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1.
Inflammatory Biomarkers and Components of Metabolic Syndrome in Adolescents: a Systematic Review.
de F Rocha, AR, de S Morais, N, Priore, SE, do C C Franceschini, S
Inflammation. 2022;(1):14-30
Abstract
Metabolic syndrome (MetS) has been prevalent among adolescents. The association between the concentration of inflammatory markers and the individual components of the metabolic syndrome indicates that inflammation, when there is no recent or ongoing disease, mediated by an inflammatory process, is an event that may precede the development of metabolic disorders in teenagers. The objective of this study is to verify the association of inflammatory biomarkers with the components of metabolic syndrome in adolescents. From a search of 3 databases, 13 articles met the study inclusion criteria. Two investigators independently extracted data from included studies. The evaluated inflammatory biomarkers are related to the components of MetS (insulin resistance, central and visceral obesity, arterial hypertension, dyslipidemia), which may increase the risk of developing the syndrome in adolescents. The results of this review are of clinical relevance, since the evaluation of inflammatory biomarkers in the presence of metabolic alterations can help to identify the risk factors that lead to the progression of MetS in adolescents.
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2.
Adverse Effects of Selected Markers on the Metabolic and Endocrine Profiles of Obese Women With and Without PCOS.
Daghestani, MH, Daghestani, MH, Warsy, A, El-Ansary, A, Omair, MA, Omair, MA, Hassen, LM, Alhumaidhi, EM, Al Qahtani, B, Harrath, AH
Frontiers in endocrinology. 2021;:665446
Abstract
The aim of the present study, is to investigate the influence of obesity, with and without polycystic ovarian syndrome (PCOS), on the levels of kisspeptin, vitamin D (Vit D), and vascular endothelial growth factor (VEGF) and to explore the relationship between these parameters and endocrine and metabolic variables. The study group included 126 obese Saudi females. Of these 63 were suffering from PCOS while the rest were normo-ovulatory obese women (non-PCOS obese). In the obese PCOS, VEGF was almost four times as high as in the non-PCOS obese, while kisspeptin and Vit D did not differ. A highly significant elevation was recorded in the waist/hip (WHR), cholesterol, LDL-C, fasting glucose, LH, LH/FSH ratio, estradiol (E2), and testosterone, while hip circumference, leptin, progesterone, and sex hormone binding globulin (SHBG) were lower in the obese PCOS subjects. BMI, HDL-C, ghrelin, insulin, and FSH levels did not differ significantly between the two groups. The obese PCOS had the same level of insulin resistance as the non-PCOS group, as judged by QUICK Index. Correlation studies showed a significant negative correlation between kisspeptin and glucose and LH levels, and a positive correlation with LH/FSH ratio in obese PCOS while in the non-PCOS obese, the kisspeptin correlated positively with glucose, and there was no correlation with LH or LH/FSH. VEGF negatively correlated with FSH and positively with LH/FSH ratio in the non-PCOS obese but this was lost in the obese PCOS. PCOS had no effect on the correlation between Vit D and all studied parameters. Multiple regression analysis showed triglyceride as predictor variable for kisspeptin as a dependent variable, while, leptin is a predictor variable for VEGF as a dependent variable. ROC studies showed the highest sensitivity and specificity for VEGF (AOC=1.00), followed by LH/FSH ratio (AOC=0.979). In conclusion, our study shows that PCOS results in significant elevation of VEGF in obese females, while kisspeptin and Vit D levels are not affected. It also leads to elevation in several of the lipid and hormonal abnormalities in the obese females. In addition, PCOS influences relationship between Kisspeptin and VEGF and some parameters such as glucose, LH or FSH and LH/FSH ratio in obese females, but does not affect Vit D relationship with other parameter.
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3.
Effect of eight-week curcumin supplementation with endurance training on glycemic indexes in middle age women with type 2 diabetes in Iran, A preliminary study.
Zamani, SK, Rezagholizadeh, DM
Diabetes & metabolic syndrome. 2021;(3):963-967
Abstract
BACKGROUND AND AIMS The purpose of this study was to determine the effects of curcumin supplementation & endurance training on glycemic indexes in middle-aged women with type 2 diabetes. METHODS 40 middle-aged women with type 2 diabetes were randomly divided into four groups (control, curcumin, training & curcumin + training). Endurance training protocol included running on treadmill for eight weeks, three sessions per week and each session for 45-60 min, with a maximum intensity of 50-70% of MHR. The experimental groups received a supplementation of curcumin as a daily dose of 80 mg curcumin soft gel for 8 weeks while the control group was subjected to no supplementation or exercise during this period. One day before and one day after the eight-week experimental period, blood samples were taken from the subjects to measure the glycemic indexes, including fasting blood glucose, glycosylated hemoglobin, and serum insulin levels. T-test and two-way covariance analysis tests were used for analyzing the findings at a significant level of less than 0.05. RESULTS Eight weeks of curcumin supplementation and endurance training, whether done separately or simultaneously, significantly reduced fasting blood glucose, glycosylated hemoglobin and serum insulin levels (P < 0.05). The combination of curcumin supplementation and endurance training compared to the other two interventions caused a significant further decrease in these glycemic indexes (P < 0.05). CONCLUSION The findings of this study showed that eight weeks of curcumin supplementation and endurance training helped each other in improving the glycemic indexes of women with type 2 diabetes.
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4.
The Effects of Vitamin D Supplementation on Metabolic and Oxidative Stress Markers in Patients With Type 2 Diabetes: A 6-Month Follow Up Randomized Controlled Study.
Cojic, M, Kocic, R, Klisic, A, Kocic, G
Frontiers in endocrinology. 2021;:610893
Abstract
Vitamin D deficiency could play an important role in the pathogenesis of type 2 diabetes mellitus (T2DM) as it may alter several crucial processes in the development of diabetes and its complications, such as pancreatic insulin secretion, peripheral insulin resistance, persistence of systemic "sterile" inflammation and immune activation. Vitamin D may also have an antioxidant effect through the inhibition of free radicals generation. The reported study was designed with eligible consecutively recruited patients with T2DM on standard metformin therapy (n=130), randomized in 1:1 ratio, considered to have undergone Vitamin D supplementation according to the guidelines proposed by the Endocrine Society, or to have continued with metformin only. The potential benefit was monitored through the influence on glycemia level, glycated haemoglobin (HbA1c), insulin resistance index (calculated as homeostatic model assessment; HOMA-IR), Castelli Risk Index I and Tryglicerides/Thiobarbituric acid-reactive substances (TG/TBARS) Index in a 6-month follow up period. Our study indicates that oral daily doses of vitamin D improve HbA1c levels over the 3-month and 6-month period, followed by a significant decrease in advanced oxidation protein products levels over the 3-month period when higher vitamin D doses are given. The effect of vitamin D on HOMA-IR index, malondialdehyde levels and TG/TBARS index was not statistically significant. Further investigation should consider defining the doses of vitamin D in patients with T2DM which may attenuate the oxidative stress risk, the risk of metabolic syndrome and the risk of related cardiovascular events.
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5.
Policaptil Gel Retard in adult subjects with the metabolic syndrome: Efficacy, safety, and tolerability compared to metformin.
Guarino, G, Della Corte, T, Strollo, F, Gentile, S, ,
Diabetes & metabolic syndrome. 2021;(3):901-907
Abstract
BACKGROUND Policaptil Gel Retard® (PGR), is a new macromolecule complex based on polysaccharides slowing the rate of carbohydrate and fat absorption. It proved to significantly reduce body weight, acanthosis nigricans expression, HbA1c levels, and glucose metabolism abnormalities in obese, hyper-insulinemic adolescents. No such data are available for adults. AIM: to compare the effects of PGR vs. metformin in adult subjects with the Metabolic Syndrome (MS) and T2DM on a Low Glycemic Index diet. SUBJECTS AND METHODS This spontaneous clinical, longitudinal, single-blind, randomized study based on a per-protocol analysis enrolled 100 outpatients with MS and T2DM consecutively referring to our clinic for three months, and randomly assigned to either the active treatment (Group A:, 6 tablets/day) or the comparator (Group B: Metformin tablets, 1500-2000 mg/day in two divided doses during the two main meals, to minimize side effects) to be taken 30 min before each main meal in equally divided doses. Serum lipid profile, anthropometry, HOMA-IR index, and tolerability parameters were evaluated before and after a 6-month follow-up period. RESULTS all parameters improved at a similar rate in both groups but for the lipid profile, which got even better in Group A. Group A also experienced less prominent gastrointestinal side effects than its counterpart. CONCLUSION For the first time, we showed the non-inferiority of PGR compared to metformin in obese adult subjects with the MS and T2DM as for glycemic control and a clear-cut superiority of PGR in terms of both serum lipid-lowering capacity and tolerability.
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6.
Lower versus standard sucrose dose for treating hypoglycemia in patients with type 1 diabetes mellitus in therapy with predictive low glucose suspend (PLGS) augmented insulin pumps: A randomized crossover trial in Santiago, Chile.
Grassi, B, Onetto, MT, Zapata, Y, Jofré, P, Echeverría, G
Diabetes & metabolic syndrome. 2021;(3):695-701
Abstract
BACKGROUND AND AIMS Recommended hypoglycemia treatment in adults with T1D consists of 15 g of rapid absorption carbohydrates. We aimed to evaluate the response to fewer carbohydrates for treating hypoglycemia in patients with T1D on insulin pumps with predictive suspension technology (PLGS). METHODS T1D patients on insulin pumps with PLGS were randomized to receive 10 or 15 g of sucrose per hypoglycemia for two weeks (S10 and S15 groups, respectively) when capillary blood glucose (BG) was <70 mg/dL, with crossover after two weeks. Evolution of capillary BG, active insulin, and suspension time were assessed. RESULTS 59 hypoglycemic episodes were analyzed, 33 in S10 and 26 in S15. Baseline BG in S10 was 54.3 ± 7.7 mg/dL versus 56.9 ± 8.8 in S15 (p = 0,239). Active insulin, present in 85% of the episodes, and PLGS suspension time were similar between groups. BG at 15 min was 77 mg/dL in S10 and 95 mg/dL in S15 (p = 0.0007). In S10, 21% of the episodes required to repeat the treatment after 15 min compared with none on S15, with a RR of 0,79 (95% CI 0.66, 0.940, p = 0,014) for successfully treating the episode. Sensor glucose was significantly different from BG at the moment of the hypoglycemia and control 15 min after treatment. No severe hypoglycemia and no rebound hyperglycemia occurred in neither group. CONCLUSIONS A hypoglycemia treatment protocol with a lower dose of sucrose might be insufficient despite PLGS technology. Our data suggest that standard doses of sucrose should still be recommended.
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7.
Glycosylation Biomarkers Associated with Age-Related Diseases and Current Methods for Glycan Analysis.
Paton, B, Suarez, M, Herrero, P, Canela, N
International journal of molecular sciences. 2021;(11)
Abstract
Ageing is a complex process which implies the accumulation of molecular, cellular and organ damage, leading to an increased vulnerability to disease. In Western societies, the increase in the elderly population, which is accompanied by ageing-associated pathologies such as cardiovascular and mental diseases, is becoming an increasing economic and social burden for governments. In order to prevent, treat and determine which subjects are more likely to develop these age-related diseases, predictive biomarkers are required. In this sense, some studies suggest that glycans have a potential role as disease biomarkers, as they modify the functions of proteins and take part in intra- and intercellular biological processes. As the glycome reflects the real-time status of these interactions, its characterisation can provide potential diagnostic and prognostic biomarkers for multifactorial diseases. This review gathers the alterations in protein glycosylation profiles that are associated with ageing and age-related diseases, such as cancer, type 2 diabetes mellitus, metabolic syndrome and several chronic inflammatory diseases. Furthermore, the review includes the available techniques for the determination and characterisation of glycans, such as liquid chromatography, electrophoresis, nuclear magnetic resonance and mass spectrometry.
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Lactobacillus rhamnosus GG and HbA1c in middle age and older adults without type 2 diabetes mellitus: A preliminary randomized study.
Sanborn, VE, Azcarate-Peril, MA, Gunstad, J
Diabetes & metabolic syndrome. 2020;(5):907-909
Abstract
BACKGROUND AND AIMS Probiotic supplementation improves glycemic control in persons with diabetes and the current study examined whether these benefits extend to healthy individuals. METHODS The current study was a 90-day placebo-controlled, double-blind, randomized clinical trial of Lactobacillus rhamnosus GG in healthy middle-aged and older adults. Fasting blood glucose and HbA1c were quantified at baseline and follow up. RESULTS ANCOVA controlling for baseline values showed group differences in follow up HbA1c [F (1,90) = 8.44, p = 0.005]; HbA1c values increased in the placebo group, though remained stable in the probiotic group. CONCLUSIONS If replicated, Lactobacillus rhamnosus GG may protect against changes in glycemic control.
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9.
Gender-based differences in the clustering of metabolic syndrome factors in children and adolescents.
Calcaterra, V, Larizza, D, De Silvestri, A, Albertini, R, Vinci, F, Regalbuto, C, Dobbiani, G, Montalbano, C, Pelizzo, G, Cena, H
Journal of pediatric endocrinology & metabolism : JPEM. 2020;(2):279-288
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Abstract
Background We depicted gender-differences in metabolic syndrome (MS) clustering before and after puberty in pediatrics, in order to develop gender specific preventive strategies for childhood obesity. Methods We considered 1079 children and adolescents (529 females and 550 males; mean age 11.5 ± 2.8 year). According to body mass index (BMI) percentiles the subjects were classified as normal weight BMI <75th, overweight BMI 75-95th and with obesity BMI >95th. MS was diagnosed when three of the following criteria for age and sex percentiles were met: BMI >95th, triglycerides (TGs) level >95th, high-density lipoprotein-cholesterol (HDL-c) level <5th, blood pressure (blood pressure) >95th percentile, fasting blood glucose (FBG) >100 mg/dL and/or homeostatic model assessment- insulin resistance (HOMA-IR) >97.5th percentile. Results The prevalence of dismetabolic factors was similar in both genders, except for pathological BP, which was higher in males (p = 0.02). MS was detected only in patients with obesity, with a higher prevalence in pubertal than late/post-pubertal subjects (p < 0.001), without any significant difference between gender. In pre-puberty, the most common MS combination was obesity (HBMI) + hypertension (HBP) + hyperglycemia/insulin resistance (HGLY/IR) followed by HBMI + low HDL-levels (LHDL) + HGLY/IR versus HBMI + HBP + HGLY/IR followed by HBMI + HBP + LHDL, respectively, in females and males. In the early and late/post-pubertal periods, the most prevalent combination remained similar to pre-puberty, additionally in both sexes other combinations, such as HBMI + HTG + HBP + HGLY/IR, HBMI + HBP + LHDL + HGLY/IR, HBMI + HTG + LHDL + HGLY/IR and HBMI + HTG + LHDL + HBP + HGLY/IR were also detected, differently distributed in males and females. Conclusions We confirm that MS is an important consequence related to obesity, particularly in the post-puberty stage. Some gender-based differences should be considered early in order to identify specific preventive and treatment strategies.
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The triglyceride/glucose ratio is a reliable index of fasting insulin resistance: Observations from hyperinsulinaemic-euglycaemic clamp studies in young, normoglycaemic males from southern India.
Anoop, S, Jebasingh, FK, Rebekah, G, Kurian, ME, Mohan, VR, Finney, G, Thomas, N
Diabetes & metabolic syndrome. 2020;(6):1719-1723
Abstract
BACKGROUND & AIMS Non-obese Asians have a high propensity to develop insulin resistance. Therefore, screening such individuals for insulin resistance using simple surrogate indices is important. In this study, we aimed to validate the triglyceride-glucose (Tg/glu) ratio against the M value of hyperinsulinaemic-euglycaemic clamp (HEC) procedure and other surrogate indices of insulin resistance in normoglycaemic Indian males from Southern India. METHODS A cohort of 105 normoglycaemic males (mean BMI: 19.2 ± 2.6 kg/m2) underwent HEC procedure. Surrogate indices of insulin resistance viz. the triglyceride-glucose (Tg/Glu) ratio, the triglyceride-glucose index, the McAuley's index, the HOMA-IR, the QUICKI, the fasting glucose to insulin ratio (FG-IR), and the fasting C- peptide index were calculated and correlated with the M value. The cut-off value for the Tg/Glu ratio was obtained using the Receiver Operator Characteristics (ROC) with Area under curve (AUC) analysis at 95% confidence interval (CI). The P value < 0.05 was considered statistically significant. RESULTS The Tg/Glu ratio demonstrated significantly higher AUC (0.81), when compared to the Tg × glu index (0.63), 20/fasting C peptide × fasting plasma glucose index (0.55), HOMA-IR (0.47), QUICKI (0.26), FGIR (0.12) and McAuley's index (0.18). For the Tg/Glu ratio, a cut-off value ≥ 1.19 had high sensitivity (80%) and specificity (79%) values (PPV: 16%; NPV: 98.8%) respectively. CONCLUSION The Tg/Glu ratio can be used as a reliable surrogate index to screen for risk of insulin resistance in lean, normoglycaemic males from Southern India.