Nutrition & Diabetes最新文献

The endogenous intestinal microflora and environmental factors, such as diet, play central roles in immune homeostasis and reactivity. The microflora and diet both influence body weight and insulin resistance, notably through their effects on adipose cells. The aim of this study was to provide an update on how nutrient-derived factors (mostly focusing on fatty acids and glucose) impact the innate and acquired immune systems, including the immune system in the gut and its associated bacterial flora. The main source of fuel for energy-demanding immune cells is glucose. Insulin-responsive adipose tissue and Toll-like receptors (TLRs), which are part of the innate immune system and expressed in immune cells, intestinal cells, and adipocytes, are essential actors in the complex balance that ensures systemic immune and metabolic health. Leptin decreases during weight loss and increases brain activity in regions involved in the cognitive, emotional, and sensory control of food intake; restoring leptin levels maintains weight loss and reverses the alterations in brain activity. Obesity-triggering nutrients affect adipocytes, whereas proinflammatory leptin prompts the generation of cytokines and T cells. Collectively, data on nutrients demonstrate that starvation culminates in fat depletion, which then impacts the immune system. In people with obesity, inflammation originates largely from adipose tissue.

Objectives: Lifestyle intervention, especially dietary modification, has been the cornerstone in preventing type 2 diabetes (T2D). We aimed to investigate the associations of various protein intake exposures with the risk of incident T2D in adults with or without metabolic diseases.

Methods: We followed 29517 residents enrolled in the Shanghai Suburban Adult Cohort and Biobank (SSACB) without diabetes at baseline through the electronic information system. Cox proportional hazard models were used to evaluate the associations of various protein intake exposures with the risk of incident T2D, visualized by restricted cubic splines (RCS). Propensity-score matching and subgroup analysis were used to characterize the association between total protein and incident T2D by metabolic diseases. Meta-analysis further explored the association between protein intake and incident T2D in broader populations.

Results: In SSACB, 1511 (5.1%) participants developed T2D during a median follow-up period of 5.69 years. A U-shaped association between total protein and risk of incident T2D was found (protective range: 12.20-16.85 percentage energy (%E), cut-off point: 14.53%E). The U-shaped association (P-nonlinear < 0.001) remained in adults with hypertension with a narrower protective range (12.20-15.35%E), with a linear association in adults with NAFLD (HR per 1%E: 0.952, 95% CI: [0.910, 0.995]), whereas no significant association in adults with hyperlipidemia or central obesity. A negative association between plant protein and risk of incident T2D was also found in SSACB (HR per 1%E: 0.947, 95% CI: [0.900, 0.996]). In addition, the U-shaped association of total protein with the risk of incident T2D was reaffirmed in the dose-response meta-analysis (cut-off point: 15.10%E).

Conclusion: In SSACB, a U-shaped association between total protein intake and risk of incident T2D was found, which was reaffirmed in the dose-response meta-analysis, and differed by metabolic diseases, especially hypertension and NAFLD. Moreover, plant protein was inversely associated with the risk of incident T2D.

Objective: To probe the effectiveness of whole course fine nursing combined with insulin pump blood glucose management on patients with diabetes mellitus (DM) combined with ischemic cerebral infarction (ICI).

Methods: The control group (conventional nursing plus insulin subcutaneous injection) and observation group (whole course fine nursing plus insulin pump blood glucose management) were established. General characteristics, glucose control effects, recovery of neurological and motor functions, self-care ability, health behaviors, quality of life, satisfaction, and adverse event incidence were compared in both groups.

Results: Serum FBG, 2hPG, and HbA1c levels and NIHSS scores reduced and FMA, ESCA, 2-DSCS, and SF-36 scores increased after the intervention in both groups, and all significantly improved in the observation group. The observation group had higher satisfaction with blood glucose monitoring and feedback, health knowledge education, disposal of unexpected situations, treatment effect and comprehensive evaluation, and lower total adverse event incidence rate during hospitalization than the control group.

Conclusion: Whole course fine nursing combined with insulin pump glucose management can enhance the glucose control effect, and improve the neurological and motor functions, self-care ability, health behaviors and quality of life in patients with DM plus ICI, with high satisfaction and reduced adverse event incidence.

Background: Type 2 diabetes (T2D) is highly prevalent, particularly among south Asian populations, and diet is the first-line strategy to manage postprandial glucose (PG) response. Mycoprotein and guar gum reduce PG in normo-glycaemic people. This study investigates the independent and interactive effects of mycoprotein and guar gum on PG, insulin and appetite responses in white Europeans and south Asians with T2D.

Methods: In this double-blind, crossover, acute, randomised controlled trial, 18 subjects with T2D (10 white European, 8 south Asian) completed six separate visits consuming soy, chicken, and mycoprotein with and without guar gum. Incremental area under the curve (iAUC_0-180 min) for PG, insulin, and appetite scores, and total AUC_0-180 min glucagon-like peptide-1 (GLP-1), peptide tyrosine-tyrosine (PYY), as well as ad libitum energy intake and 48h-post-visit energy intake were measured and analysed by linear mixed models with protein, guar gum and ethnicity as fixed effects.

Results: We found independent effects of mycoprotein, guar gum and ethnicity on PG iAUC_0-180 min (mmol/L·min), where mycoprotein reduced PG vs. chicken (-129.84 [95% CI -203.16, -56.51]; p = 0.002), guar gum reduced PG vs. no guar gum (-197.35 [95% CI -254.30, -140.40; p < 0.001], and south Asian had increased PG vs. white Europeans (195.75 [95% CI 66.14, 325.35]; p = 0.005). An interaction between guar gum and ethnicity (p < 0.015) was found for insulin iAUC_0-180 min (µUI/mL·min), with guar gum lowering insulin responses in south Asian participants (-1909.69 [95% CI -2834.83, -984.511]; p < 0.001). No independent or interactive effects were observed for appetite-related outcomes.

Conclusion: Mycoprotein and guar gum promote significant independent effects in lowering PG in both white European and south Asians with T2D.

Jujube is a widely consumed fruit with a long history in traditional medicine. Numerous studies have explored its potential effects on various health parameters. However, the overall quality of this evidence and the specific impact of jujube on metabolic syndrome remain unclear. This meta-analysis investigates the effect of jujube on body mass index, serum lipid profile, blood sugar levels, and other metabolic factors and blood indicators. The databases Web of Science, Scopus, PubMed, Google Scholar, and SID were searched up to September 2023. Our review included various clinical studies written in English and Persian that focused on the effect of jujube on lipid profiles. In vivo, in vitro, review studies, book chapters, observational studies, and low-quality studies based on critical appraisal tools were excluded from the analysis. A total of seven studies involving 483 participants were included in this review. Jujube significantly reduced BMI and TG, and also markedly decreased FBS in subjects with type 2 diabetes. Furthermore, the results varied significantly based on subgroups defined by dosage, treatment duration, and disease type. Notably, LDL and total cholesterol levels showed a significant decrease within some of these subgroups. However, HDL, AST, and ALT did not have significant changes. The findings suggest that jujube may exert beneficial effects on metabolic diseases, particularly in patients with hyperlipidemia and type 2 diabetes. However, the overall quality of the evidence is limited, and further research is needed to confirm these findings and elucidate the mechanisms underlying jujube's effects. Impact of jujube fruit on serum lipid profile, glycemic index, and liver function: a systematic review and meta-analysis.

Elevated plasma levels of trimethylamine N-oxide (TMAO)-a compound derived from diet and the gut microbiome-have been widely studied for their association with diabetes risk and their potential role in disease pathophysiology and complications. However, clinical studies, both prospective and retrospective, have yielded conflicting results. For example, elevated levels of TMAO are frequently linked to an increased risk of cardiovascular and renal complications in individuals with diabetes. However, the robustness and independence of these associations differ across study populations and are influenced by the degree of adjustment for confounding risk factors. Considering insulin's regulatory effect on FMO3 activity in liver cells, TMAO may serve as a marker of hepatic insulin resistance, which could partially explain its association with diabetes risk. The role of TMAO in diabetes pathology remains controversial; while some studies emphasize its detrimental impact on insulin sensitivity and the progression of diabetes-related complications, others suggest potential protective effects. Investigating the largely unexplored role of TMAO's precursor, trimethylamine, may help elucidate these discrepancies. This review consolidates clinical and experimental findings to clarify TMAO's complex mechanistic contributions to diabetes pathology.

Background: This study aimed to investigate the role of Apolipoprotein B (Apo B) in diabetic nephropathy (DN) from epidemiological and genetic perspectives.

Methods: We employed weighted multivariable-adjusted logistic regression to assess the relationship between ApoB and DN risk, utilizing data from the National Health and Nutrition Examination Survey spanning 2007-2016. Then, we used restricted cubic splines (RCS) to flexibly model and visualize the relation of predicted ApoB levels with DN risk. Subsequently, a bidirectional two-sample Mendelian randomization study using genome-wide association study summary statistics was performed. The primary Inverse Variance Weighted method, along with supplementary MR approaches, was employed to verify the causal link between ApoB and DN. Sensitivity analyses were conducted to confirm the robustness of the results.

Results: Our observational study enrolled 2242 participants with diabetes mellitus from NHANES. The multivariable logistic regression model indicated that elevated ApoB levels (>1.2 g/L), compared to low levels (<0.8 g/L), were significantly associated with DN risk (P < 0.05). The RCS model revealed a positive linear association with the risk of DN when ApoB levels exceeded 1.12 g/L (OR = 1.29, 95% CI: 1.07-1.57, P = 0.008). However, the MR IVW method did not reveal a direct causal effect of DN on ApoB (OR: 0.976; 95% CI: 0.950-1.004; P = 0.095), nor a direct causal effect of ApoB on DN (OR: 0.837; 95% CI: 0.950-1.078; P = 0.428).

Conclusion: The evidence from observational studies indicates a positive correlation between ApoB levels exceeding 1.12 g/L and the onset of DN. However, the causal effects of ApoB on DN and vice versa were not supported by the MR analysis.

Objectives: Oxymatrine (OMT), a quinolizidine alkaloid derived from Sophora flavescens Ait., has demonstrated therapeutic potential in type 2 diabetes mellitus (T2DM). This study aimed to investigate its effects on diabetic osteoporosis (DOP) and explore the underlying mechanisms involving gut microbiota and osteogenic regulation.

Methods: In a rat model of T2DM, intragastric Oxymatrine was used to study trabecular bone repair through bone microstructure and histopathology analyses. Changes in gut microbiota, especially Gram-negative bacteria releasing lipopolysaccharides (LPS), were assessed via 16S rRNA sequencing. miRNA sequencing on LPS-induced rat osteoblasts, with and without Oxymatrine, explored osteoblast proliferation, mineralization, and the miR-539-5p/OGN/Runx2 pathway.

Results: The administration of OMT resulted in an enhancement of diabetic osteopathy by reversing trabecular bone loss and modifying the composition of gut microbiota, specifically affecting Gram-negative bacteria that release LPS into the bloodstream. miRNA sequencing revealed that miR-539-5p, which was upregulated in LPS-induced ROBs, was downregulated following OMT treatment. Furthermore, OMT was found to promote osteoblast proliferation and mineralization under conditions of LPS exposure and modulate the miR-539-5p/OGN/Runx2 signaling pathway.

Conclusions: OMT improves diabetic osteoporosis by altering gut microbiota, decreasing LPS release, and enhancing osteoblast growth and differentiation through the miR-539-5p/OGN/Runx2 pathway, suggesting its potential as a treatment.

Background: The present clinical trial examined the efficacy of an anti-inflammatory diet combined with acupuncture compared to an anti-inflammatory diet alone and standard treatment in depressed patients with type 2 diabetes (T2DM).

Methods: In this 8-week randomized controlled clinical trial, 90 patients with T2DM who were experiencing mild to moderate depression were included. The participants were randomly assigned to one of three groups: (i) acupuncture combined with an anti-inflammatory diet, (ii) an anti-inflammatory diet alone, and (iii) standard treatment. The combination therapy group received acupuncture therapy twice a week. Mental health outcomes, biochemical parameters, dietary intake, and anthropometric indices were assessed at baseline and the end of the trial.

Results: Of the 90 diabetic patients, 83 completed the intervention. Acupuncture therapy combined with diet resulted in an ~20% reduction in depression and anxiety, 4.28 and 0.82% reduction in waist circumference (WC) and HbA1C levels, respectively at the end of the trial. This combination therapy also significantly decreased WC (p = 0.04) and HbA1c levels (p = 0.008), while increasing high-density lipoprotein cholesterol concentrations (p = 0.02) compared to diet alone.

Conclusion: Our findings indicate that acupuncture, in conjunction with an anti-inflammatory diet, may be more effective in enhancing mental health, reducing HbA1C levels, and decreasing abdominal obesity compared to an anti-inflammatory diet alone in patients with T2DM experiencing mild-to-moderate depression after 8 weeks. However, further clinical trials with larger sample sizes and extended durations are recommended to confirm the efficacy of this adjunctive therapy.

Findings on the associations of dietary/tissue levels of omega-6 polyunsaturated fatty acids (n-6 PUFAs) with the risk of colorectal cancer (CRC) are conflicting. We conducted a dose-response meta-analysis to assess the associations of dietary/tissue levels of n-6 PUFAs [total, linoleic acid (LA), and arachidonic acid (AA)] with CRC risk in adults. Twenty prospective cohort studies with a total sample size of 787,490 participants were included. Comparing extreme intake levels of LA revealed the summary relative risks (RR) of 1.15 (95% confidence interval (CI): 1.05-1.27) for CRC, and 1.30 (95% CI: 1.00-1.68) for rectal cancer, indicating a significant positive association for LA. However, neither total n-6 PUFAs nor AA were associated with cancers. A significant positive association was also found between a 1 gr/day increase in dietary LA intake and risk of colon cancer (RR: 1.01, 95% CI: 1.00-1.02). There were no significant associations between tissue levels of total n-6 PUFAs (RR: 0.94, 95% CI: 0.75-1.19), LA (RR: 0.93, 95% CI: 0.61-1.41), and AA (RR: 0.97, 95% CI: 0.70-1.33) and CRC risk. In conclusion, these findings suggest that dietary intake, but not tissue levels, of LA was associated with an increased risk of colorectal, colon, and rectal cancers. (PROSPERO registration: CRD42024516584).