Metabolic dysfunction-associated steatotic liver disease (MASLD) has replaced the term nonalcoholic fatty liver disease to better reflect its relationship with metabolic dysfunction without creating stigma. MASLD is defined by the presence of hepatic steatosis associated with risk factors, such as type 2 diabetes and overweight/obesity, without the need to exclude other causes of chronic liver disease. The global prevalence of MASLD is high, having an impact in more than one-third of the world's population, particularly in adults with overweight or obesity. When we talk about gender, it is more common in men than in women. MASLD is a complex disorder resulting from the interaction of environmental, genetic, and epigenetic factors, which leads to the dysregulation of lipid metabolism and liver accumulation of fatty acids. MASLD could be diagnosed through imaging methods and serological biomarkers. Elastography and magnetic resonance imaging are the most precise techniques for evaluating liver fibrosis. The treatment focuses on lifestyle modification, which involves weight loss, regular exercise, and a balanced diet. The Mediterranean diet and coffee consumption also have beneficial effects. Several pharmacological therapies are currently being studied, with promising results reported to date. This review aims to provide a comprehensive clinical overview of MASLD, laying the groundwork for understanding the change in nomenclature and becoming familiar with the new term, diagnosis, and treatment.

The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing, particularly among young adults, posing significant long-term health risks. Early identification of at-risk individuals is crucial for timely intervention and prevention of liver fibrosis. This study aimed to evaluate the prevalence of MASLD in young adults aged 18-30 years and assess the utility of noninvasive fibrosis scores (fibrosis 4 index, AST-to-platelet ratio index [APRI], Hepamet fibrosis score) in risk stratification. A retrospective study was conducted on 327 young adults who attended internal medicine outpatient clinics. The diagnosis of MASLD was established based on imaging findings and the presence of metabolic risk factors. Noninvasive fibrosis assessment was performed using the FIB-4, APRI, and hepamet scores, which were subsequently compared between the MASLD and non-MASLD groups. Statistical analyses included parametric and nonparametric tests, with a significance threshold set at < 0.05. Among the 327 participants, 36.8% ( = 120) were diagnosed with MASLD. Patients in the MASLD group exhibited significantly higher FIB-4, APRI, and Hepamet scores compared to those in the non-MASLD group ( < 0.05). Additionally, the MASLD group had significantly elevated body mass index, blood pressure, fasting glucose, triglyceride levels, and insulin resistance compared to the non-MASLD group ( < 0.05 for all comparisons). MASLD is highly prevalent among young adults and associated with metabolic risk factors. Noninvasive fibrosis scores provide an effective, accessible tool for early risk assessment and should be integrated into routine clinical practice for young adults to prevent future liver-related complications.

Acute pancreatitis (AP) is frequently linked to metabolic syndrome (MetS) and its individual components. Coronary artery calcium (CAC) score is also associated with MetS. This study aims to investigate the relationship between CAC and the occurrence of AP. This retrospective, single-center, case-control study included 352 patients admitted to a tertiary medical referral center between January 2017 and December 2023. Patients were divided into AP (case) and non-AP (control) groups, with controls matched to cases based on sex and age. The prevalence of MetS was significantly higher among AP patients (38.2%) compared to controls (13.3%) (OR: 2.66, 95% CI: 1.72-4.32; < 0.001). Similarly, CAC was more common in the AP group (35.5%) than in controls (10.8%) and was significantly associated with AP (OR: 3.47; 95% CI: 1.99-4.93, < 0.001). Multivariate logistic regression, adjusted for smoking, alcohol use, gallstone history, CAC, and MetS components, confirmed associations between AP and smoking (OR: 2.23; 95% CI: 1.78-4.98, < 0.001), alcohol consumption (OR: 1.78; 95% CI: 1.07-2.76, = 0.027), gallstones (OR: 22.93; 95% CI: 18.22-49.82, < 0.001), and positive CAC score (OR: 3.47; 95% CI: 1.99-4.93, < 0.001). MetS and CAC score are significantly associated with admission for AP. Further studies are needed to explore potential causative mechanisms.

Frailty and metabolic syndrome (MetS) are common conditions in older adults and may share overlapping pathophysiological pathways that impact mortality. We aimed to investigate the effect of frailty and MetS on mortality the older adults. This study included 1100 outpatients aged ≥60 years. We followed the participants for five years, during which 13.2% of them died. The status of MetS was assessed using the criteria established by the National Cholesterol Education Program Third Adult Treatment Panel. We evaluated frailty using the FRAIL scale. Mean age was 71.57 ± 7.09 years. The frail group had a significantly higher mean age (73.13 ± 7.75) compared to the nonfrail (70.20 ± 6.23) and prefrail (70.86 ± 6.73) groups ( < 0.001). In all three groups, women made up the majority, but in the frail group (76.9%), there were significantly more women than other groups ( < 0.001). MetS was more prevalent in prefrail and frail groups compared to those who were nonfrail (nonfrail: %59.1, prefrail: %71, frail: %70.2) ( = 0.010). The frail group showed a higher frequency of cognitive impairment, depressive mood, malnutrition, and dependency. The overall mortality rate for the sample was 13.2%, as anticipated, the frail group has a significantly higher mortality rate (23.4%) compared to the other two groups (nonfrail: 5.3%, prefrail: 10.2%) ( < 0.001). The Cox proportional hazards model indicated that the frail group demonstrated an increased mortality risk over five years, even after adjusting for age, sex, and metabolic disorders (hazard ratio: 4.44, 95% confidence interval = 2.19-9.02, < 0.001). Frailty was a more accurate predictor of mortality than MetS, regardless of age.

Knee osteoarthritis (KOA) is a multifactorial degenerative joint disease and a leading cause of disability in older adults. Obesity is the most modifiable risk factor for KOA. Previous studies have suggested an association between polymorphisms in the (fat mass and obesity associated) genes and KOA, potentially mediated by obesity. This study aimed to evaluate the association between the rs1558902 genetic variant, obesity, and KOA in a northern Mexican Mestizo population. A total of 462 individuals were included in the study. Participants were classified into three groups: (i) a reference population ( = 189), (ii) individuals with primary KOA ( = 130), and (iii) non-KOA individuals ( = 143). The rs1558902 variant was genotyped using DNA microarray technology in the reference population and by real-time PCR in the KOA and non-KOA groups. Binary and multinomial regression analyses were performed. The rs1558902 variant showed a significant association with obesity in the reference population under codominant ( = 0.012) and recessive ( = 0.008) genetic models. These associations remained statistically significant after adjustment for sex and age using multinomial logistic regression. In the codominant model, the association with an odds ratio (OR) of 6.884 (95% confidence interval [CI]: 1.470-32.225; = 0.014), while in the recessive model, the OR was 7.429 (95% CI: 1.619-34.091; = 0.010). However, no significant association was observed between rs1558902 and KOA. These findings confirm the association between the rs1558902 variant and overweight/obesity in a northern Mexican Mestizo population, but not with KOA. Further research is needed to explore this association in the context of other genetic and clinical factors.

To investigate the association between neck to waist circumference (N/W) ratio and insulin resistance in the adult general population under 50 years. We analyzed data from the 2020 Korea Health National Analysis Nutrition Examination Survey (KNHANES) to examine the relationship between N/W ratio and insulin resistance in the general population under 50. After adjusting for age, sex, and various cardiometabolic variables, the N/W ratio was significantly associated with fasting blood glucose, insulin, HbA1c, and homeostatic model assessment of insulin resistance (HOMA-IR) index, as well as BMI ( < 0.01). In the lowest N/W ratio quartile (Q1), metabolic risk indicators including BMI, waist circumference, blood pressure, fasting plasma glucose, HDL cholesterol, and HOMA-IR index were notably higher than those in the highest quartile (Q4) ( < 0.0001). This suggests that a higher N/W ratio may be associated with a lower metabolic risk profile. The N/W ratio is a significant predictor of insulin resistance, independent of other risk factors, in the general Korean population under 50. These findings underscore the utility of the N/W ratio as an accessible screening tool for assessing cardiometabolic risks.

Increasing maternal body mass index (BMI) represents a risk factor for Gestational Diabetes Mellitus (GDM) and adverse obstetrical and perinatal outcomes. To stratify clinical outcomes for pregnancies affected by GDM according to maternal BMI. Retrospective cohort study including individuals ≥18 years of age who were diagnosed with GDM from 2018 to 2022. Universal GDM screening was employed with a 50 g oral glucose challenge test ± a 100 g oral glucose tolerance test. Maternal demographics, preexisting medical conditions, and selected obstetric and neonatal morbidities were evaluated. A total of 2193 pregnancies in 2110 women affected by GDM were identified. This included 506 (23.0%) with normal baseline maternal BMI, 596 (27.2%) with overweight, and 1091 (49.7%) with obese BMI. Adverse maternal outcomes were more frequent in the obese compared to overweight or normal BMI categories (cesarean delivery: normal 26.9% vs. overweight 28.5% vs. obese 40.9%; < 0.001; hypertensive disorders of pregnancy: normal 8.7% vs. overweight 12.1% vs. obese 16.8%; < 0.001). Postpartum glucose intolerance was higher in women with obesity (normal 7.3% vs. overweight 5.9% vs. obese 14.9%; < 0.001). Infants born to mothers with obesity had higher birthweights (normal 3.3 kg vs. overweight 3.4 kg vs. obese 3.5 kg; < 0.001), were more likely to have neonatal hypoglycemia (normal 29.4% vs. overweight 24.3% vs. obese 41.9%; < 0.001) and require intensive care unit admission (normal 8.1% vs. overweight 5.9% vs. obese 11.9%; < 0.001). Patients with GDM and baseline BMI in the obese range experienced the highest rate of adverse outcomes, while those with overweight BMI had similar outcomes to individuals who had normal BMI at baseline.

Variants in may affect gene expression and serum adiponectin levels (SAL), contributing to the development of metabolic syndrome (MetS) components and cardiometabolic disorders in Mexican adolescents. To evaluate the association of the genetic variants rs266729, rs822396, rs2241766, and rs1501299 in , their haplotypes, and SAL with MetS components and cardiometabolic parameters in adolescents from western Mexico. A total of 494 adolescents from Jalisco, Mexico, aged 10-17 years, were studied. The biochemical and clinical characteristics of cardiometabolic disorders were diagnosed based on age-, sex-, and population-specific percentiles. Peripheral blood samples were obtained. Serum was separated and SAL were measured by ELISA. DNA was extracted and genotyped using real-time polymerase chain reaction for allelic discrimination. Hardy-Weinberg equilibrium was assessed, and associations were analyzed using logistic regression and Spearman correlations, with a 95% statistical confidence level. SAL were lower in adolescents with MetS ( = 0.03) and low high-density lipoprotein ( = 0.01). The rs266729G allele was associated with very low-density lipoprotein >30 mg/dL in the additive inheritance model [AIM; odds ratio (OR) = 1.59, 95% confidence interval (CI) = 1.01-2.53, = 0.04], dominant inheritance model (DIM; OR = 2.26, 95% CI = 1.07-4.73, = 0.03), and codominant inheritance model (OR = 2.23, 95% CI = 1.03-4.81, = 0.04). The rs822396G allele was associated with decreased SAL in AIM (OR = 5.00, 95% CI = 1.69-14.7, = 0.004) and DIM (OR = 5.23, 95% CI = 1.41-21.6, = 0.01). The rs2241766G allele (recessive model) was associated with increased alanine aminotransferase levels (OR = 3.73, 95% CI = 1.10-12.6, = 0.03) and correlated with higher SAL ( = 0.202, = 0.045). In controls, the haplotype rs822396-rs2241766-rs1501299 is in linkage disequilibrium (' = 1), but the correlation is low ( < 0.1), while in MetS adolescents, ' was incomplete. Several haplotypes were associated with cardiometabolic parameters. The variants in , are associated with MetS and low SAL. The rs822396G allele appears to be a key factor for low SAL and its association with cardiometabolic parameters. The rs2241766T allele was linked to low SAL and clinical characteristics of MetS.

Sucralose (a.k.a. Splenda when combined with dextrose and maltodextrin) is a popular nonnutritive sweetener (NNS) found in several beverages marketed for health benefits and fitness. This article examines the mechanistic aspects of sucralose's metabolic effects on satiety, obesity, glycemic control, and adipogenesis, along with gut dysbiosis, inflammation, and disruption of intestinal permeability. Some evidence suggests that sucralose may also alter appetite regulation, taste perception, and energy intake. Additionally, there are safety concerns regarding its carcinogenic potential and its epigenetic effect on the fetus due to consistent maternal consumption. Based on current findings of NNS, it was concluded that sucralose may be of use in weight reduction in the short term as an NNS. However, this needs to be weighed against the possible long-term metabolic side effects and safety precautions.

Poor sleep has been identified as a strong risk factor for metabolic syndrome. Shift workers, who often experience reduced and misaligned sleep due to nighttime work schedules, are particularly susceptible to both sleep disturbances and metabolic syndrome. However, the interplay among shift work, sleep disturbances, and metabolic syndrome remains insufficiently explored. This systematic review aimed to critically appraise, compare, and synthesize the current evidence on the pathways linking these factors. A comprehensive literature search was conducted across major electronic databases and peer-reviewed journals specializing in metabolic disorders and sleep disorders. Two independent reviewers screened titles, abstracts, and full texts for relevance. Methodological quality was assessed using the Newcastle-Ottawa Scale. Out of 4,982 studies identified, 15 met the predefined inclusion criteria, encompassing diverse occupational groups with fixed and rotating shift patterns and totaling 37,147 participants. Most studies demonstrated a positive association between shift work and sleep disturbances, particularly among fixed night shift workers. Longer durations of night shift exposure were linked to increased risk of metabolic syndrome. Notably, reduced sleep quantity was more strongly associated with metabolic syndrome than impaired sleep quality. The methodological quality of the included studies was moderate to high. This review highlights a consistent association between shift work, sleep disturbances, and metabolic syndrome. Shift work appears to impact both sleep health and metabolic outcomes independently. These findings underscore the need for targeted interventions and longitudinal studies to further elucidate causal pathways and inform occupational health strategies.

The triglyceride-glucose (TyG) index and related parameters have recently been advocated as efficient diagnostic markers for metabolic dysfunction-associated steatotic liver disease (MASLD) in the general population. Yet, there is a paucity of data addressing their significance in MASLD diagnosis and severity assessment in the vulnerable population of type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the predictive capacity of TyG-related indices for MASLD diagnosis in patients with T2DM, and to investigate the relationship of these parameters with hepatic steatosis severity. This cross-sectional study encompassed a cohort of 600 adults diagnosed with T2DM, who were enrolled from the diabetes and metabolism outpatient clinic at Alexandria Main University Hospital. After excluding secondary causes, hepatic steatosis was diagnosed using the FibroScan 430 mini+ machine (EchoSense, Paris, France), with results expressed as the controlled attenuation parameter. Anthropometric and biochemical measurements were utilized to derive TyG-related indices, including TyG index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist to height ratio (TyG-WHtR). MASLD was diagnosed in 83% of the recruited subjects. The studied TyG-related parameters were markedly higher in patients with severe steatosis. Moreover, multivariate analysis identified TyG-BMI as an independent risk factor for severe steatosis. Furthermore, the receiver operating characteristic curve was used to assess the diagnostic performance of the studied TyG indices for detecting MASLD in individuals with T2DM. The area under the curve for each of the four indicators was as follows: 0.775 for TyG-BMI, followed by 0.755 for TyG-WC, 0.741 for TyG-WHtR, and 0.637 for TyG index. These findings revealed good predictive capacity for all four parameters, especially TyG-BMI, which exhibited the highest level of predictive accuracy. The TyG index and related parameters, particularly TyG-BMI, are reliable and cost-effective biomarkers for detecting and assessing the severity of MASLD.

Diabetic foot ulcer is a condition associated with type 2 diabetes mellitus (T2DM). This study aims to examine the influence of mean platelet volume (MPV) on predicting amputation decisions in patients with diabetic foot ulcers. Patients with diabetic foot ulcers who presented to the tertiary healthcare facility from June 2023 to June 2024 were included. The first group comprises individuals who opted for amputation, whereas the second group includes patients without indications for amputation. The mean age of patients with diabetic foot ulcers is 62.68 years, and the mean glycated hemoglobin A1c level is 9.62%. The initial group comprises 61 patients who opted for amputation, whereas the subsequent group includes 56 individuals who lacked an indication for amputation. The initial group exhibits markedly elevated values for MPV, total cholesterol, and low-density lipoprotein (LDL) ( = 0.001, = 0.004, = 0.020). Logistic regression research indicates that elevated levels of LDL and MPV substantially heighten the chance of amputation. The receiver operating characteristic curve study established the MPV cutoff value for amputation prediction at 11.2. The sensitivity and specificity of this value in predicting amputation were [ = 0.01, OR (odds ratio) = 1.01, 95% confidence interval (CI): 1.00-1.03, = 0.006] for LDL and ( = 0.52, OR = 1.68, 95% CI: 1.18-2.39, = 0.003) for MPV. Every unit increment in the MPV value corresponds to an approximate 68.8% elevation in the probability of amputation. In individuals with diabetic foot ulcers, MPV and LDL levels are independent variables affecting amputation and may function as predictors for amputation.

Sarcopenic obesity (SO), defined as the coexistence of low muscle mass and function and excessive fat mass, is increasingly recognized as a health concern in older individuals with diabetes. Despite its clinical importance, SO often remains undiagnosed in outpatient settings due to complex diagnostic requirements. This study aimed to investigate the risk of SO using simple screening tools, namely the SARC-F questionnaire and handgrip strength (HGS), and to identify associated clinical, functional, and metabolic factors in diabetic patients aged 50 and older. A cross-sectional analysis was conducted with 276 diabetic outpatients. Risk of SO was defined based on a body mass index of 30 kg/m² or more, combined with either a SARC-F score of 4 or above or low HGS values (below 35 kg for men and 20 kg for women). Data on comorbidities, functionality, falls, depression, and metabolic control were collected. The prevalence of SO risk was 16.2% with HGS and 8.7% with SARC-F. Falls, depressive symptoms, and reduced quality of life were associated with SARC-F-based SO, while hypertension, elevated HbA1c, and lower quality of life were linked to HGS-based SO. Simple screening methods can help identify SO risk in diabetic outpatients and support timely clinical decision-making.

Obesity is the most important factor in obstructive sleep apnea (OSA). Even if metabolic surgery (MS) weight loss is achieved, the therapeutic effect has not been proven for OSA. This study compared the apnea-hypopnea index (AHI) before surgery (T0), 1 year after surgery (T1), and 2 years after surgery (T2), assuming that the effect of MS on the AHI is influenced by the ANB angle (formed by point A, nasion, and point B), which reflects the anteroposterior relationship between the maxilla and mandible. The study included 47 patients with a body mass index ≥35 kg/m who underwent MS. To compare the AHI before and after surgery, we classified participants into three groups based on the ANB angle at the initial examination: skeletal Class I (>1° and <4°), II (≥4°), and III (≤1°). The mean AHI of all participants was 56.8 events/hr at T0, 26.5 at T1, and 23.7 at T2. Both postsurgical values were significantly lower than the presurgical value at T0. The mean AHI in skeletal Class I was 19.1 at T1 and 15.1 at T2, which was a significant decrease compared with T0 (50.4). Although the mean AHI was 38.8 at T1 and 38.8 at T2 in the skeletal Class II, which were lower than that at T0 (65.9), no significant difference was observed. The mean AHI was 20.0 at T1 and 15.3 at T2 in the skeletal Class III, which were significantly decreased as compared with that at T0 (53.5). Measuring the ANB angle prior to surgery is useful for predicting the postoperative effect.

This study aimed to investigate health-related quality of life (HRQOL) and related factors in Hangzhou, China, in patients with non-alcoholic fatty liver disease (NAFLD). The Chinese version of the EQ-5D-5L questionnaire was employed to assess HRQOL in 594 patients. A standardized questionnaire was employed to gather data regarding demographics, clinical characteristics, and lifestyle. This study employed Tobit regression models alongside multiple linear regression to examine the components influencing HRQOL, encompassing utility values and the EQ visual analogue scale (EQ-VAS). This study included 594 participants with a mean age of 42.03 ± 13.83 years. The median utility index was 0.951 (P25-P75: 0.934-1.000), and the median EQ-VAS score was 76 (P25-P75: 66-82). Anxiety and depression were the predominant entry (31.9%) among the five health dimensions. Tobit regression models indicated that retirement ( = 0.011), monthly income >6000 ( = 0.002), alcohol consumption ( = 0.012), low-intensity activity ( = 0.002), obesity ( = 0.004), and cirrhosis ( = 0.038) were correlated with diminished HRQOL. The outcomes of multiple linear regression analyses indicated that regular exercise (β = 3.200; = 0.003) and alcohol consumption (β = 2.466; = 0.049) exhibited significant positive correlations with EQ-VAS scores, whereas obesity (β = -4.259; = 0.005) and severe hepatic steatosis (β = -3.912; = 0.036) demonstrated significant negative correlations. The anxiety/depression dimension was the most prevalent problem. The current investigation identified a notable correlation between HRQOL and low-intensity activity, obesity, and cirrhosis. Obesity and severe hepatic steatosis exhibited a substantial negative correlation with the EQ-VAS score. Future efforts should focus on enhancing the mental health and lifestyle of NAFLD patients.

Metabolic syndrome (MetS) is increasingly prevalent globally and is linked to inflammation in cardiac tissues. Cardiac allograft vasculopathy (CAV) is a significant inflammatory condition and a leading cause of graft failure after orthotopic heart transplantation (OHT). The relationship between MetS and CAV remains poorly understood. A literature search was conducted from inception to September 2024, including studies that reported associations between MetS or its components (obesity, hypertension, dyslipidemia, and diabetes mellitus) and CAV. The primary endpoint was the development of CAV after OHT. Results were presented as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI), employing both random and fixed-effect models based on heterogeneity. A total of 16 studies involving 3,366 patients were included. The prevalence of MetS was high before OHT (32%, 95% CI: 24-41%, = 75%) and increased after OHT (37%, 95% CI: 18-61%, = 83%). MetS was significantly associated with CAV (OR = 1.99, 95% CI: 1.28-3.09, = 36%). Key components of MetS linked to CAV included obesity (OR = 1.54, 95% CI: 1.11-2.13, = 0%) and dyslipidemia (OR = 1.87, 95% CI: 1.49-2.36, = 0%). New-onset diabetes mellitus after transplantation increases the risk of CAV with an HR of 1.71 (95% CI: 1.56-1.88, = 0%). The high prevalence of MetS both before and after OHT is associated with an increased risk of CAV, highlighting the need for targeted interventions to manage MetS in heart transplant recipients.

Recent studies have identified a U-shaped association between sleep duration and both poor cardiovascular health (CVH) and metabolic syndrome (MetS). However, the extent to which sleep quality affects cardiometabolic health remains understudied. Here, we examined associations of sleep quality with CVH and MetS. In a nationally representative cross-sectional study of US adults ( = 3,293), we assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI), operationalized as a continuous score (range 0-23 points) and binary (good vs. poor sleep quality) variable. We derived CVH score (range 0-100 points) using the Life's Essential 8 construct, and defined MetS using the National Cholesterol Education Program Adult Treatment Panel III criteria. We examined associations via regression models, adjusting for sociodemographic and lifestyle factors. In fully adjusted models, a 1-point higher PSQI score was associated with lower CVH scores (β -0.61; 95% CI -0.72, -0.51) and higher odds of MetS (OR 1.02; 95% CI 1.00, 1.03). Similarly, poor (vs. good) quality sleep was associated with lower CVH scores (β -4.1; 95% CI -5.4, -2.8) and higher odds of MetS (OR 1.27; 95% CI 1.04, 1.56). The associations with CVH score and MetS appeared to be driven primarily by health behaviors metrics and hypertriglyceridemia, respectively. No significant interactions were seen with age or gender. In this cross-sectional study, individuals with poor sleep quality were found to have worse CVH scores and higher odds of MetS. Future studies could explore whether strategies promoting better quality sleep would help improve CVH and prevent MetS.

We conducted an observational study on how profound hypothyroidism affects circulating citrate, a potential biomarker of mitochondrial dysfunction linked to mortality. Sixteen differentiated thyroid carcinoma patients were first studied during hypothyroidism, 4-6 weeks after total thyroidectomy, and subsequently after 20 weeks of thyroid hormone supplementation. 5 patients were also studied during euthyroidism, before total thyroidectomy. Circulating citrate and total ketone bodies were measured by nuclear magnetic resonance spectroscopy. During profound hypothyroidism (mean thyroid stimulating hormone [TSH] 106 ± 77 mU/L), circulating citrate was 72% higher (95% CI: 48%-96%), reaching 157 ± 48 µmol/L, compared to 93 ± 25 µmol/L during thyroid hormone administration (mean TSH 0.20 ± 0.53 mU/L). This increase remained significant after adjusting for estimated glomerular filtration rate (eGFR) ( < 0.001) and body mass index (BMI) ( < 0.001). Citrate during hypothyroidism was also higher compared to five euthyroid patients studied before total thyroidectomy ( = 0.014). Total ketone bodies did not significantly change during hypothyroidism ( = 0.62). Short-term profound hypothyroidism gives rise to a major increase in circulating citrate, also when adjusted for changes in eGFR and BMI, conceivably attributable to hypothyroidism-related mitochondrial dysfunction. It is suggested that thyroid function status should be taken into consideration when evaluating the association of circulating citrate with adverse health outcomes.

Based on the high prevalence of kidney stone disease (KSD) and its possible relationship with metabolic components, the aim of this study was to examine the associations of metabolic syndrome (MetS) and its components with KSD. This is a cross-sectional assessment of the Prospective Epidemiological Research Studies of Iranian Adults (PERSIAN) Guilan cohort study (PGCS), which includes 10,520 participants aged between 35 and 70 in northern Iran from 2014 to 2017. Demographic data and clinical characteristics were filled out. MetS was determined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) with the following criteria: hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), hypertension, abdominal obesity, and hyperglycemia. The association of self-reported KSD with MetS was examined using logistic regression analysis. Odds ratio (OR) and 95% confidence interval (CI) were calculated. The prevalence of MetS and KSD was 41.8% and 15.6%, respectively. In the unadjusted model, MetS was associated with 18% increased odds of KSD (OR = 1.18, 95% CI: 1.06-1.31). This association remained significant after adjustment for some demographic characteristics (aOR = 1.30, 95% CI: 1.16-1.46). All MetS components except for low HDL-C were also associated with increased odds of KSD, after adjusting for some demographic variables. In addition, the odds of KSD increased with the number of MetS components, up to an almost 2.2-fold odds among subjects with all five MetS components. This study found that the risk of KSD increases with MetS as a whole, all MetS components except for low HDL-C, and the number of MetS components. Our study might provide evidence for individualized management of MetS for preventing KSD.

Triglyceride-glucose (TyG) index and its relationship with metabolic syndrome (MetS), physical activity (PA), and physical fitness in the pediatric population remain unclear. This cross-sectional study explored the mediating effect of central obesity and PA on the relationship between the TyG index and physical fitness in a pediatric population. A total of 614 Korean children (320 boys and 294 girls) aged 7-12 years participated in this study. MetS was defined as the continuous MetS risk value in the 4th quartile obtained by adding standardized scores for the syndrome components. PA was quantified using an accelerometer, and physical fitness was evaluated using composite scores for the endurance, strength, power, and flexibility domains. Receiver operating characteristic curve analysis revealed that the TyG index outperformed body mass index (z = 3.005, = 0.003) and the homeostasis assessment model for insulin resistance (z = 3.543, = 0.001) in detecting the presence of MetS. Mediation analysis revealed that while the TyG index has a direct effect on composite physical fitness scores (β = -0.3832 and SE = -2.0942, 95% confidence interval, CI = -0.7426 to -0.0239), there was an indirect effect of the TyG index on physical fitness via vigorous PA (β = -0.0802 and SE = 0.0377) and waist-to-hip ratio (β = -0.1318, SE = 0.0509). The TyG index has a significant impact on physical fitness in the presence of the two mediators (β = 0.3832, SE = -2.0942, 95% CI = -0.7426 to 0.0239).

Cardiovascular disease (CVD) will be the leading cause of mortality in Africa by 2030. Yet, little is known about the key drivers of CVD risk in the region. To examine the risk factors associated with CVD risk in a sample of rural midlife and elderly Kenyans. Cross-sectional study design. Data were collected following established protocols and included physical activity (PA), body mass index (BMI), waist circumference, blood pressure (BP), and self-reported medical history. Absolute CVD risk scores [Framingham risk scores (FRS)] were computed using non-lab-based Framingham algorithm. Descriptive and inferential statistics were used to evaluate factors associated with CVD risk scores and related sex-specific differences. The sample ( = 102; mean age 59.8 ± 7.3 years; 57.8% female) was on average highly active (median 8891 steps/day) with 61.8% hypertension prevalence. Females versus males had higher BMI (29.2 vs. 24.8 kg/m; < 0.001) and central adiposity (84.8 vs. 18.6%; < 0.001). However, they had lower systolic BP (129.3 vs. 138.3 mmHg; = 0.032) and didn't smoke (0.0 vs. 11.6%; = 0.012). Females also were 6.6 years younger ( < 0.001) and had fewer years of education ( < 0.001) and less PA ( = 0.046). Overall, 34.3% of the sample was at high risk of CVD (FRS ≥20%), but females had lower risk compared with males (median FRS 7.4 vs. 25.0%; < 0.001). Higher CVD risk was associated with higher education ( < 0.001) and having adequate income ( = 0.048). When considering females separately, none of the sociodemographic characteristics or PA measures were associated with CVD risk, but for males, higher CVD risk was associated with higher education ( = 0.025) and lower PA ( = 0.009). Age, BMI, BP, and smoking partially explain sex differences in CVD risk burden. However, sex differences also exist with males being older with higher education-factors associated with higher CVD risk. More research is needed to examine factors associated with absolute CVD risk in females.