Obesity Medicine最新文献_第10页

Association and inequality between socioeconomic status and the prevalence of overweight and obesity among adults aged 18 and older in Bangladesh 社会经济地位与孟加拉国18岁及以上成年人超重和肥胖流行率之间的关联和不平等

Q2 Medicine

Obesity Medicine

Pub Date : 2025-02-19 DOI: 10.1016/j.obmed.2025.100595

Sukanta Das

Background

Overweight and obesity have emerged as significant public health concerns in Bangladesh. This study aims to assess the association between socioeconomic status (SES) and the prevalence of overweight and obesity while identifying socioeconomic inequalities among adults aged 18 and older in Bangladesh.

Methods

Using data from the Bangladesh Demographic and Health Survey (BDHS) 2017–18, this study analyzed a sample of 24,478 adults. Overweight and obesity were classified according to the World Health Organization's Body Mass Index (BMI) guidelines. SES was measured by wealth index, and its association with overweight and obesity was examined using multivariate logistic regression analysis. Socioeconomic inequality was evaluated using concentration curves and indexes.

Results

The overall prevalence of overweight and obesity was 31.8% and 13.4%, respectively. Even after controlling for age, gender, education, and place of residence, higher socioeconomic status was significantly associated with an increased risk of being overweight or obese. Adults in the richest wealth category were 3.2 times more likely to be overweight and 9.8 times more likely to be obese compared to those in the poorest category (p < 0.01). The concentration index of 0.35 (CI: 0.33 to 0.37;

p

< 0.01) indicated that overweight and obesity were more prevalent among wealthier adults, highlighting a pro-rich inequality.

Conclusion

There is a significant socioeconomic disparity in the prevalence of overweight and obesity in Bangladesh, with wealthier adults disproportionately affected. Targeted public health initiatives are needed to curb this growing epidemic, particularly among wealthier groups, to reduce obesity-related non-communicable diseases.

背景超重和肥胖已成为孟加拉国重大的公共卫生问题。本研究旨在评估社会经济地位（SES）与超重和肥胖患病率之间的关系，同时确定孟加拉国18岁及以上成年人的社会经济不平等。方法利用2017-18年孟加拉国人口与健康调查（BDHS）的数据，本研究分析了24,478名成年人的样本。超重和肥胖是根据世界卫生组织的身体质量指数（BMI）指南进行分类的。以财富指数衡量社会经济地位，并采用多变量logistic回归分析检验其与超重和肥胖的关系。采用浓度曲线和指数评价社会经济不平等。结果超重和肥胖的总体患病率分别为31.8%和13.4%。即使在控制了年龄、性别、教育程度和居住地之后，较高的社会经济地位与超重或肥胖的风险增加显著相关。最富有人群超重的可能性是最贫穷人群的3.2倍，肥胖的可能性是最贫穷人群的9.8倍(p <；0.01)。浓度指数为0.35 (CI: 0.33 ~ 0.37；p & lt;0.01)表明，超重和肥胖在富裕的成年人中更为普遍，凸显了亲富的不平等。结论：在孟加拉国，超重和肥胖的患病率存在显著的社会经济差异，富裕的成年人受到的影响尤为严重。需要采取有针对性的公共卫生举措，遏制这一日益严重的流行病，特别是在较富裕群体中，以减少与肥胖有关的非传染性疾病。

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引用次数: 0

Correlation between estimated glucose disposal rate, carotid intima-media thickness and cardiovascular risk prediction scales in adolescents and young adults with type 1 diabetes 青少年和青年1型糖尿病患者估计葡萄糖处置率、颈动脉内膜-中膜厚度和心血管风险预测量表的相关性

Q2 Medicine

Obesity Medicine

Pub Date : 2025-02-18 DOI: 10.1016/j.obmed.2025.100592

David Sánchez-García, Eloísa Saavedra-Castillo, Mariela Rivas-Hernández, Luis Diego Maximiliano Ramos-Anthony, Graciela Gómez-Martínez, Marcelo Diaz-Sallas, Dania Lizet Quintanilla-Flores

Aims

To analyze the correlation between estimated glucose disposal rate (eGDR), Carotid intima-media thickness (CIMT) and cardiovascular risk prediction scales in young adults with diabetes type 1 (T1D).

Methods

A cross-sectional, analytical, and retrospective study was conducted. Patients with T1D > 15 years were included, insulin resistance (IR) was defined by eGDR <8 mg/kg/min, and preclinical atherosclerosis as ≥0.54 mm of CIMT, STENO and ESC cardiovascular risk was calculated. Pearson's correlation test was used to measure the strength of association between them.

Results

102 patients with a median age of 19 years, HbA1c of 8.2%, diabetes duration of 8 years were included. IR was found in 50.9% of the patients and preclinical atherosclerosis in 46.1%, with a median CIMT of 0.52 mm. An inverse correlation was obtained between the eGDR and CIMT r = −0.23, p = 0.021, and STENO r = 0.33, p=<0.001, CIMT was higher in the IR group 0.54 vs 0.50 mm, p = 0.047, also was associated with more microvascular complications 36.5% vs 18%, p = 0.03, and proinflammatory markers, p=<0.001.

Conclusions

Carotid intima-media thickening is inversely associated with insulin sensitivity, the eGDR value could be used as a cardiovascular and as a enhance risk factor and could help to decide treatment in patients whit T1D.

目的分析1型糖尿病（T1D）青年患者估计葡萄糖处置率（eGDR）、颈动脉内膜-中膜厚度（CIMT）与心血管风险预测量表的相关性。方法采用横断面、分析和回顾性研究。T1D >患者；纳入15年，胰岛素抵抗（IR）定义为eGDR <；8 mg/kg/min，临床前动脉粥样硬化≥0.54 mm的CIMT，计算STENO和ESC心血管风险。使用Pearson相关检验来衡量两者之间的关联强度。结果纳入102例患者，中位年龄19岁，HbA1c为8.2%，糖尿病病程8年。50.9%的患者发现IR， 46.1%的患者发现临床前动脉粥样硬化，中位CIMT为0.52 mm。eGDR与CIMT r = - 0.23, p= 0.021, STENO r = 0.33, p=<；0.001呈负相关，IR组CIMT较高（0.54 vs 0.50 mm, p= 0.047），微血管并发症发生率较高（36.5% vs 18%, p= 0.03），促炎标志物发生率较高（p=<0.001）。结论颈动脉内膜-中膜增厚与胰岛素敏感性呈负相关，eGDR值可作为T1D患者的心血管和增强危险因素，有助于决定治疗方案。

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引用次数: 0

Murraya koenigii Linn. Modulate diabetic neuropathy via attenuation of mechanical hyperalgesia and allodynia in STZ-induced diabetic rats Murraya koenigii Linn。通过抑制stz诱导的糖尿病大鼠机械性痛觉过敏和异位性疼痛来调节糖尿病神经病变

Q2 Medicine

Obesity Medicine

Pub Date : 2025-02-17 DOI: 10.1016/j.obmed.2025.100593

Randhir Singh , Shah Asma Farooq , Ashi Mannan , Nikhil Garg , Sushma Devi , Kamal Dua , Thakur Gurjeet Singh

Introduction

The present research aims to examine the efficacy of Murraya koenigii (L.) extracts in the management of diabetic peripheral neuropathy (DPN).

Methods

A dose of 65 mg/kg of streptozotocin (STZ) was administered intraperitoneally (i.p.) in fresh citrate buffer with a pH of 4.5 to induce diabetes 15 min after nicotinamide (230 mg/kg, ip) was administered and on 60th day development of DPN was evaluated by measuring behavioural parameters like tactile allodynia and hyperalgesia. In-vitro and in-vivo techniques were employed for estimation of oxidative stress.

Results

Oral administration of extracts at various doses as well as standard drug was continued up to 90th day after 60th day of STZ-NAD administration. In diabetic animals, antioxidants like as SOD and GSH levels was reduced while the level of TBARS, nitrites, TNF-α, and AGE production were significantly increased. These extracts were discovered to positively impact fasting blood sugar levels, food intake, and body weight loss management. Furthermore, research demonstrated that the extracts had positive impact on pain perception as measured by thermal and mechanical hyperalgesia in experimental rats. Studies of these extracts, both in-vivo and in-vitro, indicated their potential to reduce oxidative stress as well as hyperglycemia, which are crucial in the progression of diabetes complications.

Conclusion

It can be concluded that Murraya koenigii (L.) leaf extracts, ameliorates diabetes and diabetic peripheral neuropathy by regulating hyperglycemia and oxidative stress.

摘要本研究旨在探讨鼠叶提取物对糖尿病周围神经病变（DPN）的治疗作用。方法将链脲佐菌素（STZ） 65 mg/kg滴入pH为4.5的新鲜柠檬酸缓冲液中，在烟酰胺（230 mg/kg, ip）给药15 min后诱导糖尿病，并于第60天通过测量触觉异常性痛和痛觉过敏等行为参数评价DPN的发生。采用体外和体内技术评估氧化应激。结果STZ-NAD给药60 d后，各剂量提取物及标准药均持续给药至第90天。在糖尿病动物中，抗氧化剂如SOD和GSH水平降低，而TBARS、亚硝酸盐、TNF-α水平和AGE产量显著增加。这些提取物被发现对空腹血糖水平、食物摄入和体重减轻有积极影响。此外，研究表明，提取物对实验大鼠的热痛觉和机械痛觉过敏有积极的影响。对这些提取物的体内和体外研究表明，它们具有降低氧化应激和高血糖的潜力，这对糖尿病并发症的进展至关重要。结论龙涎香叶提取物可能通过调节高血糖和氧化应激来改善糖尿病及糖尿病周围神经病变。

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引用次数: 0

GLP-1 agonists in Type 1 diabetes – Indications and use GLP-1激动剂在1型糖尿病中的应用

Q2 Medicine

Obesity Medicine

Pub Date : 2025-02-11 DOI: 10.1016/j.obmed.2025.100591

Panadeekarn Panjawatanan, Richard J. Comi

Objective

Insulin therapy in Type 1 diabetes is associated with weight gain. Glucagon-like peptide 1 (GLP-1) agonists, which lower blood glucose and promote weight loss, may help reverse this trend and reduce hemoglobin A1C (A1C) levels.

Methods

Patients with Type 1 diabetes with concomitant GLP-1 agonists used for at least one year were included. Observed outcomes were the change in A1C, weight, and basal insulin use compared at baseline and 12 months using mixed models repeated measures.

Results

Forty-nine patients with weight gain were included. Prior to treatment, patients gained an average of 2.0 kg annually over three years. After 12 months of GLP-1 agonist therapy, weight significantly decreased from 97.6 kg (95% CI: 92.7–102.5) to 90.0 kg (95% CI: 84.9–95.1) (p < 0.001). A1C levels also improved significantly, from 8.2% (95% CI: 7.9–8.6) to 7.6% (95% CI: 7.2–7.9) (p < 0.001). Basal insulin requirements were significantly reduced.

Conclusion

We conclude that GLP-1 agonists effectively reverse the trend of weight gain and improve A1C levels in patients with Type 1 diabetes.

目的：1型糖尿病胰岛素治疗与体重增加相关。胰高血糖素样肽1 （GLP-1）激动剂可以降低血糖，促进体重减轻，可能有助于扭转这一趋势，降低血红蛋白A1C （A1C）水平。方法纳入合并GLP-1激动剂治疗至少一年的1型糖尿病患者。观察结果是使用混合模型重复测量比较基线和12个月时A1C、体重和基础胰岛素使用的变化。结果纳入49例体重增加患者。在治疗前，患者在三年内平均每年增加2.0公斤。经过12个月的GLP-1激动剂治疗，体重从97.6 kg （95% CI: 92.7-102.5）显著下降到90.0 kg (95% CI: 84.9-95.1) (p <；0.001)。A1C水平也显著改善，从8.2% （95% CI: 7.9-8.6）降至7.6% (95% CI: 7.2-7.9) (p <；0.001)。基础胰岛素需要量显著降低。结论GLP-1激动剂可有效逆转1型糖尿病患者体重增加趋势，改善A1C水平。

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引用次数: 0

A novel therapeutic approach for hormonal imbalance in polycystic ovarian syndrome; evaluating the effects of Nutrition Bio-Shield Supplement in an animal model 治疗多囊卵巢综合征激素失调的新方法在动物模型上评价营养生物盾补充剂的效果

Q2 Medicine

Obesity Medicine

Pub Date : 2025-02-08 DOI: 10.1016/j.obmed.2025.100590

Mehrdad Mosadegh , Yasaman Sadeghi , Aref Khalkhali , Yousef Erfani

Background

s: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that disrupts hormone balance, leading to infertility and metabolic issues. This study evaluates the effects of a novel nutritional supplement, Nutrition Bio-Shield (NBS), on hormonal regulation in a letrozole-induced PCOS rat model.

Methods

Twenty-five female Wistar rats were assigned to five groups: healthy control, PCOS control, and three groups treated with varying doses of NBS (12.5 mg/kg, 25 mg/kg, and 50 mg/kg). PCOS was induced using letrozole, and NBS was administered for 21 days. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, progesterone, and estradiol were measured using radioimmunoassay.

Results

NBS treatment significantly improved hormone levels compared to the PCOS control group. The highest dose (50 mg/kg) effectively reduced LH and testosterone while increasing progesterone and estradiol levels (p < 0.05), nearing those of the healthy controls. The 25 mg/kg dose also showed considerable improvement in hormone balance, whereas the 12.5 mg/kg dose had a moderate effect. FSH levels were notably reduced in both 50 mg/kg and 25 mg/kg groups, suggesting a dose-dependent response to NBS treatment.

Conclusion

NBS supplementation successfully ameliorated hormonal imbalances in a PCOS rat model, demonstrating its potential as a natural therapeutic option for managing PCOS. Further research is needed to confirm these effects in clinical settings.

背景：多囊卵巢综合征（PCOS）是一种常见的内分泌疾病，它会破坏激素平衡，导致不孕和代谢问题。本研究评估了一种新型营养补充剂Nutrition Bio-Shield （NBS）对来曲唑诱导的PCOS大鼠模型激素调节的影响。方法将雌性Wistar大鼠25只分为健康对照组、PCOS对照组和不同剂量NBS （12.5 mg/kg、25 mg/kg、50 mg/kg）治疗组。来曲唑诱导PCOS， NBS治疗21 d。用放射免疫法测定血清黄体生成素（LH）、卵泡刺激素（FSH）、睾酮、孕酮和雌二醇水平。结果与PCOS对照组相比，snbs治疗显著提高了激素水平。最高剂量（50 mg/kg）有效降低黄体生成素和睾酮，同时提高孕酮和雌二醇水平(p <；0.05)，接近健康对照组。25 mg/kg剂量也显示出相当大的激素平衡改善，而12.5 mg/kg剂量则有中等效果。在50 mg/kg和25 mg/kg组中，FSH水平均显著降低，表明对NBS治疗有剂量依赖性反应。结论补充nbs成功地改善了PCOS大鼠模型的激素失衡，显示了其作为治疗PCOS的天然治疗选择的潜力。需要进一步的研究来证实这些在临床环境中的影响。

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引用次数: 0

Comparative analysis of safoof-e− muhazzil and orlistat on obesity and markers of obesity safoof-e - muhazzil和奥利司他对肥胖和肥胖标志物的比较分析

Q2 Medicine

Obesity Medicine

Pub Date : 2025-02-08 DOI: 10.1016/j.obmed.2025.100589

Mohd Aslam , Ahmad Faraz , Zaki Ahmad Siddiqui , Maaz Ozair , Hamid Ashraf , Abdul Mannan

Introduction

Obesity is truly a pandemic and associated with increased risk of multiple non-communicable diseases. The available pharmacotherapy of obesity is associated with multiple limitations. We have studied the effect of sufoof e muhazzil and compared it with orlistat in non-diabetic patients with obesity.

Material and methods

It was an open-label, interventional prospective study including 200 patients with obesity. These patients, aged between 18 and 60 years, had a body mass index (BMI) of 25–40 kg/m². We divided them equally between the Sufoof e Muhazzil and Orlistat groups. The dose of sufoof e muhazzil was 6 gm/day, and orlistat was 120 mg twice daily for 2 months. We assessed the effect on weight, BMI, biochemical, and inflammatory markers at the onset and at the end of the study.

Result

The mean age, weight, BMI, and waist circumference were 37.85 years and 35.71 years, 80.7 kg and 74.9 kg, 32.7 kg/m² and 32.4 kg/m², and 113.0 cm and 112.5 cm, respectively, for the orlistat and sufoof groups. There was a significant reduction in weight, BMI, and abdominal circumference in both groups (p value < 0.001 for all). Biochemical and inflammatory parameters also improved significantly in both groups. Sufoof e muhazzil use was associated with greater reductions in weight (5.8 vs 4.4 kg), BMI (2.5 vs 1.9 kg/m²) than orlistat.

Conclusion

Both orlistat and sufoof e muhazzil are associated with significant weight reduction and improvement in biochemical and inflammatory parameters. Both the drugs demonstrated excellent safety and tolerability.

肥胖确实是一种流行病，与多种非传染性疾病的风险增加有关。现有的肥胖药物治疗存在多种局限性。我们研究了舒福穆哈齐尔对非糖尿病合并肥胖患者的疗效，并与奥利司他进行了比较。材料与方法该研究是一项开放标签、介入性前瞻性研究，纳入200例肥胖患者。这些患者年龄在18至60岁之间，体重指数（BMI）为25-40 kg/m2。我们将他们平均分配给Sufoof e Muhazzil和Orlistat两组。穆哈齐尔剂量为6 gm/d，奥利司他剂量为120 mg，每日2次，疗程2个月。我们在研究开始和结束时评估了对体重、BMI、生化和炎症指标的影响。结果奥利司他组平均年龄为37.85岁，体重为35.71岁，BMI为80.7 kg，腰围为74.9 kg, 32.7 kg/m2, 32.4 kg/m2, 113.0 cm, 112.5 cm。两组患者的体重、BMI和腹围均有显著降低(p值<；0.001)。两组患者的生化和炎症指标均有明显改善。与奥利司他相比，sufoofmuhazzil在体重（5.8 vs 4.4 kg）和BMI （2.5 vs 1.9 kg/m2）方面的降低幅度更大。结论奥利司他和穆哈齐均能显著减轻体重，改善生化和炎症指标。两种药物均表现出良好的安全性和耐受性。

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引用次数: 0

Obesity-driven hunger: From pathophysiology to intervention 肥胖驱动的饥饿：从病理生理学到干预

Q2 Medicine

Obesity Medicine

Pub Date : 2025-02-05 DOI: 10.1016/j.obmed.2025.100588

Ahmad Khusairi Azemi , Yahkub Babatunde Mutalub , Monsurat Abdulwahab , Aida Hanum Ghulam Rasool , Sagir Mustapha , Siti Qusyasyiah Ahmad Suhaimi , Siti Safiah Mokhtar

Obesity is a complex metabolic disorder driven by an imbalance between energy intake and expenditure. A critical pathogenetic component of obesity is dysregulated hunger and satiety mechanisms, driven by both central and peripheral factors. This review explores the pathophysiology of obesity-induced hunger, focusing on key mechanisms involving neurohormonal signals, gut-brain communication, and the dysregulation of appetite-related pathways. It discusses the roles of hormones such as ghrelin, leptin, and insulin, as well as the influence of inflammatory processes on hunger regulation. Additionally, environmental and psychological factors contributing to food cravings and reward-driven eating are considered. The article also examines current and emerging therapeutic interventions targeting hunger and appetite control, including pharmacologic treatments, such as glucagon-like peptide-1 (GLP-1) receptor agonists, lifestyle modifications, and bariatric surgery. Novel strategies under investigation, including appetite-regulating peptides, are highlighted. Bridging the understanding of the intricate mechanisms driving obesity-related hunger with therapeutic advances provides a comprehensive framework for more effective treatment strategies to combat obesity and its associated comorbidities which will ultimately improve patient outcomes.

肥胖是一种复杂的代谢紊乱，由能量摄入和消耗之间的不平衡引起。肥胖的一个关键致病因素是由中枢和外周因素驱动的饥饿和饱腹机制失调。本文综述了肥胖诱导饥饿的病理生理学，重点探讨了涉及神经激素信号、肠-脑通讯和食欲相关通路失调的关键机制。它讨论了激素如胃饥饿素、瘦素和胰岛素的作用，以及炎症过程对饥饿调节的影响。此外，环境和心理因素有助于食物的渴望和奖励驱动饮食被考虑。本文还研究了当前和新兴的针对饥饿和食欲控制的治疗干预措施，包括药物治疗，如胰高血糖素样肽-1 （GLP-1）受体激动剂、生活方式改变和减肥手术。正在研究的新策略，包括食欲调节肽，被强调。将对肥胖相关饥饿的复杂机制的理解与治疗进展联系起来，为更有效的治疗策略提供了一个全面的框架，以对抗肥胖及其相关的合并症，最终将改善患者的预后。

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引用次数: 0

The role of simple and specialized non-invasive tools in predicting of metabolic dysfunction-associated fatty liver disease severity and prognosis 简单和专门的非侵入性工具在预测代谢功能障碍相关脂肪性肝病严重程度和预后中的作用

Q2 Medicine

Obesity Medicine

Pub Date : 2025-01-25 DOI: 10.1016/j.obmed.2025.100582

Marjan Mokhtare , Shahin Sharafeh , Mohammadjavad Sotoudeheian , Amir M. Sadeghian , Said A. Al-Busafi

Objectives

Metabolic-associated fatty liver disease (MAFLD) is a universal health concern. Detecting advanced fibrosis significantly impacts prognosis. This study designated to assess the accuracy of FIB-4, FIB-6, Agile3+, Agile4, and NAFLD fibrosis score (NFS) in predicting disease severity.

Design and Methods

Clinical, laboratory, and FibroScan findings of adult MAFLD patients were recorded. A fibrosis (F) score over 10 kPa indicates advanced fibrosis. We assessed the area under the receiver operating characteristic curve (AUROCC), along with the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy with various cutoff values. Reliability was analyzed with the intra-class correlation coefficient (ICC).

Results

Advanced fibrosis was found in 5 of 103 patients (4.85%). AUROCC values were as follows: 0.967 for Agile3+, 0.951 for FIB-6, 0.932 for NFS, 0.909 for Agile4, and 0.869 for FIB-4. The PPVs ranged from 18.18% (FIB-4) to 57.09% (NFS), followed by 75.02% (FIB-6), and 18.18% (Agile4) to 100% (Agile3+). All tools achieved acceptable NPVs above 96%. The ICC between the fibrosis score and other tools was 0.772 (95% CI: 0.696-0.834). Significant differences were noted in gamma-glutamyl transferase (p=0.039), diabetes mellitus (P=0.011), platelet count, hemoglobin A1C, alkaline phosphatase, triglycerides, fasting blood glucose, and Vitamin D levels

目的：代谢性脂肪性肝病（MAFLD）是一个普遍关注的健康问题。发现晚期纤维化显著影响预后。本研究旨在评估FIB-4、FIB-6、Agile3+、Agile4和NAFLD纤维化评分（NFS）预测疾病严重程度的准确性。设计与方法记录成年MAFLD患者的临床、实验室和纤维扫描结果。纤维化(F)评分超过10kpa为晚期纤维化。我们评估了受试者工作特征曲线下的面积（AUROCC），以及不同截止值的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。用类内相关系数（ICC）分析信度。结果103例患者中有5例（4.85%）出现晚期纤维化。AUROCC值如下：Agile3+为0.967，FIB-6为0.951，NFS为0.932，Agile4为0.909，FIB-4为0.869。ppv范围从18.18% （FIB-4）到57.09% (NFS)，其次是75.02% （FIB-6）和18.18% （Agile4）到100% （Agile3+）。所有工具的npv均达到96%以上。纤维化评分与其他工具之间的ICC为0.772 （95% CI: 0.696-0.834）。在γ -谷氨酰转移酶（p=0.039）、糖尿病（p= 0.011）、血小板计数、血红蛋白A1C、碱性磷酸酶、甘油三酯、空腹血糖和维生素D水平方面存在显著差异

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引用次数: 0

Pharmacological therapy for Gestational Diabetes Mellitus: A comprehensive overview 妊娠期糖尿病的药物治疗：一个全面的概述

Q2 Medicine

Obesity Medicine

Pub Date : 2025-01-21 DOI: 10.1016/j.obmed.2025.100587

Tanu Gautam , Amreen Shamsad , Renu Singh , S. Shabihe Raza Baqri , Monisha Banerjee

Gestational diabetes mellitus (GDM) is a prevalent metabolic condition affecting pregnant women, impairing glucose tolerance, and causing short- and long-term effects on mother, fetus, and neonate. The goal of management therapy during pregnancy is to obtain optimal glycemic control by preventing hyperglycemia and maintaining safety. The increasing prevalence of GDM worldwide is a rising concern, underscoring the need for dietary adjustments and improved detection, diagnostic and treatment strategies to overcome adverse consequences. International guidelines recommend pharmaceutical interventions for GDM when lifestyle adjustments do not attain glycemic control. Insulin is first-line treatment, but oral anti-hyperglycemic medications serve as often-used alternatives. Metformin and glyburide effectively regulate increased blood glucose in pregnancy. Metformin is preferred due to its ease of administration, reduced risk of hypoglycemia, and potential for improved long-term outcomes. Whereas glyburide is administered cautiously due to potential feto-maternal risk. In this review, the pharmaceutical alternatives for GDM have been discussed in detail, along with pharmacology and pharmacokinetics. The effects of metabolic and glycemic control on feto-maternal morbidity have also been elaborated, along with efficacy as well as side effects and long-term outcomes. However, their long-term safety profiles and fetal exposure remain unclear. By focusing on this research gap, we can explore effective management therapy by evaluating feto-maternal long-term outcomes through follow-up studies, comparing efficacy of pharmacological interventions, pharmacogenomics, digital health technologies, emerging pharmaceutical alternatives (GLP-1-Ra & SGLT-2 inhibitors), and personalized medicine. By incorporating these advancements into clinical practice by healthcare professionals, the risk of adverse effects may decrease to improve health and well-being.

妊娠期糖尿病（GDM）是一种影响孕妇的普遍代谢疾病，损害糖耐量，并对母亲、胎儿和新生儿造成短期和长期影响。妊娠期管理治疗的目标是通过预防高血糖和维持安全来获得最佳的血糖控制。全球范围内GDM患病率的上升日益引起关注，强调需要调整饮食并改进检测、诊断和治疗策略，以克服不良后果。当生活方式调整不能达到血糖控制时，国际指南建议对GDM进行药物干预。胰岛素是一线治疗，但口服抗高血糖药物是常用的替代方案。二甲双胍和格列本脲可有效调节妊娠期血糖升高。二甲双胍是首选，因为它易于给药，降低低血糖的风险，并有改善长期预后的潜力。然而格列本脲的使用要谨慎，因为有潜在的胎母风险。在这篇综述中，详细讨论了GDM的药物替代品，以及药理学和药代动力学。代谢和血糖控制对母婴发病率的影响，以及疗效、副作用和长期结果也得到了详细阐述。然而，它们的长期安全性和胎儿暴露情况仍不清楚。通过关注这一研究空白，我们可以通过随访研究，比较药物干预、药物基因组学、数字健康技术、新兴药物替代品(GLP-1-Ra &；SGLT-2抑制剂)和个性化医疗。通过将这些进步纳入医疗保健专业人员的临床实践，不良反应的风险可能会降低，从而改善健康和福祉。

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引用次数: 0

Exploring Betula alnoides bark: Insilico and preclinical insights into its antioxidant and lipid-lowering effects in hypercholesterolemia 探索白桦树皮：其抗氧化和降脂作用在高胆固醇血症中的临床前研究

Q2 Medicine

Obesity Medicine

Pub Date : 2025-01-19 DOI: 10.1016/j.obmed.2025.100583

Shahbaz Khan , Alka Lohani , Prashant Tiwari , Sunil Kumar Kadiri

Aim

Hyperlipidemia characterized by elevated cholesterol levels and formation of Reactive Oxygen Species (ROS) is a critical risk factor for coronary heart diseases. In traditional Indian Ayurveda and herbal medicine, various parts of Betula alnoides are reputed for their therapeutic uses. The main aim of this study is to explore the hypolipidemic and antioxidant effects of Betula alnoides bark extracts (petroleum ether and ethyl acetate) in rats with induced hypercholesterolemia.

Methods

Soxhlet extraction method was used to extract Betula alnoides bark powder, utilizing petroleum ether and ethyl acetate as solvents and both the extracts underwent phytochemical screening to identify a range of phytoconstituents. The acute oral toxicity was evaluated on male albino rats, adhering to OECD guideline No. 420. DPPH and nitric oxide scavenging assay was used to determine antioxidant capacity of bark extracts. Hypolipidemic activity was evaluated by inducing hyperlipidemia through a high-fat diet and measuring serum biochemical markers like total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides.

Results

The extraction yields were found to be 1.4% ± 0.65% for the petroleum ether extract and 3.2% ± 0.80% for the ethyl acetate extract. In the acute toxicity study, it was found that the bark extracts showed no signs of toxicity. The findings indicated that the DPPH/Nitric oxide free radical scavenging capacity of Betula alnoides bark extracts increased with higher concentrations. When compared to the petroleum ether bark extract, the ethyl acetate bark extract showed a noticeably better antioxidant capacity. Both petroleum ether and ethyl acetate extracts (50 mg/kg and 100 mg/kg) and fenofibrate (65 mg/kg), exhibited significant hypolipidemic effects.

Conclusion

The ethyl acetate extract demonstrated superior hypolipidemic activity compared to the petroleum ether extract. Lupeol binds strongly to SOD, SGLT2, and APOE proteins, showing significant docking scores and engaging multiple amino acids through various stabilizing interactions. These findings suggest that Betula alnoides bark extracts possess promising antioxidant and anti-hyperlipidemic properties.

以胆固醇水平升高和活性氧（ROS）形成为特征的高脂血症是冠心病的重要危险因素。在传统的印度阿育吠陀和草药中，白桦的各个部分都以其治疗用途而闻名。本研究旨在探讨白桦树皮提取物（石油醚和乙酸乙酯）对高胆固醇血症大鼠的降血脂和抗氧化作用。方法采用索氏提取法，以石油醚和乙酸乙酯为溶剂提取白桦树皮粉末，对提取物进行植物化学筛选，鉴定其主要成分。根据OECD指南第420号，对雄性白化大鼠进行急性口服毒性评价。采用DPPH法和一氧化氮清除法测定树皮提取物的抗氧化能力。通过高脂饮食诱导高脂血症和测定血清生化指标如总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯来评估低血脂活性。结果石油醚提取物提取率为1.4%±0.65%，乙酸乙酯提取物提取率为3.2%±0.80%。在急性毒性研究中，发现树皮提取物没有毒性迹象。结果表明，白桦树皮提取物对DPPH/一氧化氮自由基的清除能力随着浓度的增加而增强。与石油醚树皮提取物相比，乙酸乙酯树皮提取物表现出明显更好的抗氧化能力。石油醚和乙酸乙酯提取物（50 mg/kg和100 mg/kg）和非诺贝特（65 mg/kg）均表现出显著的降血脂作用。结论乙酸乙酯提取物比石油醚提取物具有更强的降血脂活性。Lupeol与SOD、SGLT2和APOE蛋白结合强烈，显示出显著的对接分数，并通过各种稳定相互作用与多个氨基酸结合。这些结果表明，白桦树皮提取物具有良好的抗氧化和抗高脂血症作用。

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引用次数: 0