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1.
Predictors of Cardiometabolic Health a Few Months Postpartum in Women Who Had Developed Gestational Diabetes.
Gómez Fernández, C, Golubic, R, Mitsigiorgi, R, Mansukhani, T, Car, J, Nicolaides, KH
Nutrients. 2025;(3)
Abstract
BACKGROUND To assess the incidence of dysglycaemia and metabolic syndrome and factors associated with them 5 months postpartum in women with gestational diabetes mellitus (GDM) in their last pregnancy. METHODS We conducted an observational prospective cohort study in 558 women with previous GDM who attended a 5-month postpartum follow-up clinic. Backward elimination was performed to select significant factors for the multivariable logistic regression model. Dysglycaemia (prediabetes and type 2 diabetes (T2D)) and metabolic syndrome were used as outcomes in separate models. RESULTS Dysglycaemia was diagnosed in 202 (36.2%) women, including 174 (31.2%) with prediabetes and 28 (5.0%) with T2D. Women with dysglycaemia, compared with those with normoglycaemia, were more likely to be of black ethnicity (33.2 vs. 20.5%) and have severe GDM (31.7 vs. 16%), a higher postpartum BMI (29.5 vs. 27.6 kg/m2), and metabolic syndrome (20 vs. 7%). Multivariable logistic regression analysis showed that significant predictors of dysglycaemia were black (OR 2.09; 95% CI: 1.27-3.46) and mixed ethnicity (OR 3.05; 95% CI: 1.26-7.42), diagnosis of GDM before 24 weeks gestation (OR 3.05, 95% CI: 1.90-4.91), and treatment of GDM with metformin (OR 1.63; 95% CI: 1.05-2.55) or insulin (OR 2.08; 95% CI: 1.14-3.79) rather than diet alone. Significant predictors of metabolic syndrome were postpartum maternal BMI (OR 5.49; 95% CI: 2.60-11.59) and absence of breastfeeding (OR 2.14; 95% CI: 1.21-3.77). CONCLUSIONS At 5 months postpartum, a high proportion of women who developed GDM showed evidence of dysglycaemia. Future studies should investigate interventions that could reduce the risk of short- and long-term consequences of suboptimal cardiometabolic health in such women.
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2.
Effects of Saffron Supplementation on Glycolipid Metabolism and Blood Pressure in Patients With Metabolic Syndrome and Related Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Zhang, X, Miao, J, Song, Y, Miao, M
Phytotherapy research : PTR. 2025
Abstract
Saffron is a traditional herbal medicine used to treat conditions associated with metabolic syndrome (MetS). However, the conclusions of relevant clinical studies have been inconsistent. This study aimed to assess the impact of saffron supplementation on the metabolism of glycolipids and blood pressure in individuals with MetS and related disorders. Web of Science, PubMed, Cochrane Library, Scopus, and Embase were comprehensively searched for studies investigating saffron supplementation for MetS and related disorders up to February 2024. Stata 17.0 was used to conduct the Meta-analysis. Twenty-five randomized controlled trials (RCTs) were included in this study, involving 1486 participants with MetS and related conditions. Compared to placebo, saffron supplementation triggered significant reductions in fasting blood glucose (FBG) (WMD: -6.67 mg/dL; 95% CI: -10.55, -2.78; p = 0.001; I2 = 50.0%), glycosylated hemoglobin A1c (HbA1c) (WMD: -0.25%; 95% CI: -0.35, -0.14; p < 0.001; I2 = 0.0%), total cholesterol (TC) (WMD: -4.77 mg/dL; 95% CI: -8.83, -0.71; p = 0.021; I2 = 31.8%), systolic blood pressure (SBP) (WMD: -1.15 mmHg; 95% CI: -1.66, -0.64; p < 0.001; I2 = 41.8%), and diastolic blood pressure (DBP) (WMD: -1.61 mmHg; 95% CI: -1.88, -1.34; p < 0.001; I2 = 7.0%). However, no significant changes were observed for homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), body mass index (BMI), and waist circumference (WC). Saffron supplementation has an improving effect on FBG, HbA1c, TC, DBP, and SBP in patients with MetS and related disorders. Nonetheless, additional high-quality RCTs involving diverse ethnic populations are necessary to validate this effect.
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3.
Effects of Nanocurcumin Supplementation on Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Wilar, G, Suhandi, C, Fukunaga, K, Shigeno, M, Kawahata, I, Abdulah, R, Sasaki, T
Pharmacological research. 2025;:107641
Abstract
BACKGROUND Metabolic syndrome (MetS) encompasses metabolic risk factors like elevated blood glucose, abnormal lipid levels, and hypertension. Nanocurcumin, a nanoscale formulation of curcumin, may offer therapeutic benefits for MetS management. This systematic review and meta-analysis evaluates the impact of nanocurcumin supplementation on key MetS parameters. METHODS A systematic literature search identified 20 randomized controlled trials (RCTs) with 1,394 participants. Data were pooled using a random-effects model, and standardized mean differences (SMDs) were calculated for key outcomes. RESULTS Nanocurcumin supplementation significantly improved waist circumference (WC) (standardized mean difference (SMD): -0.30cm), fasting blood sugar (FBS) (SMD: -0.34mg/dL), HbA1c (SMD: -0.33%), and quantitative insulin sensitivity check index (QUICKI) score (SMD: 0.73). Lipid profile parameters, including total cholesterol (SMD: -0.18mg/dL), LDL-C (SMD: -0.16mg/dL), and HDL-C (SMD: 0.32mg/dL), also reduced significantly. Improvement in diastolic blood pressure (DBP) (SMD: -0.32mmHg), total antioxidant capacity (TAC) (SMD: 0.44mmol/L), malondialdehyde (MDA) (SMD: -0.37mmol/L), tumor necrosis factor-α (TNF-α) (SMD: -2.30ng/L), interleukin-6 (IL-6) (SMD: -1.07ng/L), and high-sensitivity C-reactive protein (hs-CRP) (SMD: -0.34mg/L) were observed. CONCLUSION Nanocurcumin supplementation significantly improves multiple MetS-related parameters, including anthropometric measures, glycemic control, lipid profile, blood pressure, oxidative stress markers, and inflammatory biomarkers. These findings highlight nanocurcumin's potential as an effective adjunctive therapy for managing MetS. However, the variability in study participant ages, treatment durations, and sample sizes suggests the need for further well-designed RCTs to establish optimal usage guidelines.
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Anti-glycaemic effect of the Chinese modified DASH diet combined with 23% low-sodium salt in patients with hypertension and type 2 diabetes: a clinical trial.
An, J, Liu, G, Luo, W, Zhou, X, Mei, Y, Zhang, Z, Zhao, L, Huang, Y, Mu, L
Diabetology & metabolic syndrome. 2025;(1):55
Abstract
BACKGROUND Although many previous trials have formalized the blood glucose-lowering effect of the DASH diet, relevant reports in China remain limited. This study aimed to explore the anti-hyperglycaemic effect of the Chinese Modified Dietary Approaches to Stop Hypertension diet combined with 23% low-sodium salt and meal packs in patients with hypertension and type 2 diabetes. METHODS We conducted a randomized controlled single-blinded trial with a semi-open design; 100 participants were randomly assigned to Group A (control), Group B (23% low-sodium salt), and Group C (meal packs) for 8 weeks of dietary intervention. All participants were followed up weekly to collect glycaemia data (standardized meal tolerance test), salt use, and adverse events. RESULTS Generalized estimating equation analysis indicated that fasting blood glucose decreased in all three groups following the intervention when compared to baseline. Group A decreased by 0.72 mmol/L (P = 0.008), while Groups B and C decreased by 2.02 mmol/L and 2.06 mmol/L, respectively (both P < 0.001). Although the latter two groups experienced greater reductions than Group A, the differences among the groups were not statistically significant (P = 0.450). For postprandial blood glucose, Group C showed the most pronounced decrease. The three groups recorded reductions of 2.43 mmol/L, 2.52 mmol/L, and 4.29 mmol/L, respectively (all P < 0.001), with again no significant difference observed between the groups (P = 0.088). The most notable enhancement in postprandial glucose was observed in Group C, which demonstrated a 51.5% improvement in its control rate. However, there was no statistically significant difference between the groups. No serious adverse events occurred during the trial. CONCLUSION The CM-DASH diet combined with 23% low-sodium salt and meal packs demonstrates potentially beneficial effects on glycemic control in patients with hypertension and type 2 diabetes. This intervention reduces salt intake and fosters the development of healthy eating habits, thereby contributing to the improvement of patients' blood glucose. However, larger studies are necessary to confirm these findings. Trial registration ChiCTR2000029017. Registered January 11, 2020-Prospective registration, http://www.chictr.org.cn/.
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5.
Biomarkers of residual risk and all-cause mortality after acute coronary syndrome.
Toso, A, Leoncini, M, Maioli, M, Villani, S, Bellandi, F
American journal of preventive cardiology. 2025;:100934
Abstract
BACKGROUND Adverse cardiovascular events often recur after acute coronary syndrome (ACS), despite secondary prevention measures. Residual risk involves various inflammatory, metabolic and renal factors as well as lipid and thrombotic processes. This cohort study investigates the relationship between four risk biomarkers at 1 month after ACS and all-cause death within 3 years in patients treated with early invasive strategy and high-intensity statins from admission. METHODS Levels of residual risk for the biomarkers were: low-density lipoprotein cholesterol (LDL-C) ≥ 70 mg/dl; high-sensitivity C reactive protein (hs-CRP) ≥ 2 mg/l; glycosylated hemoglobin (HbA1c) ≥ 7% in diabetic and ≥ 5.7% in non-diabetic patients; decrease in estimated glomerular filtration rate (eGFR) ≥ 25% compared to baseline. The association between the four biomarkers and all-cause death within 3 years was evaluated with Cox proportional analysis. RESULTS This study included 1099 patients (68±12 years; 70.3% males). At 1 month the majority of patients had levels of LDL-C, hs-CRP and/or HbA1c above the risk cut-points, and only 7% of cases presented reduced eGFR. Reduced eGFR and hs-CRP ≥ 2 mg/l at 1 month were the sole independent biomarker predictors of 3-year mortality (adjusted hazard ratios 3.03 and 2.66, respectively). CONCLUSIONS In this population on high-intensity statin therapy only hsCRP and eGFR were independently associated with medium-term mortality. Diversification of secondary preventive measures based on routine evaluations of inflammation and kidney function markers, not only LDL-C, could lead to better targeted reduction of residual risk after ACS.
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6.
Combined lifestyle factors and metabolic syndrome risk: a systematic review and meta-analysis.
Deng, Y, Yang, Q, Hao, C, Wang, HH, Ma, T, Chen, X, Ngai, FW, Xie, YJ
International journal of obesity (2005). 2025;(2):226-236
Abstract
BACKGROUND/OBJECTIVES The metabolic syndrome is a complex condition influenced by many factors including lifestyle. Recently, more and more studies explored the relationships between combined lifestyle factors (often measured as lifestyle scores/indices) and metabolic syndrome due to the co-occurrence of these factors. These scores/indices considered potential interactions among lifestyle factors, offering a more comprehensive understanding of their relationship with metabolic syndrome. However, no review/meta-analysis has been conducted to summarize existing evidence. Thus, this study aimed to synthesize the associations between lifestyle scores/indices and metabolic syndrome in cross-sectional and cohort studies. SUBJECTS/METHODS A literature search was performed in Embase and Medline. Multivariable-adjusted estimates were synthesized using random-effects models. In research where higher scores indicated better health, we used original estimates directly. In studies where higher scores denoted poorer health, we first calculated the coefficients and standard errors based on original estimates. Afterward, we reversed coefficients' directions and recalculated new estimates. Thus, the pooled estimates compared the healthiest with the least-healthy lifestyles (the highest vs. lowest scores/indices). Subgroup analyses were conducted based on study design, region, baseline time, baseline age, sex, health status, metabolic syndrome diagnosis, and lifestyles' number. Sensitivity analyses were performed by including only high-quality studies and employing leave-one-out analyses. RESULTS Nineteen studies from 16 publications were included. Physical activity, diet, and smoking were the top three included lifestyle factors. Compared to participants with the least-healthy lifestyles, those with the healthiest lifestyles had a 43% lower metabolic syndrome risk (95% confidence interval = 0.41-0.73). In subgroup analyses, healthy lifestyle scores/indices were inversely associated with both metabolic syndrome prevalence in cross-sectional studies (Odds ratio = 0.62; 95% confidence interval = 0.51-0.73) and metabolic syndrome incidence in cohort studies (Odds ratio = 0.40; 95% confidence interval = 0.11-0.68). The inverse association was consistent in other subgroup and sensitivity analyses. CONCLUSIONS Adherence to a healthy lifestyle pattern was beneficial to metabolic syndrome prevention.
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Identification of Risk Factors Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease in Psoriatic Patients.
Küçük, K, Moreno, C, Nijmi, H, Daoud, M, Mintoff, D, Willaert, F, Benhadou, F
Dermatology (Basel, Switzerland). 2025;(1):92-100
Abstract
INTRODUCTION Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common cause of chronic liver disease. Patients suffering from psoriasis are at an increased risk of developing MASLD. Psoriasis and MASLD share a pro-inflammatory cytokine milieu; however, it is still unclear whether these conditions are related through shared metainflammatory processes or shared comorbidities such as obesity, diabetes, insulin resistance, and metabolic syndrome. The aim of our study was to better characterize the anthropometric and metabolic profile of psoriatic patients with MASLD. METHODS We conducted a prospective, single-center, cross-sectional study between June 2014 and August 2017. Recruitment was restricted to adult patients with psoriasis. Blood analysis, liver ultrasonography, and a FibroScan were performed. Blood investigations, baseline anthropometric measurements, and components of fatty liver disease (hepatic ultrasound, FibroScan) were assessed. RESULTS A total of 100 patients were recruited, of which, 43% (65.1% men, n = 28) were diagnosed with MASLD. The mean BMI was significantly higher in MASLD than in non-MASLD (27.7 kg/m2 vs. 30.1 kg/m2, p =< 0.001). The mean waist circumference in MASLD patients was significantly higher than in non-MASLD patients (105.6 cm vs. 97.2 cm, p = 0.005). There was no significant difference between the mean age of both patient groups (50.4 vs. 47.3 years, p = 0.26). Psoriatic arthritis was more prevalent in MASLD than in the non-MASLD group (14.3% vs. 1.8%, p = 0.004). Biochemical analysis revealed significantly higher C-peptide level in patients with MASLD compared with patients without MASLD (2.5 vs. 1.6 ng/mL, p = 0.036). Moreover, MASLD patients were found to have a lower HDL level and higher glycemia, triglyceridemia, cholesterol, and LDL levels than non-MASLD patients. A total of 16.3% of patients with MASLD had fibrosis stage ranging from F2 to F4 based on liver stiffness measurement compared with only 10.6% of patients without MASLD. DISCUSSION We identified parameters which were more prevalent in patients with psoriasis having MASLD, specifically a high BMI, elevated triglyceride levels, decreased HDL levels, and an elevated level of C-peptide. Patients with psoriasis and MASLD were more likely to suffer from comorbid psoriatic arthritis, despite having similar psoriasis disease severity as measured by PASI. CONCLUSION This study highlights the importance of screening patients with psoriasis for MASLD to prevent the progression to liver fibrosis.
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The role of melatonin and circadian rhythms in the pathogenesis of diabetic retinopathy: A systematic review.
Senthil, MP, Devlin, E, Hassani, A, Lee, E, Sheng An, RY, Oh, S, Barclay, J, Husnain, M, Estevez, JJ, Chakraborty, R
Diabetes & metabolic syndrome. 2025;(2):103202
Abstract
AIMS: This review investigates literature on systemic melatonin levels and circadian timing in diabetic retinopathy (DR), examining their associations with DR. METHODS Our search was conducted in March 14, 2024, and included the databases Medline, Web of Science, Scopus, ProQuest Health, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane, International Standard Randomised Controlled Trial Number (ISRCTN) registry, and International Clinical Trials Registry Platform (ICTRP). RESULTS Our review analysed twelve articles measuring melatonin concentration in saliva, blood serum, urine, or aqueous humour. Studies measuring melatonin levels in saliva found no significant differences in the average nocturnal or daytime melatonin levels between type 2 diabetes (T2D) patients with and without DR. The studies comparing serum melatonin levels in patients with different stages of DR and controls showed inconsistent results. Only two studies measured the endogenous onset of melatonin secretion, known as dim light melatonin onset (DLMO), a highly accurate biomarker for circadian regulation. These studies showed that only 33% and 57% of patients with DR had detectable DLMO in saliva and serum, respectively. All studies evaluating overnight melatonin production using urinary aMT6s (urinary 6-sulfaoxymelatonin) levels found that DR was associated with lower nocturnal melatonin production. CONCLUSIONS Our review results showed evidence of reduced nocturnal melatoin production in DR with no significant changes in melatonin circadian timing.
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Interferon Upregulation Associates with Insulin Resistance in Humans.
Adeva-Andany, MM, Carneiro-Freire, N, Castro-Quintela, E, Ameneiros-Rodriguez, E, Adeva-Contreras, L, Fernandez-Fernandez, C
Current diabetes reviews. 2025;(3):86-105
Abstract
In humans, insulin resistance is a physiological response to infections developed to supply sufficient energy to the activated immune system. This metabolic adaptation facilitates the immune response but usually persists after the recovery period of the infection and predisposes the hosts to type 2 diabetes and vascular injury. In patients with diabetes, superimposed insulin resistance worsens metabolic control and promotes diabetic ketoacidosis. Pathogenic mechanisms underlying insulin resistance during microbial invasions remain to be fully defined. However, interferons cause insulin resistance in healthy subjects and other population groups, and their production is increased during infections, suggesting that this group of molecules may contribute to reduced insulin sensitivity. In agreement with this notion, gene expression profiles (transcriptomes) from patients with insulin resistance show a robust overexpression of interferon- stimulated genes (interferon signature). In addition, serum levels of interferon and surrogates for interferon activity are elevated in patients with insulin resistance. Circulating levels of interferon- γ-inducible protein-10, neopterin, and apolipoprotein L1 correlate with insulin resistance manifestations, such as hypertriglyceridemia, reduced HDL-c, visceral fat, and homeostasis model assessment-insulin resistance. Furthermore, interferon downregulation improves insulin resistance. Antimalarials such as hydroxychloroquine reduce interferon production and improve insulin resistance, reducing the risk for type 2 diabetes and cardiovascular disease. In addition, diverse clinical conditions that feature interferon upregulation are associated with insulin resistance, suggesting that interferon may be a common factor promoting this adaptive response. Among these conditions are systemic lupus erythematosus, sarcoidosis, and infections with severe acute respiratory syndrome-coronavirus-2, human immunodeficiency virus, hepatitis C virus, and Mycobacterium tuberculosis.
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10.
Regional and Sectorial Distribution of Cardiovascular Risk Factors Among Sub-Saharan Africa Workforce: A Systematic Review.
Bamidele Adelowo, A, Lemos Ferreira, N, Besis, G, Gupta, A, Mlawa, G, Khan, Z
Cureus. 2025;(1):e76831
Abstract
The sub-Saharan African region is currently experiencing an unprecedented cardiovascular disease (CVD) epidemic, with CVD accounting for the highest mortality among adults in the region. Changing demographic profiles, lifestyle choices, and preferences for corporate work are identified as root causes of the CVD epidemic in sub-Saharan Africa (SSA). The primary objective of this study was to determine the prevalence of CV risk factors among different regions, countries, and work sectors in SSA. The secondary objective is to identify the work sector with the highest cluster or aggregate of CV risk factors in SSA. This systematic review reports the prevalence of CV risk factors among corporate workers in SSA between 2010 and 2024. Reputable platforms, such as the Cochrane Library, Google Scholar, PubMed, Medline, and Science Direct, were searched for relevant data. A total of 105 studies involving 76,027 participants from nine countries were analyzed. East Africa, Central Africa, West Africa, and Southern Africa had the highest prevalence of unhealthy diet (100%), physical inactivity (80%), high BMI (76%), and metabolic syndrome (MS) (55%), respectively. Ethiopia and South Africa had the highest prevalence of unhealthy diet (100%) and MS (55%), respectively, while Nigeria had the highest prevalence of both stress (71%) and poor sleep (79%). The healthcare work sector had the highest cluster of CV risk factors and the highest prevalence of unhealthy diet (80%), central obesity (51%), and high total cholesterol (36%); the education sector ranked highest in physical inactivity (75%); the administration sector ranked highest in current tobacco smoking (27%) and dysglycemia (17%); and the finance sector workers had the highest prevalence of stress (62%). The prevalence of most risk factors among the corporate workforce in SSA is high, with significant distribution variation across different regions, countries, and work sectors.