Nutrition & Metabolism最新文献

Background: Frailty syndrome poses significant challenges in older populations. Understanding the genetic and biochemical factors associated with frailty is essential for effective management strategies.

Methods: In this study, Thai older adults (≥ 60 years, n = 170) were assessed for physical parameters, levels of B vitamins, creatinine, and homocysteine. The polymorphisms of methylenetetrahydrofolate reductase (MTHFR) (677 C > T) and Transcobalamin II (TCN2) 776G > C were identified. Global DNA methylation (global DNAm) was assessed using a colorimetric assay.

Results: Participants were categorised into robust (n = 61), pre-frail (n = 62), and frail (n = 47) groups by Fried criteria and Kihon checklist. The physical parameters, including chair stand, functional reach, gait speed, and handgrip strength, showed highly significant differences among the groups (p < 0.01). Significant differences in folate and vitamin B₆ concentrations were observed between MTHFR and TCN2 genotypes, respectively. In addition, global DNAm levels were significantly lower in pre-frail individuals, particularly among those carrying the MTHFR C677T genotype, compared to both robust and frail groups. Notably, lower global DNAm was associated with a higher likelihood of being classified as pre-frail rather than frail, and a lower likelihood of being pre-frail compared to robust individuals. Moreover, correlation analyses revealed significant associations among physical parameters, clinical characteristics, and global DNAm.

Conclusions: This study demonstrated the interplay between genetic variants, micronutrient status, and epigenetic modifications in the context of frailty among older adults. These findings highlight the potential of epigenetic and metabolic markers in identifying early frailty, though longitudinal and mechanistic studies are needed to further clarify causal pathways.

Trial registration: This study was duly registered with the Thai Clinical Trial under the identifier TCTR20240626002 (date of registration: 21/06/2024).

Background: The coexistence of sarcopenia and obesity has been established as a pivotal factor driving the pathological progression of metabolic dysfunction-associated steatotic liver disease (MASLD). This study systematically evaluates the prevalence and risk of MASLD in patients with sarcopenic obesity (SO).

Method: A comprehensive literature search was conducted in PubMed, Cochrane Library, EMBASE, Web of Science and SCOPUS up to March 2025. All studies investigating the association between SO and MASLD were included in this meta-analysis. Two independent reviewers performed screening and data extraction. ORs and 95% CIs were calculated using random effect models. Subgroup analysis was used to identify the sources of heterogeneity. Heterogeneity was assessed using Cochran's Q test and quantified via the I² statistic. Quality assessment and publication bias (by Funnel plots and Egger's test) evaluation were also performed.

Results: Thirteen studies involving 35,373 SO patients (from six countries) were included after screening. Odds ratios (ORs) of the included studies were combined by random effect model. The pooled results revealed that 63.4% of SO patients had MASLD. Compared to non-SO individuals, SO was significantly associated with an increased risk of MASLD (OR = 4.45, 95% confidence interval (CI): 2.57-7.72, P < 0.001). Females exhibited a higher MASLD risk than males (OR = 4.22, 95% CI: 2.10-8.50 vs. OR = 7.56, 95% CI: 2.39-23.92). Substantial heterogeneity was observed across pooled results and subgroups. Additionally, SO patients had a 2.34-fold higher risk of MASLD-related fibrosis than non-SO individuals (OR = 2.34, 95% CI: 1.78-3.08, P < 0.001).

Conclusion: SO may be closely associated with a high prevalence of MASLD and accelerated fibrosis progression. These findings highlight SO as a potential high-risk population for MASLD, underscoring the need for targeted screening and intervention strategies. However, more high-quality research with unified definitions and different races is needed.

Background: The association of sugar sweetened beverages (SSBs) and coronary artery disease (CAD) has not been well-established in Asians, where SSBs are the leading ultra-processed food product.

Objective: We aim to examine the association between SSBs and premature CAD (PCAD) in Iranian adults.

Design: Case-control.

Participants: A multi-centric study of Iranians including 2006 PCAD and 1131 healthy individuals as control group.

Main outcome measures: Dietary intakes were assessed using a validated food frequency questionnaire (FFQ). SSBs consist of artificial juice and sugar -sweetened drinks. The PCAD was determined based on the results of angiography and the occlusion percent of vessels.

Statistical analysis: The odds of PCAD across the quartiles of SSBs were assessed by binary logistic regression.

Results: The mean (SD) age of participants and SSB consumption was 51.5 years and 46.9 g/d, respectively. In the fully-adjusted model, compared with participants in the first quartile, those in the fourth quartile had higher risk of PCAD (OR = 1.50, 95% CI: 1.12, 2.00; P trend = 0.044). Consistently, SSB consumption was directly associated with the severity of PCAD. The higher SSB consumption, the greater risk for the severe PCAD (OR Q4 vs. Q1 = 1.34, 95% CI: 1.06, 1.68; P < 0.001).

Conclusion: This study demonstrated that higher consumption of SSB might be associated with higher risk of PCAD. However, more prospective cohort studies are necessary to confirm this association.

Background: The prevalence of prediabetes and, consequently, type 2 diabetes is increasing around the world. Previous meta-analyses reported controversial findings regarding the association between vitamin D supplementation with glycemic control and diabetes risk. This comprehensive meta-analysis summarized existing research to provide an estimate of the impact of vitamin D supplementation on metabolic parameters and diabetes risk in individuals with prediabetes.

Method: A comprehensive systematic search was conducted across the Web of Science, Scopus, PubMed, and Cochrane databases, and Google Scholar using relevant keywords until 22 July 2025. The AMSTAR2 scale was used to evaluate the methodological quality of the included articles. Moreover, the certainty of the evidence was assessed using the GRADE tool. Stata 17 software was used for data analysis.

Results: Fourteen meta-analyses comprising 31 randomized controlled trials (RCTs) of 3856 prediabetic patients were included in this review. Combining the findings of RCTs revealed that vitamin D supplementation significantly reduced the levels of fasting blood sugar (WMD= -0.377 mg/dl, 95% CI (-0.589, -0.165), p < 0.001), insulin (WMD = -0.174 µU/mL, 95% CI (-0.274, 0.074), p < 0.001), hemoglobin A1c (WMD = -0.479%, 95% CI (-0.714, -0.245), p < 0.001), and serum triglyceride (TG) (WMD = -0.385 mg/dl, 95% CI (-0.622, -0.147), p = 0.002) in comparison with the control group. The effects of vitamin D on insulin resistance by homeostasis model assessment, 2-hour oral glucose tolerance test plasma glucose, homeostasis model assessment of β-cell function, body mass index, and diabetes risk of participants were not significant.

Conclusion: The findings of this umbrella review suggested that vitamin D supplementation could help to improve some glycemic indices and TG levels. However, due to discrepancies among the results, more well-designed RCTs are warranted to confirm and clarify the impacts of vitamin D supplementation in prediabetic patients.

Clinical trial number: Not applicable.

Background: Among all the elderly patients with type 2 diabetes mellitus (T2DM) of different body compositions, patients with sarcopenic obesity exhibited the most severe degree of insulin resistance despite possessing a normal body weight. It is well-established that interventions encompassing resistance training alone or in combination with whey protein supplementation, referred to hereafter as muscle-building interventions, are effective for increasing muscle mass and function in the elderly population. However, the impact of these muscle-building interventions on glucose metabolism in elderly T2DM patients with sarcopenic obesity remains unclear. The objective of this study was to elucidate the effect of muscle-building interventions on blood glucose and insulin resistance in elderly T2DM patients with sarcopenic obesity.

Methods: The muscle-building interventions in this study included resistance training alone and resistance training combined with whey protein supplementation. In this randomized controlled trial, elderly T2DM patients with sarcopenic obesity were divided into three distinct groups: the control group, the resistance training group, and the resistance training combined with whey protein supplement group. The muscle-building interventions were conducted for 12 weeks.

Results: Implementing muscle-building interventions showed significant improvements in glycemic indices (HbA1c, OGTT 2-hour plasma glucose) and insulin resistance levels (HOMA-IR, Gutt index) for elderly T2DM patients with sarcopenic obesity. These muscle-building interventions enhanced muscle functional indices (handgrip strength, 5-time chair stand test). The combination of resistance training with whey protein supplementation did not significantly enhance the favorable effects on glucose metabolism compared to resistance exercise alone. Correlation analyses revealed that improvements in muscle strength were significantly associated with enhancements in glucose metabolism.

Conclusions: In elderly T2DM patients with sarcopenic obesity, muscle-building interventions (particularly resistance exercise) have been shown to significantly improve blood glucose control and insulin resistance.

Background: Although prior studies have examined meal timing and health, few have considered the impact of individual chronotypes and diurnal preference. This study explored how meal distribution and chronotype-morning (M-type) versus evening (E-type)- are associated with cardiometabolic health.

Methods: A cross-sectional study was conducted among 574 women in Tehran, Iran. Dietary intake was assessed through three 24-hour recalls and chronotype was determined via the Morningness-Eveningness Questionnaire. Cardiometabolic markers-including blood pressure (BP), glucose, lipids, insulin, and high-sensitivity C-reactive protein (hs-CRP)-were measured.

Results: In E-type individuals, higher breakfast energy intake was linearly associated with lower systolic [β 95% CI, -0.03 (-0.05 _to -0.01)] and diastolic BP [-0.01 (-0.04 _to -0.003)]. Afternoon energy intake was associated with lower BMI [-0.02 (-0.04 _to -0.001)] and hs-CRP [-0.001 (-0.002 _to -0.0006)] in E-type women. Additionally, U-shaped associations were found between breakfast intake and systolic BP (turning point: 23% of total energy intake (TEI)), and between afternoon intake and BMI (13% TEI) and hs-CRP (12% TEI). In contrast, higher dinner energy intake was linearly associated with greater BMI in the intermediate [-0.01 (-0.02 _to -0.002)] and E-type group [0.05 (0.003 _to 0.09)], respectively. Eating window was associated with higher fasting blood glucose [0.001 (0.002 _to 0.003)] in E-type vs. M-type individuals.

Conclusion: Aligning energy intake with wake-up time-rather than delaying meals-may benefit evening chronotypes prone to circadian misalignment. Moderate breakfast and afternoon intake, with lower dinner intake, was related to better cardiometabolic health. Accordingly, longitudinal studies are advocated.

Background: Numerous trials confirm dietary interventions benefit type 2 diabetes mellitus (T2DM) management, but the optimal model is unclear. We evaluated 12 interventions through a Network Meta-Analysis (NMA) on their effects on Fasting Plasma Glucose (FPG), 2-h Postprandial Glucose (2hPG), HbA1c, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Total Cholesterol (TC), Triglycerides (TG), and BMI, providing evidence to guide clinical nursing.

Methods: We conducted an NMA of randomized controlled trials (RCTs) (PROSPERO registration: CRD42023429616), searching eight databases for studies published between January 1, 2010, and August 31, 2024. Two reviewers independently screened studies, extracted data, and assessed bias using the Cochrane Risk of Bias tool. Key and important outcomes were analyzed using Stata 17.0, with evidence quality assessed via the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Confidence in Network Meta-Analysis (CINeMA) scores.

Results: Eighteen RCTs comprising 1,687 patients were included. Among 12 evaluated dietary interventions, MNT ranked highest in reducing FPG (SUCRA = 77.6%; SMD = -0.75; 95% CI: -0.88 to -0.61). Digital dietary models were most effective for reducing HbA1c (SUCRA = 84.6%; SMD = -1.06; 95% CI: -2.11 to -0.01), while LGI diets were superior for both 2hPG (SUCRA = 62.1%; SMD = -0.62; 95% CI: -0.76 to -0.47) and HOMA-IR (SUCRA = 96.9%; SMD = -10.13; 95% CI: -15.96 to -4.30). The LGI + LGL intervention was most effective in reducing TC (SUCRA = 88.3%), TG (SUCRA = 80.6%), and BMI (SUCRA = 99.8%), with statistically significant differences observed in pairwise comparisons (P < 0.05). The quality of evidence was rated as high for FPG, 2hPG, HbA1c, and BMI, and moderate for HOMA-IR, TC, and TG.

Conclusions: These findings highlight the potential of MNT, LGI, digital dietary models, and LGI + LGL interventions to improve glycemic control and metabolic outcomes in patients with T2DM. However, further large-scale, multicenter RCTs are warranted to validate their long-term efficacy and safety.

Trial registration: CRD42023429616.

Background: Obesity has emerged as a global health crisis, with its prevalence having increased alarmingly over recent decades. There is significant damage to pancreatic islets due to obesity, as well as metabolic syndrome. Improving the function of β-cells in obese patients is meaningful for treatment. Thus, GLP-1 receptor agonists like semaglutide may be beneficial for islet structural remodeling and their endocrine function in diet-induced obese mice and associated with food intake. However, whether the specific impact of semaglutide on obesity is the same as calorie restriction(CR) has not been investigated.

Methods: In this study, Five-week-old male C57BL/6 mice were divided into two dietary groups and fed for 12 weeks a control diet or a high-fat diet (HFD). Then, for an additional four weeks, the main groups were resampled to include treatment (Semaglutide, SME, 40 µg/kg), or CR, totaling four groups: Control, Model, Model + SME, Model + CR. Immunofluorescence, Western blot, and RT-qPCR were used in the study.

Results: Semaglutide or CR was capable of ameliorating hyperglycemia and insulin sensitivity, and reduces the lesion on the islet, increases islet cell proliferation, and recovers islet size and alpha- and beta-cell masses. Moreover, the changes include improvement of METTL3/14, pancreatic duodenal homeobox 1 (PDX-1), and insulin signaling. Meanwhile, Semaglutide or CR significantly decreases the abundance of Firmicutes, Proteobacteria, and Verrucomicrobia, but increases the Bacteroides content.

Conclusions: Semaglutide plays a positive role in alleviating β-cell dysfunction by regulating gut microbiota, and METTL3/14, PDX-1, insulin signal pathway-related genes may be associated with CR.