Nutrition and Metabolic Insights最新文献

Background: Neonatal hyperinsulinemia is a rare condition, but poses a significant increase in the risk of recurrent and persistent hypoglycemia in newborns, which can lead to long-term neurodevelopmental complications if not identified early. This condition may be due to a congenital disorder, or arise transiently due to perinatal stress, and may develop as a consequence of interventions such as total parenteral nutrition (TPN). Infants diagnosed with SBO following extensive intestinal resection are particularly at higher risk.

Case presentation: This report is of a 2-week-old male neonate, delivered at 36 weeks gestation with a birth weight of 2.5 kg, the patient presented with jaundice, bilious emesis, and poor weight gain. Surgical intervention showed a midgut volvulus with extensive ischemic necrosis. A near-total resection of the small intestine performed. As a result, the patient developed short bowel syndrome as a result and required total parenteral nutrition (TPN). Even with administration of high-dose intravenous glucose (up to 13 mg/kg/min), the patient continued to experience recurrent, persistent hypoglycemia. Elevated insulin levels alongside normal cortisol, ACTH, growth hormone, and ammonia are revealed by laboratory evaluation, the profile suggest a stress-induced hyperinsulinemia. Management included careful glucose monitoring, optimization of TPN, and initiation of pharmacotherapy including diazoxide with hydrochlorothiazide. This approach led to stabilization of blood glucose and gradual transition to partial enteral feeding.

Conclusion: This case highlights the complexity of diagnosing and managing hyperinsulinemia in neonates with short bowel syndrome who totally depend on TPN. Persistent hypoglycemia despite high glucose infusions should raise the concern of hyperinsulinism. Early identification is important. A multidisciplinary team approach is required to avoid serious complications.

Background: Type 1 diabetes mellitus is associated with adverse maternal and neonatal outcomes. We aimed to evaluate the impact of CGM use on glycemic control and neonatal and maternal outcomes.

Methods: This was a single-center study with prospective longitudinal data collection of pregnant women with T1DM allocated to 1 of 2 monitoring methods: Capillary blood monitoring and interstitial fluid glucose monitoring.

Results: A total of 30 patients were enrolled. The average age was 31.26 ± 3.39 years, with an average gestational age of 9.4 ± 3.63 weeks at the first consultation. The average diabetes duration was 15.6 ± 7.36 years, with a mean preconception HbA1c of 8.67 ± 0.95%. The average BMI was 25 ± 2.88 kg/m², and the average weight gain throughout pregnancy was 8.26 ± 5.84 kg. There was a substantial decrease in TBR compared to the control group. The control group had a slightly greater rate of pregnancy-induced hypertension, toxemia, eclampsia, and premature labor (33%, 13%, 7%, and 40%, respectively) than the CGM group (26%, 7%, 0%, and 26%). The differences were not statistically significant. Furthermore, the control group had a greater rate of preterm birth, neonatal hypoglycemia, NICU admission, and congenital abnormalities (27%, 40%, 46%, and 6.7%, respectively) than the CGM group (20%, 33%, 33%, and 0%, respectively), with no significant differences. The rates of macrosomia (20%), LGA (13%), neonatal respiratory distress (33%), and stillbirth (7%) were comparable between the groups. However, hydramnios occurred slightly more frequently in the CGM group (46% vs 40% in the control group).

Conclusion: Early implementation and sustained use of CGM in pregnant women with T1DM may optimize glucose control and mitigate maternal-fetal risks.

Obesity is a complex metabolic disorder associated with chronic low-grade inflammation, insulin resistance, and heightened risk of comorbidities such as cardiovascular diseases and type 2 diabetes mellitus (T2DM). The Cluster of Differentiation 44 (CD44), a transmembrane glycoprotein, interacts with hyaluronic acid (HA), a major extracellular matrix (ECM) component, to regulate adipogenesis, immune cell infiltration, and metabolic dysfunction. Dysregulation of the CD44-HA signalling axis promotes adipose tissue hypertrophy, macrophage infiltration, and activation of pro-inflammatory pathways, including nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinases (MAPKs), which further aggravate metabolic disturbances. This review provides a comprehensive analysis of CD44-HA signalling in the pathophysiology of obesity and evaluates therapeutic strategies targeting this axis. Small-molecule inhibitors, such as CD44 antagonists and hyaluronan biosynthesis modulators (eg, 4-methylumbelliferone), offer advantages in synthesis, bioavailability, and cost-effectiveness, but face challenges related to limited specificity, systemic toxicity, and potential resistance. In contrast, Nanobioconjugates engineered nanoparticles conjugated with biomolecules such as HA enable targeted delivery to CD44-overexpressing adipose tissues, enhance therapeutic efficacy, prolong drug release, and minimize off-target effects. Examples include lipid-based nanoparticles, polymer-based nanocarriers, and HA-functionalized systems, all of which show promise in preclinical models of obesity. Comparative analysis underscores the superior specificity and bioavailability of nanobioconjugates, though issues of large-scale production, immunogenicity, and regulatory approval remain. Combining nanobioconjugates with small molecules may optimize treatment outcomes by leveraging synergistic mechanisms. Emerging strategies including high-affinity HA ligands, monoclonal antibodies, RNA-based therapeutics, and artificial intelligence (AI) guided drug design, offering new opportunities for precision obesity management. Future directions highlight the importance of personalized and combinatorial therapies, supported by biomarker profiling and gene editing technologies such as CRISPR, to overcome current limitations in CD44-HA-targeted interventions.

Background: Dietary and circulating branched-chain amino acids (BCAA) exhibited divergent associations with obesity, and this study evaluated the independent and joint associations of dietary intakes and circulating concentrations of BCAA with obesity.

Methods: Energy-adjusted dietary and log-transformed circulating BCAAs from 540 Filipino women were categorized into quartiles and dichotomized by the median, low(2) at a two-sided P < 0.05.

Results: The odds of being obese by increasing quartile of dietary total BCAA were 1.00, 0.84 (0.49, 1.43), 0.68 (0.39, 1.19), and 0.56 (0.31, 1.02; P for trend = .05). However, the odds of being obese by increasing quartile of circulating total BCAA were 1.00, 2.62 (1.38, 5.00), 3.43 (1.83, 6.44), and 5.97 (3.19, 11.16; P for trend < .0001). The ORs (95% CI) for being obese by categories of the joint total dietary and circulating BCAA (using low dietary and low circulating BCAA as reference) were 2.06 (1.19, 3.56) for low dietary and high circulating, 0.54 (0.28, 1.02) for high dietary and low circulating and 1.84 (1.03, 3.28) for high dietary and high circulating (P for interaction = .61).

Conclusion: Higher circulating BCAA profiles, independent of dietary BCAA intake levels, were associated with a higher prevalence of obesity, with no evidence of interaction in the divergent independent associations between dietary and circulating BCAAs and obesity.

Background: In Ethiopia, teachers and bankers together represent a significant portion of the urban professional workforce approximately 900 000 teachers and 130 000 banking employees, accounting for nearly 7% of total employment. The nature of their work involves prolonged sitting, limited physical activity, and high mental workloads, which increase the risk of overweight and obesity. Bankers spend long hours at desks or computers, while teachers face extended classroom hours and administrative duties, often with limited access to recreational facilities. Unlike professionals in high-income countries, Ethiopian bankers and teachers generally have fewer workplace wellness programs, limited occupational health services, and lower awareness of lifestyle-related health risks. Adult overweight and obesity have risen sharply, exceeding 8% nationally and 20% in urban areas, posing a growing public health concern.. However, there is a lack of data on the lifestyle behaviors and health status, including factors related to overweight and obesity, among bankers and teachers in Ethiopia We investigated Factors associated with overweight and obesity among bankers and teachers in southern Ethiopia.

Methods: We conducted a comparative cross-sectional study in Wolaita Sodo city from August 1st to 30th, 2022. A stratified sampling technique was used to select 227 bankers and 287 teachers. Data was collected using a modified version of the World Health Organization's Stepwise approach to chronic disease risk factor surveillance tool. We used an ordinal logistic regression analysis to determine the factors associated with overweight/obesity.

Results: The prevalence of overweight was 44.4% and 21.8% among bankers and teachers, respectively, while the prevalence of obesity was 14% and 4.37%. Among bankers, low physical activity (aPOR: 5; 95% CI: 1.73, 14.6), being female (aPOR: 2.82; 95% CI: 1.51, 5.27), marital status (aPOR: 2.62; 95% CI: 1.27, 5.43), snack intake habits (aPOR: 3.1; 95% CI: 1.37, 7.16), higher monthly income (aPOR: 2.47; 95% CI: 1.11, 5.50), and alcohol consumption (aPOR: 2.73; 95% CI: 1.45, 5.14) were significantly associated with overweight/obesity. For teachers, female sex (aPOR: 2.1; 95% CI: 1.18, 4.0), marital status (aPOR: 5.1; 95% CI: 2.13, 12.4), and low physical activity (aPOR: 3.38; 95% CI: 1.31, 8.70) were significant factors .

Conclusion: Overweight and obesity are more prevalent among bankers than teachers in southern Ethiopia. Factors such as low physical activity, female gender, higher income, snacking habits, and alcohol consumption were strongly associated with overweight and obesity. Targeted workplace health promotion and non-communicable disease prevention strategies are urgently needed to address these risks among sedentary professionals.

[This retracts the article DOI: 10.1177/11786388221146683.].

This preliminary study investigates the relationship between cooking skills 'CS' (ability to prepare food), food skills 'FS' (educational level about food and nutrition), sociodemographic factors (age, gender, height, weight, physical activity levels, and predefined diets), psychological behaviour (how mood states influence food intake), interest in a healthy sustainable lifestyle, and other food-centric factors. Using self-reported data from a total of 126 participants from 2 distinct surveys, the results mainly show a positive correlation between food-related scores like CS and FS, and differences in external factors (eg, social environment) that influence eating habits. While some relationships between self-reported behaviour and actual nutrition are limited due to the studies design and scope, the findings highlight the critical role of CS and FS in promoting sustainable eating habits, weight management, and cooking skills. The study emphasises the need for further research and the development of educational strategies to improve dietary behaviour and overall well-being. Another contribution is the publication of all developed tools and apps for free use to promote future research.

Background: Sarcopenia now constitutes a serious issue that can affect the obese adult population. The aims of our study were to estimate the prevalence of sarcopenia in a group of obese patients, investigate the impact of sarcopenic obesity (SO) on patient health and quality of life, and identify its risk factors.

Methods: We conducted a cross-sectional descriptive observational study of a group of obese adult patients. Physical activity was assessed with the Ricci and Gagnon questionnaire and quality of life was evaluated using the SF-12 and ORWELL-97 questionnaires. SO was defined in accordance with the EASO-ESPEN consensus statement.

Results: We included 100 patients with a mean age of 44.42 ± 13.25 years. SO was diagnosed in 19% of the study population. The assessment of the impact of SO revealed that it was associated with osteoarthritis (P < .0001), functional disability (P = .001) and obesity-specific quality of life impairment (P < .0001). SO was associated with lower education levels (P = .011), a low score in the daily physical activities' dimension of the Ricci and Gagnon score (P = .028), class 2 obesity (P = .032), elevated blood triglyceride levels (P = .019), potassium and manganese intake deficiency (P = .042 and P = .004, respectively). Non-sarcopenic obese patients had a higher frequency of a history of weight loss interventions (P = .038), excess protein intake (P = .042), and excess lipid intake (P = .011). Multivariate analysis identified class 2 obesity (P = .048), osteoarthritis (P = .038), elevated triglyceride levels (P = .049), manganese deficiency intake (P = .026), increased score in the daily physical activities' dimension (P = .048), increased gait speed (P = .025) and excess fat intake (P = .047) as factors independently associated with SO.

Conclusion: It is essential to incorporate the screening for sarcopenia into the therapeutic approach for obese adult patients due to its clinical consequences and impact on individuals' quality of life.

Background: Recent studies reported that omega-3 fatty acids may improve renal function in patients with chronic kidney disease (CKD). The aim of the present study was to assess the effect of omega-3 supplements on renal function indices in patients with CKD undergoing hemodialysis.

Methods: This randomized controlled clinical trial was carried out on 120 CKD patients who were undergoing hemodialysis treatment in Rasht, Iran. The intervention group (n = 60) received 3 capsules of 1000 mg omega-3 fatty acid supplement capsules daily for 2 months. The control group (n = 60) received 3 placebo capsules containing 1000 mg of MCT. Renal function indicators included blood urea nitrogen (BUN), creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and phosphorus (P) were measured at baseline and after the intervention.

Results: Omega-3 supplementation significantly improved BUN (68.26 ± 2.97 to 56.59 ± 2.14, P = .03) and Cr levels (8.94 ± 0.29 to 7.58 ± 0.41, P < .01) after adjustment for age, gender, body mass index (BMI), smoking, diet, and underlying diseases including diabetes and hypertension. However, no significant effect was found on serum levels of Na, K, Ca, and P.

Conclusion: According to the present study, giving omega-3 supplementation to patients with CKD undergoing HD may enhanced their renal function. Additional research is required to verify these results.