perspective review provided recommendations to enhance the precision of diagnosis and prognostic accuracy of liver diseases.

肝脏疾病在全球的发病率为 25%,占全球死亡总人数的 4%,与致命和非致命心血管事件风险增加 36% 相关。代谢功能障碍相关脂肪性肝病是代谢综合征在肝脏的表现,也是肝病的主要类型。活组织切片的显微镜分析可对一小部分组织进行评估,并推断出整个器官的情况,被认为是确定是否存在肝脏疾病的金标准。然而,肝脏活检可能存在取样误差,因为获得的组织仅占整个肝脏的一小部分,可能无法准确反映真实的病理状态。研究表明,肝活检存在取样误差,尤其是在炎症严重程度、纤维化程度和肝硬化的存在方面。此外,临床研究还表明,如果同时从左右两个肝叶采集肝脏样本,就能更好地检测出人体组织病理学异常。然而,在临床研究中,要明确这些肝叶之间的差异在改善肝病诊断和预后方面的作用还存在差距。基于在肝叶中观察到的病理改变的异质性,本视角综述为提高肝病诊断和预后的准确性提供了建议。
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引用次数: 0
Metabolomics Characterization of Disease Markers in Diabetes and Its Associated Pathologies. 糖尿病及其相关病症中疾病标志物的代谢组学特征。
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-01 Epub Date: 2024-05-23 DOI: 10.1089/met.2024.0038
Swarnima Pandey

With the change in lifestyle of people, there has been a considerable increase in diabetes, which brings with it certain follow-up pathological conditions, which lead to a substantial medical burden. Identifying biomarkers that aid in screening, diagnosis, and prognosis of diabetes and its associated pathologies would help better patient management and facilitate a personalized treatment approach for prevention and treatment. With the advancement in techniques and technologies, metabolomics has emerged as an omics approach capable of large-scale high throughput data analysis and identifying and quantifying metabolites that provide an insight into the underlying mechanism of the disease and its progression. Diabetes and metabolomics keywords were searched in correspondence with the assigned keywords, including kidney, cardiovascular diseases and critical illness from PubMed and Scopus, from its inception to Dec 2023. The relevant studies from this search were extracted and included in the study. This review is focused on the biomarkers identified in diabetes, diabetic kidney disease, diabetes-related development of CVD, and its role in critical illness.

随着人们生活方式的改变,糖尿病患者大幅增加,随之而来的某些后续病症也造成了巨大的医疗负担。确定有助于筛查、诊断和预后糖尿病及其相关病症的生物标志物,将有助于更好地管理病人,促进预防和治疗的个性化治疗方法。随着技术和科技的进步,代谢组学已成为一种能够进行大规模高通量数据分析、鉴定和量化代谢物的全息方法,可帮助人们深入了解糖尿病及其进展的内在机制。从 PubMed 和 Scopus 开始到 2023 年 12 月,在指定关键词(包括肾脏、心血管疾病和危重病)的对应关系中搜索糖尿病和代谢组学关键词。从搜索中提取相关研究并将其纳入本研究。本综述的重点是在糖尿病、糖尿病肾病、糖尿病相关心血管疾病的发展及其在危重病中的作用中发现的生物标志物。
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引用次数: 0
Causality of Genetically Determined Metabolites on Chronic Kidney Disease: A Two-Sample Mendelian Randomization Study In Silico. 基因决定的代谢物对慢性肾病的因果关系:双样本孟德尔随机化硅学研究。
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-01 Epub Date: 2024-05-14 DOI: 10.1089/met.2024.0030
Zekai Zhang, Beibei Cao, Qiutong Wu

Introduction: Chronic kidney disease (CKD) is associated with metabolic disorders. However, the evidence for the causality of circulating metabolites to promote or prevent CKD is still lacking. Methods: The two-sample Mendelian randomization (MR) analysis was conducted to evaluate the latent causal relationship between the genetically proxied 486 blood metabolites and CKD. Genome-wide association study (GWAS) data for exposures were derived from 7824 European GWAS on metabolite levels, which have been extensively utilized in the medical field to elucidate the mechanisms underlying disease onset and progression. The random inverse variance weighted (IVW) is the primary analysis for causality analysis while MR-Egger and weighted median as complementary analyses. For the further identification of metabolites, reverse MR and linkage disequilibrium score regression were performed for further evaluation. The drug target for N-acetylornithine was subsequently supplemented into the analysis, with MR and colocalization analysis being utilized. Key metabolic pathways were identified via MetaboAnalyst 4.0 (https://www.metaboanalyst.ca/) online website. Results: N-acetylornithine was identified as a reliable metabolite that increases the susceptibility to estimated glomerular filtration rate (eGFR) decrease (β = 0.047; 95% confidence interval: -0.068 to -0.026; PIVW = 1.5E-5). The "glyoxylate and dicarboxylate metabolism" pathway showed significant relevance to CKD development (P = 6E-4), whereas the "glycine, serine, and threonine metabolism" pathway was also recognized as associated with CKD by general practitioners (P = 7E-4). Colocalization analysis revealed a robust genetic link between N-acetylornithine and both CKD and eGFR, with 85.1% and 99.4% colocalization rates, respectively. IVW-MR analysis substantiated these findings with a significant positive association for CKD (odds ratio = 1.43, P = 4.7E-5) and a negative correlation with eGFR (b = -0.04, P = 1.13E-31). Conclusions: MR was utilized to explore the potential causal links between 61 genetic serum metabolites and CKD. N-acetylornithine and NAT8 were further explored as a potential therapeutic target for CKD treatment.

简介慢性肾脏病(CKD)与代谢紊乱有关。然而,循环代谢物对促进或预防 CKD 的因果关系仍缺乏证据。研究方法采用双样本孟德尔随机化(MR)分析法评估 486 种血液代谢物的基因代型与 CKD 之间的潜在因果关系。暴露的全基因组关联研究(GWAS)数据来自欧洲 7824 项关于代谢物水平的全基因组关联研究。随机逆方差加权(IVW)是因果关系分析的主要分析方法,而 MR-Egger 和加权中位数则是补充分析方法。为进一步鉴定代谢物,还进行了反向 MR 和连接不平衡得分回归以进一步评估。随后,利用磁共振和共定位分析对 N-乙酰鸟氨酸的药物靶标进行了补充分析。通过 MetaboAnalyst 4.0 (https://www.metaboanalyst.ca/) 在线网站确定了关键代谢途径。结果N-乙酰鸟氨酸被确定为增加估计肾小球滤过率(eGFR)下降易感性的可靠代谢物(β = 0.047;95% 置信区间:-0.068 至 -0.026;PIVW = 1.5E-5)。乙醛酸盐和二羧酸盐代谢 "途径与 CKD 的发展有显著相关性(P = 6E-4),而 "甘氨酸、丝氨酸和苏氨酸代谢 "途径也被全科医生认为与 CKD 有关(P = 7E-4)。共定位分析表明,N-乙酰鸟氨酸与慢性肾功能衰竭和 eGFR 之间存在密切的遗传联系,共定位率分别为 85.1%和 99.4%。IVW-MR 分析证实了这些发现,与 CKD 呈显著正相关(比值比 = 1.43,P = 4.7E-5),与 eGFR 呈负相关(b = -0.04,P = 1.13E-31)。结论:利用磁共振技术探索了 61 种基因血清代谢物与慢性肾脏病之间的潜在因果关系。进一步探讨了 N-乙酰鸟氨酸和 NAT8 作为治疗 CKD 的潜在治疗靶点的可能性。
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引用次数: 0
Evaluating the Potential of a Novel Metabolic Syndrome Severity Score to Inform Exercise Interventions for People with Complex Chronic Conditions. 评估新型代谢综合征严重程度评分的潜力,为复杂慢性病患者的运动干预提供参考。
IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.1089/met.2024.0031
Riley C C Brown, Jeff S Coombes, Marguerite M Conley, Lindsey Webb, Hannah L Mayr, Nicole M Isbel, Dev K Jegatheesan, Graeme A Macdonald, Nicola W Burton, Jaimon T Kelly, Ingrid J Hickman, Shelley E Keating

Aims: Exercise interventions positively affect numerous cardiometabolic risk factors. To better evaluate the health effects of exercise training, it may be more appropriate to evaluate risk factors together. The Metabolic Syndrome Severity Score (MetSSS) is a composite score representing cardiometabolic risk. Purpose: To evaluate the relationships between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS in a heterogenous sample of people with complex chronic disease. Material and Methods: Fifty-three people with kidney or liver disease and at least one feature of the metabolic syndrome (MetS) were included. Pearson correlations were conducted between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS. Linear regressions were performed for multi-level categorical variables. Independent variables with an association with MetSSS (P ≤ 0.2) were included in a multiple regression analysis. Results: The 6-minute walk test (6MWT) distance was inversely and independently associated with MetSSS [standardized beta coefficient (β) = -0.31, P = 0.04]. No relationship was found between MetSSS and physical activity or neuromuscular fitness. Mean 6MWT in the highest tertile was 550 m (range: 505-620 m) and 346 m (range: 233-408 m) in the lowest. The analysis showed a medium-large between-group effect for the difference in MetSSS for the lowest and highest tertile of 6MWT [Eta squared (η2) = 0.16, P = 0.01]. Conclusions: Exercise capacity was inversely and independently associated with MetSSS in people with complex chronic disease. Clinical trials with exercise interventions are needed to further investigate if improvements in exercise capacity result in clinically significant changes in the MetSSS.

目的:运动干预会对多种心脏代谢风险因素产生积极影响。为了更好地评估运动训练对健康的影响,可能更适合同时评估风险因素。代谢综合征严重程度评分(MetSSS)是代表心脏代谢风险的综合评分。目的:在复杂慢性病患者的不同样本中,评估体育锻炼、神经肌肉健康、运动能力和 MetSSS 之间的关系。材料与方法:纳入 53 名患有肾脏或肝脏疾病并至少患有一种代谢综合征(MetS)的患者。在体力活动、神经肌肉健康、运动能力和 MetSSS 之间进行了皮尔逊相关性分析。对多级分类变量进行了线性回归。与 MetSSS 相关的独立变量(P ≤ 0.2)被纳入多元回归分析。结果6分钟步行测试(6MWT)距离与MetSSS呈独立的反比关系[标准化β系数(β)=-0.31,P=0.04]。MetSSS与体力活动或神经肌肉健康之间没有关系。最高三等分组的平均 6MWT 为 550 米(范围:505-620 米),最低三等分组为 346 米(范围:233-408 米)。分析表明,6MWT 最低和最高三分位数的 MetSSS 差异具有中大型组间效应[Eta 平方 (η2) = 0.16,P = 0.01]。结论运动能力与复杂慢性病患者的 MetSSS 呈独立的反比关系。需要对运动干预进行临床试验,以进一步研究运动能力的提高是否会导致 MetSSS 发生具有临床意义的变化。
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引用次数: 0
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Metabolic syndrome and related disorders
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