Minerva endocrinology最新文献

Introduction: Over the past decade, there has been increasing interest in exploring the relationship between overweight, obesity and vertebral fractures. Nonetheless, available data from studies on the relationship between overweight, obesity and vertebral fractures remains controversial.

Evidence acquisition: A systematic search was performed in the PubMed and Cochrane Library databases. We selected relevant literature by using these keywords: fracture, vertebral fracture, vertebral compression fracture, overweight, obese, obesity. The retrieval mainly collected publicly published observational studies on the correlation between overweight, obesity and vertebral fractures, excluding the literature that did not meet the inclusion criteria. Meta-analysis for the data extracted from all the included literatures was performed by STATA 12.0 (StataCorp LLC, College Station, TX, USA) to summarize test performance with forest plots and assess the heterogeneity.

Evidence synthesis: Ten studies, including 1,024,181 subjects satisfied the predefined eligibility criteria. The results showed that the overweight (25.0≤ Body Mass Index [BMI] ≤29.9 kg/m²) and obesity (BMI≥30.0kg/m²) were associated with a decreased risk of vertebral fractures, respectively. The pooled RR is 0.86 (95% CI: 0.79, 0.95) and 0.81(95% CI:0.74-0.90) with no evidence of statistical heterogeneity. However, the relationship between overweight/obesity (BMI≥25 kg/m²) and vertebral fractures is not statistically significant.

Conclusions: This study showed that overweight and obesity might decrease the risk of vertebral fractures, respectively. However, we did not observe a significant association between overweight/obesity (BMI≥25 kg/m²) and vertebral fractures.

Background: Diabetes has severe impacts on the health of patients. The differentiation of mesenchymal stem cells (MSCs) into islet-like cell clusters (ICCs) is an effective protocol for the treatment of diabetes. microRNAs (miRs) regulate multiple cellular processes including cell differentiation. This study sought to identify the mechanism of miR-365-3p in the differentiation of bone marrow MSCs (bMSCs) into ICCs.

Methods: Initially, the differentiation of bMSCs into ICCs was induced. Then, the miR-365-3p expression pattern in the bMSCs and ICCs was detected. Next, the miR-365-3p expression pattern was silenced in bMSCs to assess the effect on differentiation efficiency and measure the expressions of ICC marker genes during the differentiation of bMSCs into ICCs. The miR-365-3p downstream target genes were predicted and verified. Paired box protein 6 (Pax6) was downregulated in bMSCs with silenced miR-365-3p to evaluate the differentiation of bMSCs into ICCs. Furthermore, the Pax6 downstream pathway was evaluated.

Results: The differentiation of bMSCs into ICCs was successfully induced. The miR-365-3p expression in bMSCs was higher than that in ICCs. miR-365-3p downregulation in bMSCs facilitated the differentiation of bMSCs into ICCs, as evidenced by elevated releases of insulin and C-peptide in ICCs and elevated expressions of ICC marker genes. Our findings denoted that miR-365-3p targeted Pax6. Inhibition of Pax6 expression annulled the promotion of miR-365-3p downregulation on the differentiation of bMSCs into ICCs. Increased phosphorylation levels of MEK and ERK were identified in ICCs after downregulation of miR-365-3p however they were decreased after downregulation of Pax6.

Conclusions: This study supported that miR-365-3p inhibited the differentiation of bMSCs into ICCs via targeting Pax6 and inhibiting the MEK/ERK pathway.

Background: Hypothyroidism is a very common disease that requires life-long treatment. In our study, we analyze the quality of the YouTube videos concerning hypothyroidism as a "source of health information" for the patients, and the (possible) correlation between video quality and video popularity.

Methods: We included 96 YouTube videos obtained by using the following search terms: "hypothyroidism," "Hashimoto's disease," "thyroid insufficiency," and "low thyroid hormone." We evaluated video quality by using the DISCERN criteria, and video popularity by using the Video Power Index.

Results: The mean DISCERN Score for both raters was 1.995, indicating poor YouTube videos' quality. Sixty-eight videos achieved a high score in the video power index (VPI). The mean popularity score for videos with misleading information was higher than the mean score for all evaluated videos.

Conclusions: The overall quality of YouTube videos regarding hypothyroidism was poor. Videos frequently lack the source of information presented. Besides, content is often incomplete, and sometimes includes misleading statements. Physicians dealing with hypothyroid patients should be aware of the possibility that information and instruction they give to patients could be "modulated" by the availability of both low quality and popular alternative "sources of medical knowledge."

Background: We aimed to determine the cis-expression Quantitative Trait Loci (cis-eQTL) and trans-eQTL of differentially expressed genes (DEGs) in insulin resistance (IR) related pathways.

Methods: The expression profile data for insulin sensitivity (IS) and IR in the adipose tissue of patients with type 2 diabetes mellitus (T2DM) were acquired from the Gene Expression Omnibus databases. Then, the Gene set enrichment analysis (GSEA) and Gene set variation analysis (GSVA) methods were performed to identify the significant enrichment of potential Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways between IS and IR groups, and the Wilcoxon rank sum test was carried out to identify the DEGs related to KEGG pathways. Finally, the cis-eQTLs and trans-eQTLs that can affect the expression of DEGs were screened from the eQTLGen database.

Results: The GSEA and GSVA analysis indicated that the mTOR signaling pathway, insulin signaling pathway and T2DM had a strong correlation with the pathological process of T2DM. Furthermore, six genes (ACACA, GYS2, PCK1, PRKAR1A, SLC2A4, and VEGFA) were found to be significantly differentially expressed in IR-related pathways. Finally, we have identified a total of 1073 cis-eQTLs and 24 trans-eQTLs.

Conclusions: We screened out six genes that were significantly differentially expressed in IR-related pathways, including ACACA, GYS2, PCK1, PRKAR1A, SLC2A4, and VEGFA. Moreover, we discovered that these six genes were affected by 1073 cis-eQTLs and 24 trans-eQTLs.

Background: Kisspeptin has a major role in reproductive regulation. Furthermore, it is also involved in metabolic and cardiovascular regulation as well as is a potent vasoconstrictor. This study aimed to: 1) determine correlations between serum kisspeptin levels with obesity/metabolic parameters; 2) compare parameters between non-hypertensive ([non-HT] N.=15) and hypertensive ([HT] N.=15) female subjects; and 3) determine correlations between leptin, systolic blood pressure (SBP) or diastolic blood pressure (DBP) with obesity and metabolic factors.

Methods: Clinical parameters and fasting blood and adipose tissue samples were collected from women undergoing open abdominal surgery.

Results: Serum kisspeptin was not correlated with obesity parameters but was positively correlated with only SBP (P<0.05). Serum kisspeptin, SBP, DBP, body weight, waist circumference, hip circumference, plasma glucose, plasma insulin, the homeostatic model assessment for insulin resistance (HOMA-IR), and height of visceral adipocytes (VA) were higher but the Quantitative Insulin Sensitivity Check Index (QUICKI) was lower in hypertensive compared to non-hypertensive female subjects (P<0.05). Leptin was positively correlated with obesity and metabolic paramters including area, width, and perimeter of subcutaneous adipocytes, and area, width, height, and perimeter of VA (P<0.05) but was negatively correlated the QUICKI (P<0.001). SBP had positive correlations with insulin, glucose, HOMA-IR, and kisspeptin, but had a negative correlation with QUICKI (P<0.05). DBP had positive correlations with body weight, BMI, waist circumference, hip circumference, insulin, glucose, HOMA-IR, and width of VA (P<0.05), but had a negative correlation with the QUICKI (P<0.05).

Conclusions: Kisspeptin, obesity especially visceral adiposity, and insulin resistance might contribute to increased blood pressure. Further studies are required to reveal the underlying mechanism of kisspeptin on metabolic and cardiovascular regulation.

Background: The vast majority of erectile dysfunction (ED) treatments are currently symptomatic and do not influence disease progression. Regenerative medicine may potentially reverse or stop the progression of complicated ED by restoring erectile capacity. We aimed to evaluate potential safety and effectiveness and the clinical correlates of platelet function before platelet-rich plasma (PRP) injection in men with vascular ED unresponsive to phosphodiesterase-5 inhibitors (PDE-5is).

Methods: A number of 150 patients with vascular ED were enrolled in an open-label, single arm, multicenter, prospective, interventional, non-randomized study. After 1-month pharmacological washout from PDE-5is, the 5-item International Index of Erectile Function (IIEF-5) questionnaire was administered and dynamic penile duplex ultrasound (d-PDU) was performed. Patients then underwent intracavernous PRP injection. One month after treatment, IIEF-5 and d-PDU were evaluated. Primary aim of the study was to assess efficacy and safety of PRP treatment by evaluating the proportion of patients achieving minimal clinically important differences (MCID) in the IIEF-5 questionnaire. Secondary endpoint was to determine whether MPV could correlate with improvement in d-PDU parameters.

Results: Most patients (80%) had a significant improvement in ED symptoms (IIEF-5 Score: 12±2.6 vs. 19±3.0; P<0.0001) and in PSV (32±3.5 cm/s vs. 42±7.6 cm/s; P<0.0001) after d-PDU evaluation. The ROC curve analysis showed a significant accuracy (72.1%, CI: 64.0-80.2, P≤0.0001) for MPV in identifying men clinically responding to PRP with favorable MCID≥5 at 1 month follow-up. The MPV<8.95 fL was identified as the best predictor of success rate with a sensitivity of 90% and a specificity of 54.1%.

Conclusions: This study provides the first evidence that PRP could represent an effective and safe option for patients poorly responding to PDE-5is. MPV higher than 8.95 fL may identify patients with poor response to treatment that might benefit of successive re-challenge with PRP.

Background: Ovarian senescence is associated with increased cardiovascular risk. We aimed to evaluate the association between menopausal symptoms and cardiometabolic risk factors in a cohort of apparently healthy middle-aged women.

Methods: The cohort included 2793 peri- and postmenopausal women not on menopausal hormone therapy. Demographic/anthropometric and biochemical/hormonal data were assessed. The severity of menopausal symptoms was evaluated by the Greene Climacteric Scale (GCS).

Results: GCS-Total Score was associated with BMI (b=0.12, 95% CI: 0.04 to 0.20), T2DM (b=2.10, 95% CI: 0.06 to 4.15), and late-postmenopause (b=-1.24, 95% CI: -2.17 to -0.33). GCS-psychological score was associated with BMI (b=0.06, 95% CI: 0.00 to 0.11). GCS-Physical Score was associated with BMI (b=0.06, 95% CI: 0.03 to 0.09), central obesity (b=0.18, 95% CI: 0.02 to 0.34), and postmenopause (early-/late-postmenopause vs. perimenopause, b=-0.36, 95% CI: -0.59 to -0.13 and b=-0.65, 95% CI: -0.97 to -0.34, respectively). All GCS-scores were negatively associated with age. GCS-Sexual Score was associated with early-postmenopause (incidence rate ratio (IRR)=1.53, 95% CI: 1.21 to 1.94), central obesity (IRR=1.18, 95% CI: 1.00 to 1.39), smoking, diastolic blood pressure, age. Cox-regression analysis showed that incident T2DM was positively associated with increasing age, BMI, daily alcohol consumption, moderate-to-severe vasomotor symptoms (VMS, OR=1.045, 95% CI: 1.011 to 1.079), and negatively with moderate-to-strenuous physical activity. These associations persisted in lean but not in obese women.

Conclusions: The severity of menopausal symptoms is associated with T2DM, obesity, and smoking in a cohort of peri-/postmenopausal women. VMS were associated with incident T2DM, especially in lean women. These associations must be considered in implementing primary and secondary prevention strategies.

Background: Neudesin is a protein that is secreted from adipose tissue and central nervous system and has a regulatory function on energy metabolism. Although the effect of this protein is shown in the experimental model of type-2 diabetes mellitus (type-2DM), its effect in humans is not clearly known. In this study, we aimed to evaluate the relationship between serum neudesin level and metabolic, anthropometric and cardiovascular parameters in newly diagnosed type-2DM patients (group 1).

Methods: Forty patients in each were included in our study for group 1 and for the control group (group 2), which consisted of age and sex-matched healthy subjects. Serum neudesin, hs-CRP, carotid intima media thickness (CIMT), Body Mass Index (BMI) and insulin resistance (HOMA-IR) levels were compared prospectively.

Results: Serum neudesin levels were significantly higher in diabetic patients than in the control group (type-2DM: 64.69±3.06 ng/mL, control: 55.52±5.48 ng/mL, P=0.004*). There was an independent relationship between serum neudesin and HOMA-IR and BMI. Although there is a correlation between serum neudesin and CIMT; this feature disappeared in the regression analysis.

Conclusions: Serum neudesin increased in new diagnosis type-2DM patients. This increase seems to be related to obesity and insulin resistance. However, more extensive research is needed to clarify this issue.

Background: Lifestyle modifications (i.e., physical activity [PA] and lower dietary intake) often are not sufficient to improve testosterone (TE) levels and promote weight loss in men with metabolic hypogonadism. The aim of the study was to investigate the effects of a nutraceutical formulation containing myoinositol, alpha lipoic acid, folic acid and SelectSIEVE^® as add-on treatment to lifestyle modifications in improving obesity-related subclinical hypogonadism.

Methods: Body composition, insulin resistance, testicular and erectile function were investigated in 15 males (age=39.5±14.5 years; Body Mass Index [BMI]=30.2±3.8 kg/m², with subclinical hypogonadism (TE levels <14 and normal luteinizing hormone [LH]). After a run-in three months unsupervised PA period (T1), the nutraceutical supplement was administered two-times per day for three additional months (T2).

Results: BMI, the percentage fat mass, insulinemia and Homeostasis Model Assessment Index (P<0.01) along with glycemia (P<0.05) were significantly reduced at T2 compared to T1, respectively; fat free mass (FFM) was significantly higher at T2 compared to T1 (P<0.01). Also, TE, LH and 5-item international index of erectile function score were significantly increased at T2 compared to T1 (P<0.01), respectively.

Conclusions: The combination of unsupervised PA and nutraceutical supplement improves body composition, insulin sensitivity and TE production in overweight-obese men with metabolic hypogonadism. Further controlled studies in the long-term are warranted to elucidate potential changes in fertility.

Overweight and obesity are an important public health problem that affects a significant part of the world population and increases the risk of many metabolic diseases. Weight loss is the primary goal in obesity treatment, and many different dietary interventions are tried for this purpose. Intermittent fasting is a diet that has become popular in recent years with the weight loss it provides and includes periods of fasting and feeding. In addition to providing weight loss, intermittent fasting also has positive effects on important risk factors such as glucoregulatory parameters, blood lipids, and oxidative stress. Intermittent fasting appears to be an effective and safe way to achieve weight loss in obesity. It could also have therapeutic effects on obesity-related diseases. The aim of this review was to bring together up-to-date information on the effects of intermittent fasting on obesity and various obesity-related diseases, mechanisms of action, possible benefits and harms, and potential uses.