Metabolic Syndrome and Related Disorders

The Magnetic Resonance Image-Arterial Spin Labeling Characteristic of Nonketotic Hyperglycemic Hemichorea in an Elderly Type 2 Diabetic Female Patient
Wen S, Fang H, Xu D, Liu X and Zhou L
Nonketotic hyperglycemia-induced hemichorea is a rare condition of type 2 diabetes. It is characterized by hyperglycemia with the symptom traced to the basal ganglion like hemichorea or hemiballism, with the hyperintensity within basal ganglion presented in computed tomography (CT) or hyper signal in T1-weighted magnetic resonance image (MRI). It was also confirmed with a relatively better prognosis in that the symptoms of these patients could be relieved after the alleviation of hyperglycemia. However, the exact pathophysiology or mechanism of this condition currently was unclear. Besides, the duration of improvement in tomography as far was varied. In the present study, we reported an elderly female patient who tested with nonketotic hyperglycemia (random blood glucose of fingertips was 19 mmol/L or 342 mg/dL, blood ketone was 0.1 mmol/L) with the symptoms of dysphoria and mild chorea of left low limb, the MRI and CT showed contralateral striatopathy. Her condition achieved alleviation after the normalization of blood glucose. We subsequently rechecked her MRI in arterial spin labeling sequence which showed the hypoperfusion in the right basal ganglion rather than the opposite. Therefore, we suppose the hyperglycemia could induce temporary hypoperfusion in the basal ganglion associated with motor dysfunction which is manifested by hemichorea or hemiballism.
Socioeconomic Status and Lifestyle Factors Differences in the Association Between Dietary Patterns and Metabolic Syndrome: Tehran Lipid and Glucose Study
Hosseinpour-Niazi S, Abbasi H, Mirmiran P, Malmir H and Azizi F
Socioeconomic status and lifestyle factors could potentially modify the association between diet and chronic diseases such as metabolic syndrome (MetS). This study aimed to investigate the combined effect of socioeconomic status, lifestyle factors, and dietary patterns on the MetS risk. During 8.9 years of follow-up, dietary information of 1915 individuals was collected by a validated Food Frequency Questionnaire (FFQ). Dietary patterns were derived using principal component analysis. Two major dietary patterns including healthy dietary and Western dietary patterns were identified. In the crude and fully adjusted models, an association was not found between Western and healthy dietary patterns and the risk of MetS. There was a significant decrease in the risk of MetS among participants with higher levels of education who adhered to a healthy dietary pattern (hazard ratio: 0.71, 95% confidence interval: 0.34-0.89). Furthermore, the risk of MetS decreased in the fourth quartile of healthy dietary pattern among nonemployed (0.78, 0.51-0.94). According to the stratification of physical activity levels, it was shown that the healthy dietary pattern had a negative association with the risk of MetS only among participants who engaged in a high level of physical activity (0.70, 0.40-0.91). About the smoking status, it was shown that among non-smoker participants, higher adherence to a healthy dietary pattern was associated with a reduction in the risk of MetS. The risk of MetS reduced by 36% (0.64, 0.51-0.97) in the third quartile and by 39% (0.61, 0.54-0.95) in the fourth quartile of the healthy dietary pattern. No association was found between Western dietary pattern with MetS in different status of socioeconomic and lifestyle factors. Adhering to a healthy dietary pattern, engaging in regular physical activity, and abstaining from smoking could reduce incidents of MetS. Moreover, socioeconomic status modified the association between healthy dietary pattern and MetS.
A Comparison of Metabolic-Associated Fatty Liver Disease and Steatotic Liver Disease in a Cohort of Egyptian People Living with Human Immunodeficiency Virus
Elrashdy F, Mohamed R, Cordie A, Abdel Aziz H, Mohamed N, Kamel A, Ramadan A, Hamdy M, Yasser M, Meshaal S, Abdel Alem S, Elsharkawy A and Esmat G
The prevalence of fatty liver disease in people living with human immunodeficiency virus (PLHIV) is significantly higher than in general population. This study aims to compare the burden of fatty liver disease in Egyptian PLHIV using both metabolic dysfunction-associated fatty liver disease (MAFLD) and steatotic liver disease (SLD) criteria. A retrospective cross-sectional study was conducted on PLHIV attending the HIV reference center at Embaba Fever Hospital in Egypt between November 2019 and July 2021. Data collection included demographics, comorbidities, physical examination, laboratory tests, liver ultrasound, controlled attenuation parameter, and liver stiffness measurement using Fibroscan®. The prevalence of SLD and MAFLD was 26.92% and 21.15%, respectively. The concordance between MAFLD and SLD definitions was low (kappa = 0.465). The presence of SLD was significantly associated with increased odds of significant fibrosis ( = 0.045). However, MAFLD was not significantly associated with fibrosis ( = 0.369). SLD demonstrates a stronger association with significant fibrosis than MAFLD in PLHIV. This highlights the potential of SLD as a more inclusive and representative classification for steatosis in PLHIV.
Wrist Circumference as a Predictor of Abnormal Cardiometabolic Risk in Children and Adolescents with Obesity
Sert S, Büyükinan M and Yılmaz AF
The objective of this study was to evaluate the utility of wrist circumference (WrC) as a predictor of abnormal cardiometabolic risk (CMR) in children and adolescents with obesity. A cross-sectional study was conducted from July 2024 to September 2024. Children with obesity (aged 5-17.9 years) were categorized into metabolic syndrome (MetS) and non-MetS groups according to the International Diabetes Federation consensus criteria for pediatric MetS. Participants were divided into three groups based on their pubertal stages: pre-pubertal, pubertal, and post-pubertal. A total of 307 children and adolescents with obesity were analyzed, comprising 160 females and 147 males, with a median age of 12.9 years (interquartile range 4.2). MetS was diagnosed in 94 participants (30.6%). Participants with MetS demonstrated significantly higher waist circumference, WrC, body mass index (BMI), blood pressure, serum triglycerides, fasting plasma glucose, insulin levels, and homeostasis model assessment of insulin resistance, alongside lower high-density lipoprotein-cholesterol (HDL-C) levels compared with those without MetS. In correlation analyses, WrC positively correlated with age, BMI, and various metabolic parameters, while it negatively correlated with HDL-C levels. Logistic regression analysis identified the pubertal stage and WrC as the strongest independent predictors of MetS. In the mid-pubertal group, a cutoff of 1.795 (96.2nd percentile) for the WrC z-score effectively predicted MetS in children with obesity. In the post-pubertal group, a cutoff of 1.805 (96.7th percentile) for the WrC z-score effectively predicted MetS in children with obesity. Participants with increased WrC presented significantly higher rates of hypertension and MetS in both the mid-pubertal and post-pubertal groups. This study demonstrates that WrC is significantly elevated in children with obesity diagnosed with MetS compared with their non-MetS counterparts. Furthermore, findings indicate that mid-pubertal and post-pubertal subjects with increased WrC are at a greater risk of presenting CMR factors than those with normal WrC values.
Association Between Two Novel Visceral Obesity Indicators and Heart Failure Among US Adults: A Cross-Sectional Study
Luo X, Cai B and Jin W
This study aimed to explore the association of cardiometabolic index (CMI), CMI-age, visceral adiposity index (VAI), and VAI-age with heart failure (HF) and to compare those indicators for early identification of HF. Drawing from the National Health and Nutrition Examination Survey (NHANES) for 2011-2018, we enrolled 8999 participants in a cross-sectional study. The association of different visceral obesity indicators (CMI, CMI-age, VAI, and VAI-age) with HF was estimated by multivariable regression analysis. Receiver operating characteristic (ROC) curves were used to examine the predictive ability of CMI, CMI-age, VAI, and VAI-age on patients with HF. CMI, CMI-age, VAI and VAI-age showed positive correlations with HF. When indicators were analyzed as continuous variables, CMI, CMI-age, VAI, and VAI-age showed positive correlations with HF in both the crude and adjusted models (all < 0.05). When indicators were analyzed as categorical variables, it was found that in all four models, the ORs of group Q4 was significantly different compared to Q1 (all < 0.05), suggesting the risk of HF is significantly increased with higher CMI, CMI-age, VAI, or VAI-age. The association between those indicators (CMI, CMI-age, VAI, and VAI-age) and HF was similar in all stratified populations ( for interaction >0.05).The areas under the ROC curve (AUCs) of four indicators in predicting HF were significantly different (CMI: 0.610, 95% CI, 0.578-0.643; CMI-age: 0.700, 95% CI, 0.669-0.726; VAI: 0.593, 95% CI, 0.561-0.626; VAI-age: 0.689, 95% CI, 0.661-0.718), suggesting that CMI-age was significantly better than the other three indicators in predicting HF ( < 0.001). CMI, CMI-age, VAI, and VAI-age were all independently correlated with the risk of HF. In four indicators, the CMI-age was significantly better than the other three indicators in predicting HF, which provides new insights into the prevention and management of HF.
Household Food Insecurity and Metabolic Syndrome in Adults: A Meta-Analysis
Camargo TL, Rupolo VL, Beretta MV and Garcez A
Household food insecurity (HFI) refers to the lack of access to safe and nutritious food, and this condition may be associated with the occurrence of metabolic syndrome (MetS). Thus, this study aimed to conduct a quantitative synthesis (meta-analysis) to summarize the evidence from epidemiological studies on the association between HFI and MetS. A systematic search was conducted in the PubMed, Embase, Web of Science, and Latin American and Caribbean Health Sciences Information Center databases to retrieve epidemiological studies published until October 2023. The entire process of selection, data extraction, and assessment of article quality was independently performed by two reviewers. The quality of the studies was evaluated using the criteria proposed by the National Institutes of Health instrument. The random-effects model was used to report the quantitative synthesis of combined data. The -test and index were used to assess heterogeneity. Egger's and Begg's tests were employed to evaluate publication bias. A total of 10 articles meeting the eligibility criteria were selected and included in this meta-analysis. High heterogeneity was observed among the studies ( > 70), along with a low risk of publication bias. Considering all ten included studies, no statistically significant association was found between HFI and MetS (odds ratio = 1.17; 95% confidence interval: 0.89-1.55; = 79.9%). The findings of this meta-analysis did not reveal a statistically significant association between HFI and MetS, indicating the need for further studies aimed at exploring and expanding the scientific evidence on this relationship.
Association Between Body Mass Index and Resting Blood Pressure in a Nondiabetic Population: Mediating Effect of Triglyceride-Glucose Index
Kang S, Kang M, Kim J and Kang H
The role of the triglyceride-glucose (TyG) index in determining the effect of obesity on blood pressure (BP) in patients without diabetes remains unclear. We examined the association between body mass index (BMI), the TyG index, resting BP, and hypertension in Korean adults. We used the baseline data (4206 males and 4724 females aged 40-69 years) from the Korean Genome and Epidemiology Study conducted from 2001 to 2002. The primary outcomes were the TyG index, BMI, resting BP, and hypertension. The demographic characteristics, health behaviors, levels of fasting blood glucose, insulin resistance (IR) markers, lipoprotein lipids, and liver enzymes were included as covariates. The TyG index was significantly associated with higher IR marker levels, poor lipoprotein-lipid profiles, elevated hepatic liver enzyme levels, elevated BP, and hypertension. Logistic regression analysis showed that individuals living with obesity had a higher risk of hypertension compared to individuals with underweight. Individuals in the second, third, and fourth quartiles of the TyG index had a higher risk of hypertension compared with those in the first quartile (odds ratio = 1). Mediation analysis showed that BMI has an indirect effect on diastolic and systolic BP through the TyG index. Our study findings indicate that the TyG index plays a pathological intermediary role between obesity and increased BP in individuals without diabetes, implying its clinical value in assessing the impact of obesity on hypertension risk.
Prevalence of Metabolic Syndrome and Combinations of Its Components: Findings from the Mexican National Health and Nutrition Survey, 2021
Campos-Nonato I, Ramírez-Villalobos M, Monterrubio-Flores E, Mendoza-Herrera K, Aguilar-Salinas C, Pedroza-Tobías A and Simón B
Metabolic syndrome (MetS) is a clinical construct that conglomerates risk factors interconnected with cardiovascular diseases and type 2 diabetes. More than a thousand million individuals in the world were diagnosed with MetS in 2018. Our objective was to examine the prevalence of MetS and its components among Mexican adults. Data from 1733 adults aged ≥20 years who participated in the Mexican National Health and Nutrition Survey 2021. Sociodemographic, and clinical factors were gathered and analyzed. To define MetS, we used the harmonized diagnosis criteria. The prevalence of MetS in Mexican adults was 45.3% (43.7% in men and 46.8% in women). This was mainly driven by increased abdominal obesity (AO) 79.8% and dyslipidemia (low high-density lipoprotein [HDL]-cholesterol and hypertriglyceridemia) 77.1%. The proportion of subjects with a least one MetS component was 90.5% and with any combination of two components was 25.2% and for three was 28.9%. The most frequent combination of MetS components was the cluster of AO, low HDL-cholesterol, and hypertriglyceridemia (15.6%). A high prevalence of MetS was registered in Mexico in 2021. Women and adults aged 40 years or older were the groups with the highest prevalence of MetS and its components. The health system in Mexico must promote strategies for the prevention and control of MetS and its components in adults.
Podocyte-Specific Protein Expression in Urine Exosome Acts as a Marker for Renal Injury in Post-COVID State
Nandula SR, Brichacek B and Sen S
Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) has been associated with the development of COVID-19. COVID-19 may cause endothelial cell dysfunction (ECD), which can lead to cardiometabolic diseases and podocytopathy. In this study, we explored whether presence of hyperglycemia predisposes to SARS-CoV-2 infection, , and whether COVID-19 can put an individual at a higher risk of persistent renal damage in the long-term following acute COVID infection. To estimate renal damage, we evaluated albuminuria and podocytopathy. Podocytopathy was estimated by measuring podocyte-specific protein levels in urine-derived exosomes from patients who were admitted with acute COVID-19 at 10 days, 6 months, and 12 months post-acute SARS-CoV-2 infection. Blood and urine samples from patients with SARS-CoV-2 post-infection were procured from the George Washington University COVID repository. Peripheral blood mononuclear cells and urine exosomes were isolated. Podocyte-specific proteins Podocalyxin (PODXL) and Nephrin (NEPH) were identified from urine exosomes. Urine exosomal podocalyxin levels were significantly high at 10 week ( = 18; = 0.001), 6 month ( = 25; = 0.003) and 12 month ( = 14; = 0.0001) time points. Nephrin levels were also noted to be high at 10 week ( = 18; = 0.001) and 12 month ( = 14; = 0.007) time points, compared with urine samples obtained from type 2 diabetes subjects who never had COVID-19. Though urinary podocyte-specific proteins were high, compared to control, there were no significant differences noted on urine albumin:creatinine ratios (UACR) between the groups. Persistent high levels of podocyte-specific proteins noted in urinary exosomes even at 12 months post-Covid may lead to the development of chronic kidney disease.
Effectiveness of Low Doses of Semaglutide on Weight Loss and Body Composition Among Women in Their Menopause
Nicolau J, Blanco-Anesto J, Bonet A, Félix-Jaume JJ and Gil-Palmer A
Menopause is a complex period in women's life, when weight gain and predisposition to obesity are frequent. Moreover, even during menopause transition, women begin to lose lean mass up to 0.5% and, therefore, an increase in the percentage of fat mass with central distribution and an increased risk of metabolic syndrome. Despite lifestyle habits remain the cornerstone in this period, their long-term effectiveness is a challenge. In this sense, GLP-1 analogs have shown their efficacy in improving weight loss and other cardiovascular risk factors. To assess the effectiveness of low doses of semaglutide on body weight and composition for 4 months during menopause compared with premenopausal women. Baseline weight and body mass index were significantly greater among postmenopausal women (95 ± 23.4 vs. 86.4 ± 12.8 kg and 35.9 ± 7.3 vs. 32.9 ± 4.7 kg/m; = 0.02 and = 0.03, respectively). Fat mass was higher among postmenopausal women (45.2 ± 17.1 vs. 38.2 ± 9.8 kg; = 0.03). The percentage of fat mass and lean mass were comparable between the two groups (43.2 ± 8.1% vs. 40.9 ± 7.1% and 29.6 ± 5.5 vs. 32.4 ± 8.4 kg; = 0.2 and = 0.08, respectively). After 4 months of semaglutide 1 mg, either weight loss (5.9 ± 5.2 vs. 4.5 ± 3.5 kg; = 0.1) or percentage of weight loss (5.8 ± 4.7% vs. 5.1 ± 3.2%; = 0.4) were comparable. Furthermore, both fat mass loss in kilos (4.1 ± 4.5 vs. 3.1 ± 3.7 kg; = 0.3) and lean mass loss (-0.4 ± 1.7 vs. -1.1 ± 3.7 kg; = 0.1) were similar between the two groups. Despite a greater initial weight and fat mass among postmenopausal women, after 4 months of treatment with semaglutide 1 mg, either fat mass loss or weight loss were similar to premenopausal women.
Metabolic Syndrome and the Risk of Alzheimer's Disease: A Meta-Analysis
Feng Y, Cheng L, Zhou W, Lu J and Huang H
The relationship between metabolic syndrome (MetS) and the risk of Alzheimer's disease (AD) remains unclear. This meta-analysis aims to clarify the prospective association between MetS and AD risk and to explore how individual MetS components contribute to this relationship. Comprehensive searches of MEDLINE, Web of Science, and Embase were conducted up to April 12, 2024. Relevant prospective cohort studies were included. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the associations. A random-effects model was used to incorporate the potential impact of heterogeneity. Six prospective cohort studies with seven datasets, including 484,994 participants and a follow-up of 3.5 to 13.0 years, were included. The pooled analysis showed no significant association between MetS and AD risk (HR: 0.96, 95% CI: 0.89-1.04, = 0.37; = 0%). Sensitivity and subgroup analyses confirmed these findings. Individual MetS components exhibited varied effects as follows: abdominal obesity was linked to a reduced AD risk (Risk ratio (RR): 0.70, 95% CI: 0.56-0.88, = 0.002), whereas high blood pressure (BP) (RR: 1.15, 95% CI: 1.04-1.27, = 0.007) and hyperglycemia (RR: 1.24, 95% CI: 1.08-1.42, = 0.002) were associated with an increased risk. Low high-density lipoprotein cholesterol and high triglycerides showed no significant associations. This meta-analysis found no significant overall association between MetS and AD risk. However, specific MetS components, such as abdominal obesity, high BP, and hyperglycemia, may influence AD risk differently.
Vitamin D Receptor Gene Polymorphism and Risk of Type 2 Diabetes Mellitus: A Case-Control Study Among Ethiopian Population
Nakachew E, Melake A, Alemu M, Eshetie T and Berhane N
Type 2 diabetes mellitus (T2DM) is a complex and diverse illness that is influenced by several vulnerable genes as well as environmental risk factors. The aim of this study was to ascertain the relationship between the vitamin D receptor gene polymorphisms and the risk of T2DM at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. An age- and sex-matched hospital-based case-control study involved 70 patients with T2DM and 70 nondiabetic healthy controls. Demographic information was assessed in order to identify the associated risk variables. To ascertain the genotypes, DNA was taken from blood samples and used in a polymerase chain reaction and agarose gel electrophoresis analysis. The frequency of the homozygous -tt genotype [odds ratios (OR): 2.69; 95% confidence level (CL): 1.05-6.44; = 0.38], and the t allele (OR: 1.90; 95% CL: 1.16-3.12; = 0.0099) was significantly higher in patients with T2DM compared to nondiabetic controls. The results suggest that the gene polymorphism may be related to the onset of T2DM in the Ethiopian population under study.
Influence of Body Mass Index on the Clinicopathological Features of Papillary Thyroid Carcinoma in a Chinese Population
Zhang L, Xu S, Cheng X, Zhu Y, Cai G, Wu J, Gao W, Bao J and Yu H
Previous studies suggested a relationship between obesity and a high risk of thyroid cancer. However, the association between high body mass index (BMI) and the aggressiveness of papillary thyroid carcinoma (PTC) is controversial. In this study, we aimed to investigate the impact of excess BMI on histopathologic aggressiveness of PTC in a Chinese population. Between January 2015 and September 2020, 4369 PTC patients who were tested for mutation at Jiangyuan Hospital were enrolled. Logistic regression analyses were used to evaluate the associations between BMI and clinicopathological features of PTC as well as tumor mutational status. Of 4369 PTC patients, the mean BMI was 24.06 ± 3.49 kg/m, and mutations were detected in 3528 (80.8%) patients. BMI ≥24.0 at initial surgery was associated with tumor multifocality and bilaterality, but not with advanced tumor stage, extrathyroidal extension (ETE), ratio of positive lymph nodes >0.3, distant metastasis, or mutation. Our present study suggested that compared to patients with a normal BMI, overweight and obese patients had a greater risk of multifocality and bilaterality of PTC. No significant associations were observed between higher BMI and the more advanced tumor-node-metastasis stage or mutational status.
Association of Skeletal Muscle Mass with Habitual Exercise, Mealtime and Sleep in Middle-Aged Men: Cross-Sectional Study
Masuda Y, Kishimoto N, Kuroda E, Ogata T, Misaki S, Chimura Y, Kikuchi M, Yamada C, Kubo A and Nishizaki Y
To investigate the cross-sectional association between skeletal muscle mass and lifestyles including exercise, mealtime, and sleep habits in adult men aged under 64. A total of 101 Japanese men aged under 64 who underwent "Anti-aging Health Checkups" were enrolled in the study. Cross-sectional analyses were conducted using the subjects' data such as body mass index, skeletal muscle mass index (SMI), and self-reported lifestyle information. The physical activity (PA) value of habitual exercise per week (metabolic equivalent hr/week) was categorized into three groups. Mealtime combination of breakfast and dinner time was categorized into five groups. A multiple regression analysis demonstrated how each PA group has an association with SMI. Moreover, an analysis of covariance was performed to investigate the association between "mealtime combined with PA" and SMI levels by comparison and to investigate the association between "sleep duration or satisfaction combined with PA" and SMI levels, respectively. The subjects with "breakfast before 8 a.m." had a significant positive association between SMI and PA levels; in addition, among the subjects from the "dinner before 8 p.m." group, as the PA level was higher, the SMI level increased. Consequently, the SMI level increased as the PA level was higher among the subjects who had "breakfast before 8 a.m. and dinner before 8 p.m." Furthermore, sufficient sleep such as more than 6 hr and satisfied sleep had positive associations with SMI as PA levels increased. These findings suggest a potential benefit of habitual exercise with breakfast before 8 a.m., dinner before 8 p.m., and sufficient sleep for maintaining skeletal muscle mass among middle-aged men.
Lipid Accumulation Product Outperforms BMI and Waist Circumference in Metabolic Disorders
Elsayed D, Al-Kuwari M, Naeim J, Al-Marri A, Al-Thani N, Al-Mohannadi H, Al-Suliati H, Al-Ali A and Doi SA
Obesity is a global health issue intricately linked to metabolic syndrome (MetS), insulin resistance, and dyslipidemia. Anthropometric indices, particularly those measuring central obesity, have emerged as more reliable predictors of these metabolic disorders than general obesity indices such as body mass index (BMI). However, the relative predictive power of these indices remains debated, particularly across sexes. This study aimed to evaluate the discriminative performance of various anthropometric measures, including lipid accumulation product (LAP), BMI, waist circumference (WC), and visceral adiposity index (VAI), in predicting insulin sensitivity, β-cell function, MetS, and dyslipidemia using National Health and Nutritional Evaluation Survey III (NHANES III) data. A cross-sectional analysis of 3,706 adults from the NHANES III database was conducted. Anthropometric indices were compared against insulin sensitivity Homeostasis Model Assessment (HOMA)-S, β-cell function (HOMA-B), metabolic syndrome (MetS) status, and dyslipidemia. Receiver-operating characteristic (ROC) curves and linear regression models were used to identify thresholds for predicting metabolic abnormalities. LAP emerged as the most discriminative index across all outcomes, outperforming BMI and WC, particularly in predicting insulin sensitivity and β-cell function in males. In females, BMI was superior in predicting β-cell function. VAI demonstrated the strongest association with dyslipidemia but was less effective in predicting insulin resistance. LAP significantly outperforms conventional anthropometric indices in identifying insulin resistance and MetS, highlighting its potential as a screening tool for cardiometabolic risk. Gender differences in the predictive abilities of these measures suggest that BMI may retain value in assessing β-cell function in females. VAI should be considered when screening for dyslipidemia but is less effective for insulin resistance.
A Novel Insight into Postmenopausal Hypercholesterolemia: Carnitine as a Key Player
Lixing W, Lin C, Lijun Y, Xiaojin X, Zhuyang S, Juan Z, Linsheng L and Dan H
Postmenopausal women (post-MW) are at a heightened risk of cardiovascular diseases, including hypercholesterolemia. This study aimed to investigate metabolomic variations to identify potential markers and targets for postmenopausal hypercholesterolemia. Sixty-two female volunteers aged 40-65 were recruited for this study. Metabolomic analysis using the Ultra-Performance Liquid Chromatography Quadrupole Orbitrap Mass Spectrometry (UPLC-Q-Orbitrap MS) platform was conducted to investigate changes in endogenous substances in premenopause ( = 25) and postmenopause ( = 37) women. Following ovariectomy surgery, menopausal mice were monitored for changes in their biomarker levels, and the integrity of the large artery walls in each treatment group was observed through hematoxylin and eosin staining. cellular models were utilized to assess variations in lipid metabolism, reactive oxygen species (ROS) levels, and changes in the levels of superoxide dismutase and glutathione peroxidase enzymes in different cell groups postintervention using Western blot analysis. Treatment with carnitine in postmenopausal mouse models led to increased plasma cholesterol and carnitine levels, as well as indicators of arterial sclerosis. In HepG2 cells, carnitine treatment resulted in heightened lipid levels, elevated ROS production, and decreased antioxidant enzyme levels. The findings suggest that carnitine may serve as a potential risk marker or therapeutic target for postmenopausal hypercholesterolemia. This study provides valuable insights into cardiovascular conditions in post-MW and offers new avenues for therapeutic interventions. Continued research in this area is crucial to enhance our understanding of cardiovascular diseases in post-MW and to explore additional treatment options.
Truncated Albumins as Novel Surrogate Biomarkers in Diabetes Therapy: Epiphenomena and Potential Clinical Applications
Vaishnav MS, Kumari N, Srikanta S, Simha V, Krishnaswamy PR and Bhat N
Among various albumin posttranslational modifications (PTMs), N- and C-terminal truncations (HSA-DA and HSA-L) have also shown biomarker potential in disease states. We examined albumin truncation longitudinal trends and correlations during diabetes therapy toward possible future clinical applications. In a preliminary longitudinal therapy investigation, mass spectrometry was employed to track PTMs of human serum albumin (HSA), including glycation (GA), cysteinylation (CA or HNA1; reversible), di/trioxidation (OA or HNA2; irreversible), and truncation (TA). These modifications were correlated with ongoing therapy in four distinct subject groups: type 1 diabetes (T1DM), type 2 diabetes (T2DM), prediabetes-obesity (PDOB), and healthy controls (NORM), observed over a follow-up period extending up to 280 days. Diabetes was associated with significant reduction ("deficiency") of measured albumin truncations (For HSA-DA: T2DM = 0.32 ± 0.3%, = 2E-08; T1DM = 1.02 ± 0.4%, = 3E-05; PDOB = 1.61 ± 0.2%, = 0.004; compared to NORM = 2.08 ± 0.2%). Albumin truncation reduction was more striking in T2DM (HSA-DA: T2DM vs. T1DM: = 0.004). Improvements in glycemic control and decrease of albumin glycation during diabetes therapy were associated with concomitant increase of albumin truncations toward the "healthy" normal ranges, and vice versa ("mirror image" trends). Accordingly, albumin truncation correlated inversely with albumin glycation (HSA-DA vs. GA: R = -0.53, = 1E-09). The "epiphenomenon" of albumin truncation (reflecting the severity of mean hyperglycemia and also insulin resistance) can possibly provide novel, sensitive, and complementary biomarkers ( via simpler HSA-DA peptide fragment immunoassays) to monitor efficacy of diabetes therapy and also progression from "healthy" to prediabetes and type 2 diabetes, highlighting potential diagnostic and prognostic utility in clinical diabetes care.
Confusion Concerning the Calculation of the Triglyceride-Glucose Index: An Urgent Need for Clarity
Jialal I
Impact of Laboratory-Measured Euthyroid Hashimoto's Thyroiditis on Reproductive Hormone Profile in Women with Obesity
Akbas F, Teke ZB, Cavdar VC and Zerdali H
Hashimoto's thyroiditis is a common endocrinological disorder that often coexists with obesity. Thyroid hormones interact with the regulation of sex steroids, and thyroid autoimmunity has a negative impact on female fertility. There are studies showing when euthyroid state is achieved with hormone replacement therapy (HRT), the reproductive hormone profile is improved but they usually compare the reproductive hormones before and after HRT in the same individuals. Studies comparing patients with Hashimoto's thyroiditis in an euthyroid state receiving HRT with individuals having normal thyroid function are limited. Here, it was aimed to search the impact of euthyroid Hashimoto's thyroiditis on reproductive hormone profile in women living with obesity. Sixty-one randomly selected female patients with Hashimoto's thyroiditis were included as the case group and 60 patients without Hashimoto's thyroiditis were included as the control group, from our obesity center. The case group included patients who had menstrual cycles and were euthyroid under l-thyroxine treatment for at least 6 months. Data on weight, height, body mass index (BMI), waist circumference (WC), free thyroxine (fT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (anti-TPO), cortisol, insulin, prolactin (PRL), follicular stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E), progesterone (prog), testosterone (T), and dehydroepiandrosterone sulfate (DHEAS) levels, l-thyroxine treatment dosage (for case group), and accompanying diseases were recorded. The results were evaluated using SPSS. A total of 121 patients were included in the study. Mean age was 41.8 ± 8.5 years in case and 38.6 ± 8.9 years in control group. There was no significant difference in weight, height, BMI, WC, or accompanying diseases between Hashimoto's thyroiditis and control group. fT4, anti-TPO, cortisol levels were higher in Hashimoto's thyroiditis group when compared with control group, but there was no significant difference for TSH, insulin, FSH, LH, E, prog, T, DHEAS, or PRL. In women living with obesity, it is important to screen for Hashimoto's thyroiditis and achieve euthyroidism through effective LT4 treatment to promote a healthy reproductive system and improve fertility rates.
Methylation Patterns of Diabetes and Obesity Susceptibility Genes in Gestational Diabetes Mellitus: A Cross-Sectional Analysis from Karachi, Pakistan
Fatima SS, Fatimi AS, Abbas M, Farhat S and Mohammed N
Women with gestational diabetes mellitus (GDM) and their offspring have an increased risk of adverse perinatal and long-term health outcomes, which may be attributable to epigenetic modification of diabetes and obesity susceptibility genes. We aimed to investigate the methylation patterns of eight genes in GDM and normoglycemic (NG) mothers, and their respective offspring. This cross-sectional study, conducted at Aga Khan University from August 2019 to December 2022, recruited pregnant women in the first trimester of gestation from the outpatient obstetrics clinic. Participants were classified as NG or GDM based on the Society of Obstetricians and Gynecologists Pakistan. Venous blood samples were collected from mothers and cord blood from neonates. Peripheral blood mononuclear cells were used for DNA extraction and methylation analysis using methylation-specific PCR. Maternal and neonatal clinical data were recorded. Statistical analysis was performed using R, including binary logistic regression to assess the association between various gene methylation levels and GDM. The study found that GDM mothers had significantly higher fasting blood glucose, 2-hr OGTT, and serum carboxymethyl lysine (CML) levels compared to NG mothers, but no significant differences in neonatal birth weight or serum CML levels. Chemerin methylation was significantly lower in GDM mothers and their babies, while , and methylation levels were higher in GDM offspring compared to NG offspring. GDM mothers also had higher methylation levels of brain-derived neurotrophic factor gene (). Multivariable binary logistic regression identified methylation levels of maternal BDNF and neonatal MTNR1B to be independently associated with GDM. Our study shows a trend of epigenetic modifications in both GDM mothers and their offspring in various genes related to metabolism and inflammation, suggesting an intergenerational transmission of increased risk of developing metabolic disorders. These findings emphasize the need for high throughput studies, early screening, tight glucose control during pregnancy, and postnatal follow-up to mitigate long-term health risks.
Association of Dietary Vitamin C Intake with the Risk of Metabolic Syndrome Among Adults: NHANES 2007-2018
Yu X, Zhu J and Xu Z
There has been discussion over the association between vitamin C intake and the risk of metabolic syndrome (MetS). This study examined the relationship between dietary vitamin C intake and the risk of MetS in a sizable adult American population. We examined the relationship between dietary vitamin C intake and the risk of MetS in 12,943 persons from the 2007 to 2018 National Health and Nutrition Examination Survey (NHANES). This association was then evaluated using logistic regression and restricted cubic spline models. Sex and age-based subgroup analyses were carried out. According to the results of the multiple regression model, the risk of MetS was inversely correlated with dietary vitamin C intake, vitamin C intake derived from fruits and vegetables. The adjusted results (odds ratios with 95% confidence intervals) for the highest versus lowest tertile were 0.80 (0.68-0.93), 0.86 (0.75-0.98), and 0.80 (0.69-0.93). Subgroup analyses further showed that the negative correlation of dietary vitamin C intake with the risk of MetS was particularly pronounced among females, those in the 20-39 age group, and those in the ≥60 age group. The dose-response relationship's findings indicated that vitamin C from diet and fruits had a nonlinear correlation with the risk of MetS, whereas vitamin C from vegetables had a linear correlation. The risk of MetS in adult Americans was found to be negatively correlated with dietary vitamin C intake, particularly from fruits and vegetables.