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Background: Despite numerous studies confirming the association between insulin resistance (IR) and macrophage polarization, there is a lack of bibliometric analysis in this area. Therefore, our objective is to conduct a comprehensive analysis of published literature and identify potential future research trends using bibliometrics. Method: Publications on the topic of macrophage polarization in IR were gathered from the Web of Science Core Collection database (WoSCC) spanning the years 1999–2023. Bibliometric analysis and visualization were conducted using VOSviewers, CiteSpace, the R package "bibliometrix" and Tableau Public. Result: A total of 3435 articles published between 1999 and 2023 were included in the analysis. These articles originated from 75 countries, with the United States and China leading in contributions. The top five research institutions are the University of California, San Diego, Harvard University, the University of Michigan, Shanghai Jiao Tong University, and Huazhong University of Science and Technology. In this research domain, Diabetes is the most frequently published journal, and the Journal of Clinical Investigation is the most co‐cited. Among the 19,398 authors contributing to these publications, Lumeng CN. not only authored the most papers but also received the highest number of co‐citations. "Insulin resistance" emerges as a primary keyword in the analysis of emerging research hotspots. Conclusion: For the first time, bibliometric methods have been employed to conduct a comprehensive summary of papers relevant to macrophage polarization in IR. This study aims to identify the current research direction and future research hotspots, offering valuable guidance and insights for scholars in the field. [ABSTRACT FROM AUTHOR]

Background: Acanthosis nigricans (AN) is a common skin disease characterized by clear pigmented patches on the folds of the skin. However, the AN research field lacks scientific and comprehensive bibliometric analysis. This article aims to use bibliometric methods to summarize and visualize the distribution patterns, research hotspots, and development trends of AN literature. Methods: Literature from 1900 to 2024 was retrieved from the Web of Science Core Collection database through AN's thematic search. Using CiteSpace, VOSviewer, and Excel 2019, conduct a comprehensive analysis of the number of publications, countries/regions, institutions, authors, journals, highly cited literature, keywords, and so on, and sort out the hotspots and directions of AN. Results: From 1900 to 2024, 1675 publications were included in the bibliometric analysis, showing a steady annual increase in the number of publications. The United States leads in this research field, with the University of Texas System being a key research institution. The Journal of Clinical Endocrinology & Metabolism has the highest number of published papers. The most cited article is "Syndromes of Insulin Resistance and Acanthosis Nigricans: Insulin‐Receptor Disorders in Man" (1976). The author Taylor, SI, has published the most papers. "Acanthosis nigricans" is the most frequently occurring keyword. The main research hotspots and frontier areas in AN research are as follows: (1) The relationship between AN and other diseases is a popular research topic; (2) The connection between AN and insulin resistance (IR) is a current research focus; (3) Treatment of AN, with an emphasis on addressing the underlying causes and improving local skin conditions, represents the cutting edge of this field. Conclusion: This study summarizes the research trends and hotspots in the field of AN, offering valuable information and insights for scholars focused on AN scientific research, and providing a reference for future research directions. [ABSTRACT FROM AUTHOR]

The prevalence of nonalcoholic fatty liver disease (NAFLD) is likely to be approaching 38% of the world's population. It is predicted to become worse and is the main cause of morbidity and mortality due to hepatic pathologies. It is particularly worrying that NAFLD is increasingly diagnosed in children and is closely related, among other conditions, to insulin resistance and metabolic syndrome. Against this background is the concern that the awareness of patients with NAFLD is low; in one study, almost 96% of adult patients with NAFLD in the USA were not aware of their disease. Thus, studies on the therapeutic tools used to treat NAFLD are extremely important. One promising treatment is a well-formulated ketogenic diet (KD). The aim of this paper is to present a review of the available publications and the current state of knowledge of the effect of the KD on NAFLD. This paper includes characteristics of the key factors (from the point of view of NAFLD regression), on which ketogenic diet exerts its effects, i.e., reduction in insulin resistance and body weight, elimination of fructose and monosaccharides, limitation of the total carbohydrate intake, anti-inflammatory ketosis state, or modulation of gut microbiome and metabolome. In the context of the evidence for the effectiveness of the KD in the regression of NAFLD, this paper also suggests the important role of taking responsibility for one's own health through increasing self-monitoring and self-education. [ABSTRACT FROM AUTHOR]

• TyG index can be used as an alternative biomarker for insulin resistance (IR) with high specificity and sensitivity. • The TyG index can be used as a potential key and practical indicator for different diseases. • The multi-faceted interaction between metabolic parameters and different diseases. The Triglyceride-glucose index (TyG index) is a comprehensive statistical measure that incorporates fasting triglyceride and fasting glucose levels. Research has demonstrated that it can serve as an effective alternative biomarker for insulin resistance (IR) due to its high sensitivity and specificity. The TyG index is straightforward to compute and imposes fewer time and cost constraints, rendering it suitable for large populations and advantageous for use in various applications, clinical settings, and epidemiological investigations. Numerous high-quality clinical studies have underscored the significance of the TyG index in diverse medical conditions. This review provides a synthesis of the association between the TyG index and diseases such as diabetes, cardiovascular diseases, cerebrovascular diseases, fatty liver, kidney diseases, and reproductive system diseases. Furthermore, the TyG index has exhibited predictive capabilities for identifying IR in children and adolescents. Through a systematic review of pertinent clinical trials, this paper elucidates the correlation between the TyG index and various diseases. The findings presented herein suggest that the TyG index holds promise as a valuable and practical indicator for different medical conditions, prompting a reevaluation of conventional disease risk assessment paradigms and highlighting the intricate interplay of metabolic parameters with diverse diseases. By leveraging insights from the TyG index, tailored disease risk management strategies can be developed to offer a fresh perspective and guidance for clinical interventions. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusions Many review articles have explored data regarding the coexistence of specific types of pituitary adenomas (PAs) and polycystic ovary syndrome (PCOS), particularly focusing on the potential pathogenesis of this intersection and overlapping features. However, a comprehensive evaluation encompassing the full spectrum of PAs and their association with PCOS remains lacking. This review aims to provide a broad assessment of the interactions between these entities, emphasizing pathophysiological mechanisms, clinical presentations, diagnostic challenges and therapeutic implications.A comprehensive literature search was conducted in the PubMed/MEDLINE database, focusing primarily on publications from the years 2000 to 2024, while also including seminal papers from the 1950s. The reference lists of selected articles were also manually searched. Inclusion criteria encompassed review articles, retrospective studies, clinical trials, case reports and meta‐analyses providing data on the pathogenesis, clinical features, diagnostic challenges and therapeutic approaches related to PCOS and different PAs.PCOS and functioning PAs often exhibit overlapping clinical features, complicating diagnosis and management. PCOS may precede and delay the diagnosis of growth hormone (GH)‐secreting adenomas. The prevalence of PCOS or its features in acromegaly is influenced by disease activity, while approximating 13% in cases with controlled disease. Excess GH and insulin‐like growth factor 1 (IGF‐1) adversely affect ovarian function through direct pathways and by inducing insulin resistance, contributing to acromegaly‐associated PCOS. In Cushing's syndrome (CS), findings consistent with PCOS may be present in 46% of patients, with cortisol excess contributing to menstrual dysfunction, hyperandrogenism and insulin resistance. While the prevalence of PCOS in patients with prolactinomas remains under‐researched, recent studies indicate a 2.8%–10% prevalence of prolactinomas in PCOS. Elevated prolactin (PRL) levels in these patients may promote insulin resistance, further contributing to PCOS pathogenesis. Moreover, increased androgen bioavailability may be observed in all three aforementioned adenomas. To date, no studies have provided prevalence data for PCOS in other types of PAs.Distinct clinical features, along with biochemical evaluations and imaging, can help differentiate the presence of both PAs and PCOS. Moreover, excluding other mimicking disorders is essential for an accurate diagnosis of PCOS. The persistence or recurrence of menstrual dysfunction, hyperandrogenism and metabolic disturbances in patients with controlled functioning adenomas may indicate a coexisting PCOS diagnosis. Timely diagnosis may optimize management and improve long‐term outcomes for both conditions. Future studies should focus on investigating the clinical differences between patients with co‐occurring PCOS and PAs compared to those with PCOS alone, ideally in larger cohorts, to better understand unique diagnostic and therapeutic considerations. [ABSTRACT FROM AUTHOR]

Cinnamon is one of the world's oldest and most popular spices, and is derived from the inner bark of several tree species from the genus Cinnamomum. During the last two decades, cinnamon has demonstrated beneficial metabolic effects not only in animal experiments but also in clinical trials. Even recent meta-analyses have shown the protective effects of cinnamon on different components of metabolic syndrome and their complications. In the last 5 years, several experimental studies have unraveled the intricate molecular mechanisms underlying the antihypertensive, antihyperglycemic, lipid-lowering, weight-lowering, and cardioprotective properties of cinnamon. This review paper will discuss how cinnamon and its active components, particularly cinnamaldehyde, suppress inflammation and oxidative stress, modulate mitochondrial dysfunction, and regulate glucose uptake, insulin resistance, lipogenesis, beta-oxidation, Ca2+ signaling, and other cellar events at the molecular level. Specifically, we will delve into the molecular mechanisms involved in the metabolic effects of cinnamon to provide a deeper insight into how cinnamon can bring such beneficial effects. This review hopes to encourage the use of cinnamon in clinical settings, guide the combination of cinnamon with other drugs used to treat different components of metabolic syndrome based on their mechanism of action, and support the concept of complementary medicine for metabolic diseases. [ABSTRACT FROM AUTHOR]

Metabolic syndrome is increasingly recognized as a significant precursor to various chronic diseases, contributing to a growing public health concern. Its complex pathogenesis involves multiple interrelated mechanisms, with oxidative stress identified as a cornerstone that exacerbates other pathogenic pathways. This study elucidates the molecular mechanisms by which oxidative stress intensifies metabolic disturbances, particularly insulin resistance. Some recent research has focused on fisetin, a natural product known for its potential benefits in diabetes and its associated microvascular and macrovascular complications. This paper compiles a comprehensive collection of findings by reviewing studies conducted over the past decade, detailing dosages, investigated markers, and their respective outcomes. Notably, a recurrent finding was fisetin's ability to enhance Nrf2, a principal regulator of antioxidant defense, in both metabolic and non-metabolic diseases. Furthermore, intriguing results suggest that the effects of Nrf2 extend beyond oxidative stress modulation, demonstrating favorable impacts on tissue-specific functions in metabolic regulation. This highlights fisetin not only as an antioxidant but also as a potential therapeutic agent for improving metabolic health and mitigating the effects of metabolic syndrome. In conclusion, fisetin can enhance the body's antioxidant defenses by modulating the Nrf2 pathway while also improving metabolic health through its effects on inflammation, cell survival, and energy metabolism, offering a comprehensive approach to managing metabolic disorders. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance: Natural substance geraniol has anti-inflammatory and antioxidant qualities. It may be used to treat metabolic diseases such as diabetes, obesity, and cardiovascular illnesses. Innovations in nanoformulations enhance geraniol's absorption, stability, and targeted distribution, augmenting its therapeutic effectiveness and mitigating side effects, despite the limits of traditional treatment. Aim of the review: The therapeutic potential of geraniol in the management of metabolic disorders such as diabetes, obesity, neuroinflammation, and cardiovascular disease is examined in this review. It highlights the anti-inflammatory, antioxidant, and lipid-lowering qualities of geraniol as well as the potential for nanoformulations to increase bioavailability and therapeutic efficacy. Materials and methods: A collection of pertinent research articles about the potential of geraniol in metabolic illnesses, including obesity, type 2 diabetes, as well as cardiovascular diseases, was compiled from PubMed, Scopus, and Google Scholar. Terms such as "metabolic syndrome," "antioxidant," "anti-inflammatory," "geraniol," and "nanoformulations" were employed. Google Patents were also examined in order to offer insights into current and upcoming research. Results: The potential of geraniol to treat metabolic disorders, including obesity, diabetes, hyperlipidemia, and cardiovascular illnesses, is thoroughly reviewed in this article. Recent research has demonstrated the lipid-lowering, antioxidant, and anti-inflammatory properties of geraniol as well as its ability to improve endothelial function and reduce oxidative stress in preclinical animals. The paper delves into the various nanoformulations, including liposomes, nanoparticles, and nanoemulsions, which enhance geraniol's therapeutic efficacy and bioavailability, making it a viable option for managing metabolic syndrome. Conclusion: The antioxidant, anti-inflammatory, and lipid-lowering qualities of geraniol make it a promising treatment for metabolic diseases. Its bioavailability along with therapeutic efficacy are increased by nanoformulations, which makes it a compelling option for the treatment of conditions such as neuroinflammation, diabetes, and obesity. [ABSTRACT FROM AUTHOR]

Background: Adiponectin is an adipocyte-derived hormone that acts as a marker of insulin sensitivity. Bloodspot sampling by fingerstick onto filter paper may increase the feasibility of large-scale studies of the determinants of insulin sensitivity. We first describe the validation of an enzyme-linked immunoassay (ELISA) for quantifying adiponectin from dried blood spots and then demonstrate its application in a large trial (PROBIT). Methods: We quantified adiponectin from 3-mm diameter discs (≈3 µL of blood) punched from dried blood spots obtained from: i) whole blood standards (validation); and ii) PROBIT trial samples (application) in which paediatricians collected blood spots from 13,879 children aged 11.5 years from 31 sites across Belarus. We examined the distribution of bloodspot adiponectin by demographic and anthropometric factors, fasting insulin and glucose. Results: In the validation study, mean intra-assay coefficients of variation (n = 162) were 15%, 13% and 10% for ‘low’ (6.78 µg/ml), ‘medium’ (18.18 µg/ml) and 'high’ (33.13 µg/ml) internal quality control (IQC) samples, respectively; the respective inter-assay values (n = 40) were 23%, 21% and 14%. The correlation coefficient between 50 paired whole bloodspot versus plasma samples, collected simultaneously, was 0.87 (95% CI: 0.78 to 0.93). Recovery of known quantities of adiponectin (between 4.5 to 36 µg/ml) was 100.3–133%. Bloodspot adiponectin was stable for at least 30 months at −80°C. In PROBIT, we successfully quantified fasting adiponectin from dried blood spots in 13,329 of 13,879 (96%) children. Mean adiponectin (standard deviation) concentrations were 17.34 µg/ml (7.54) in boys and 18.41 µg/ml (7.92) in girls and were inversely associated with body mass index, fat mass, triceps and subscapular skin-fold thickness, waist circumference, height and fasting glucose. Conclusions: Bloodspot ELISA is suitable for measuring adiponectin in very small volumes of blood collected on filter paper and can be applied to large-scale studies. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance (IR) is considered the pathogenic driver of diabetes, and can lead to obesity, hypertension, coronary artery disease, metabolic syndrome, and other metabolic disorders. Accumulating evidence indicates that the connection between gut microbiota and IR. This bibliometric analysis aimed to summarize the knowledge structure of gut microbiota in IR. Methods: Articles and reviews related to gut microbiota in IR from 2013 to 2022 were retrieved from the Web of Science Core Collection (WoSCC), and the bibliometric analysis and visualization were performed by Microsoft Excel, Origin, R package (bibliometrix), Citespace, and VOSviewer. Results: A total of 4 749 publications from WoSCC were retrieved, including 3 050 articles and 1 699 reviews. The majority of publications were from China and USA. The University Copenhagen and Shanghai Jiao Tong University were the most active institutions. The journal of Nutrients published the most papers, while Nature was the top 1 co-cited journal, and the major area of these publications was molecular, biology, and immunology. Nieuwdorp M published the highest number of papers, and Cani PD had the highest co-citations. Keyword analysis showed that the most frequently occurring keywords were "gut microbiota", "insulin-resistance", "obesity", and "inflammation". Trend topics and thematic maps showed that serum metabolome and natural products, such as resveratrol, flavonoids were the research hotspots in this field. Conclusion: This bibliometric analysis summarised the hotspots, frontiers, pathogenesis, and treatment strategies, providing a clear and comprehensive profile of gut microbiota in IR. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that has a high prevalence worldwide. Apigenin is a flavonoid present in several vegetables and fruits and has anti-inflammatory, anti-oxidant, and anti-MetS properties. This study aims to systematically review the effects of apigenin against MetS and the relevant molecular and cellular mechanisms of action, pharmacokinetics features, and potential structure-activity relationship. Electronic databases including Scopus, PubMed, Science Direct and Cochrane Library were searched for in vivo, and in vitro, and human studies with the following keywords: "apigenin" and "metabolic syndrome or insulin resistance syndrome", "fatty liver", "hypertension or blood pressure", "diabetes or blood glucose", "dyslipidemia", "heart or cardiovascular" and "obesity" in title/abstract. Data were collected from 2000 until 2021 (up to April). Only papers published in the English language were included. Forty-six full-text articles out of 1016 retrieved papers were reviewed and underwent quality assessment by investigators. Antiobesity activity of apigenin is mainly through attenuating adipocyte differentiation by suppressing the mitotic clonal expansion and the adipogenesis-related factors. Its anti-diabetic effects can be exerted through inhibition of protein tyrosine phosphatase1B expression, maintaining the activity of anti-oxidant enzymes, reducing intracellular ROS production, cellular DNA damage, protein carbonylation, and attenuating ß-cell apoptosis. Moreover, apigenin could attenuate dyslipidemia and subsequent atherosclerotic conditions through down-regulating sterol regulatory elementbinding proteins (SREBP)-1c, SREBP-2, stearyl-CoA desaturase-1, and 3-hydroxy-3-methyl-glutaryl- CoA reductase. Apigenin as a dietary bioactive compound would be a promising candidate for improving MetS and its components. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this meta-analysis was to examine the effect of pomegranate juice (PJ) intake on glycemic control in adults. Design/methodology/approach: Materials and methods: PubMed (Medline), ISI Web of Science, Cochrane Library and Scopus databases, measuring glucose and/or insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in adults, were searched from inception to December 11, 2021. Moreover, to examine whether grouping factors influenced heterogeneity between research results, subgroup analysis was used. Findings: This meta-analysis showed that PJ intake reduced HOMA-IR significantly, especially if =250 mL was used. This reducing effect remained significant in females, nondiabetic patients and unhealthy subjects. Originality/value: The authors believe the presented data would be highly motivating and of a wide readership for the readers of your journal, and this paper stimulating a surge of research on the impact of PJ consumption on glycemic indices. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context. [ABSTRACT FROM AUTHOR]

Background: Although the pathogenesis of essential hypertension is not clear, a large number of studies have shown that oxidative stress plays an important role in the occurrence and development of hypertension and target organ damage. Purpose: This paper systematically summarizes the relationship between oxidative stress and hypertension, and explores the potential mechanisms of Chinese herbal medicine (CHM) in the regulation of oxidative stress in hypertension, aiming to establish a scientific basis for the treatment of hypertension with CHM. Methods: To review the efficacy and mechanism by which CHM treat hypertension through targeting oxidative stress, data were searched from PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, the Chinese National Knowledge Infrastructure, the VIP Information Database, the Chinese Biomedical Literature Database, and the Wanfang Database from their inception up to January 2024. NPs were classified and summarized by their mechanisms of action. Results: In hypertension, the oxidative stress pathway of the body is abnormally activated, and the antioxidant system is inhibited, leading to the imbalance between the oxidative and antioxidative capacity. Meanwhile, excessive production of reactive oxygen species can lead to endothelial damage and vascular dysfunction, resulting in inflammation and immune response, thereby promoting the development of hypertension and damaging the heart, brain, kidneys, blood vessels, and other target organs. Numerous studies suggested that inhibiting oxidative stress may be the potential therapeutic target for hypertension. In recent years, the clinical advantages of traditional Chinese medicine (TCM) in the treatment of hypertension have gradually attracted attention. TCM, including active ingredients of CHM, single Chinese herb, TCM classic formula and traditional Chinese patent medicine, can not only reduce blood pressure, improve clinical symptoms, but also improve oxidative stress, thus extensively affect vascular endothelium, renin–angiotensin–aldosterone system, sympathetic nervous system, target organ damage, as well as insulin resistance, hyperlipidemia, hyperhomocysteinemia and other pathological mechanisms and hypertension related risk factors. Conclusions: CHM display a beneficial multi-target, multi-component, overall and comprehensive regulation characteristics, and have potential value for clinical application in the treatment of hypertension by regulating the level of oxidative stress. [ABSTRACT FROM AUTHOR]

Background: This study explores the intricate relationship between Chronic Kidney Disease (CKD), the Triglyceride-Glucose (TyG) index, and Cardiovascular Disease (CVD) in a U.S. adult population. It focuses on understanding how the TyG index, as a marker of insulin resistance, relates to cardiovascular risk in the presence of CKD. Methods: A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. The study involved classifying stages of CKD, calculating the TyG index, and applying statistical analyses including logistic regression. Results: The investigation revealed that individuals with CKD, who comprised 49% males with an average age of 47 years, exhibited a higher incidence of CVD. The study demonstrated that before adjusting for the TyG index, the odds ratio (OR) for the association between CKD and CVD was 1.77. Importantly, the TyG index was found to mediate 10% of the association between CKD and CVD. Moreover, a significant synergistic interaction was observed between a high TyG index and CKD, with the combined presence of these conditions increasing the risk ratio for CVD to 3.01. Conclusion: The findings highlight the crucial role of insulin resistance in the link between CKD and CVD. The paper discusses the implications of chronic inflammation and endothelial dysfunction in CKD patients and the importance of the TyG index in assessing cardiovascular risk. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease （NAFLD） is one of the common chronic liver diseases in the world. The molecular mechanism of NAFLD is complex, involving many signal molecules, and the vitamin D （VD）/VDBP/vitamin D receptor （VDR） axis is also involved. VD is a lipid-soluble steroid, which can participate in the regulation of lipid metabolism, insulin secretion, immune function, inflammatory response and other biological processes. Studies have shown that VD deficiency is closely related to liver lipid accumulation, inflammation, insulin resistance, oxidative stress, intestinal flora imbalance, autophagy, apoptosis, pyroptosis and fibrosis, and plays an important role in the occurrence and development of NAFLD. This paper reviews the research progress on Vitamin D in recent years in the field of NAFLD, including the physiological characteristics of VD and its role in the NAFLD mechanism, so as to provide references for the prevention and treatment of NAFLD. [ABSTRACT FROM AUTHOR]

The global prevalence of diabetes has increased significantly, leading to various complications and a negative impact on quality of life. Hyperglycemia hyperglycemic‐induced oxidative stress (OS) and inflammation are closely associated with the development and progression of type 2 diabetes mellitus (T2D) and its complications. This review explores the effect of T2D on target organ damage and potential treatments to minimize this damage. The paper examines the pathophysiology of T2D, focusing on low‐grade chronic inflammation and OS and on their impact on insulin resistance. The review discusses the role of inflammation and OS in the development of microvascular and macrovascular complications. The findings highlight the mechanisms by which inflammatory cytokines, stress kinases, and reactive oxygen species (ROS) interfere with insulin signaling pathways, leading to impaired glucose metabolism and organ dysfunction. Lifestyle interventions, including a balanced diet and exercise, can help reduce chronic inflammation and OS, thereby preventing and controlling T2D and its associated complications. Additionally, various antioxidants and anti‐inflammatory agents show potential in reducing OS and inflammation. Some anti‐diabetic drugs, like pioglitazone, metformin, and glucagon‐like peptide‐1 (GLP‐1) agonists, may also have anti‐inflammatory effects. Further research, including randomized controlled trials, is needed to evaluate the efficacy of these interventions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Metabolic syndrome (MetS) is a condition marked by a complex array of physiological, biochemical, and metabolic abnormalities, including central obesity, insulin resistance, high blood pressure, and dyslipidemia (characterized by elevated triglycerides and reduced levels of high-density lipoproteins). The pathogenesis develops from the accumulation of lipid droplets in the hepatocyte (steatosis). This accumulation, in genetically predisposed subjects and with other external stimuli (intestinal dysbiosis, high caloric diet, physical inactivity, stress), activates the production of pro-inflammatory molecules, alter autophagy, and turn on the activity of hepatic stellate cells (HSCs), provoking the low grade chronic inflammation and the fibrosis. This syndrome is associated with a significantly increased risk of developing type 2 diabetes mellitus (T2D), cardiovascular diseases (CVD), vascular, renal, pneumologic, rheumatological, sexual, cutaneous syndromes and overall mortality, with the risk rising five- to seven-fold for T2DM, three-fold for CVD, and one and a half–fold for all-cause mortality. The purpose of this narrative review is to examine metabolic syndrome as a "systemic disease" and its interaction with major internal medicine conditions such as CVD, diabetes, renal failure, and respiratory failure. It is essential for internal medicine practitioners to approach this widespread condition in a "holistic" rather than a fragmented manner, particularly in Western countries. Additionally, it is important to be aware of the non-invasive tools available for assessing this condition. Materials and Methods: We conducted an exhaustive search on PubMed up to July 2024, focusing on terms related to metabolic syndrome and other pathologies (heart, Lung (COPD, asthma, pulmonary hypertension, OSAS) and kidney failure, vascular, rheumatological (osteoarthritis, rheumatoid arthritis), endocrinological, sexual pathologies and neoplastic risks. The review was managed in accordance with the PRISMA statement. Finally, we selected 300 studies (233 papers for the first search strategy and 67 for the second one). Our review included studies that provided insights into metabolic syndrome and non-invasive techniques for evaluating liver fibrosis and steatosis. Studies that were not conducted on humans, were published in languages other than English, or did not assess changes related to heart failure were excluded. Results: The findings revealed a clear correlation between metabolic syndrome and all the pathologies above described, indicating that non-invasive assessments of hepatic fibrosis and steatosis could potentially serve as markers for the severity and progression of the diseases. Conclusions: Metabolic syndrome is a multisystem disorder that impacts organs beyond the liver and disrupts the functioning of various organs. Notably, it is linked to a higher incidence of cardiovascular diseases, independent of traditional cardiovascular risk factors. Non-invasive assessments of hepatic fibrosis and fibrosis allow clinicians to evaluate cardiovascular risk. Additionally, the ability to assess liver steatosis may open new diagnostic, therapeutic, and prognostic avenues for managing metabolic syndrome and its complications, particularly cardiovascular disease, which is the leading cause of death in these patients. [ABSTRACT FROM AUTHOR]

Summary: Psychological distress has a demonstrable impact on cardiovascular diseases (CVD) and risk factors. Transcendental Meditation (TM) has been shown to reduce stress and improve health and well‐being. The current review aimed to synthesize the evidence on the effects of TM on cardiometabolic outcomes and identify gaps for future research. We searched PubMed/MEDLINE, EMBASE, SCOPUS, and Web of Science databases for relevant literature. Forty‐five papers that reported studies of TM on cardiometabolic risk factors and diseases were included. Evidence shows that TM is effective in reducing blood pressure (BP). We found some evidence that TM can improve insulin resistance and may play a role in improving dyslipidemia, exercise tolerance, and myocardial blood flow, and in reducing carotid intima‐media thickness and left ventricular mass. Studies show that long‐term TM practice can reduce the risk of myocardial infarction, stroke, and CVD mortality. This review identified that certain studies have high participant drop‐out rates, and fewer studies targeted comprehensive cardiometabolic outcomes beyond BP with longer follow‐up periods. We found that most studies were conducted in specific populations, which may limit generalizability. In conclusion, TM has the potential to improve cardiometabolic health; however, research gaps highlight the need for larger phase III multicenter clinical trials with long‐term follow‐ups. [ABSTRACT FROM AUTHOR]

Visfatin is an adipokine involved in energy metabolism, insulin resistance, inflammation, and female reproduction. Due to limited data about its action in the human placenta, the aims of our studies included the analysis of visfatin expression and immunolocalization in trophoblast cell lines JEG-3 and BeWo as well as in human placentas from normal and pathological pregnancies. Moreover, we also checked the hormonal regulation of visfatin levels and the molecular mechanism of observed changes in JEG-3 cells. Cell culture and placental fragments collection along with statistical analysis were performed using standard laboratory procedures also described in our previous papers. We demonstrated an increased gene and protein expression of visfatin in JEG-3, BeWo cells, while variable expression in maternal and fetal parts of normal/ pathological pregnancy placentas. In addition, the immunolocalization of visfatin was observed in the cytoplasm of both cell lines, the capillary epithelium of the maternal part and syncytiotrophoblasts of the placental fetal part; in all tested pathologies, the signal was also detected in decidual cells. Furthermore, we demonstrated that hormones: progesterone, estradiol, human chorionic gonadotropin, and insulin increased the visfatin levels in JEG-3 cells with the involvement of specific signaling pathways. Taken together, differences in the expression and localization of visfatin between normal and pathological placentas suggested that visfatin may be a potential marker for the diagnosis of pregnancy disorders. In addition, we found that placental levels of visfatin can be regulated by hormones known to modulate the function of placental cells. [ABSTRACT FROM AUTHOR]

With increasing numbers of patients worldwide diagnosed with diabetes mellitus, renal disease, and iatrogenic immune deficiencies, an increased understanding of the role of electrolyte interactions in mitigating pathogen virulence is necessary. The levels of divalent cations affect host susceptibility and pathogen survival in persons with relative immune insufficiency. For instance, when host cellular levels of calcium are high compared to magnesium, this relationship contributes to insulin resistance and triples the risk of clinical tuberculosis. The movement of divalent cations within intracellular spaces contributes to the host defense, causing apoptosis or autophagy of the pathogen. The control of divalent cation flow is dependent in part upon the mammalian natural resistance-associated macrophage protein (NRAMP) in the host. Survival of pathogens such as M tuberculosis within the bronchoalveolar macrophage is also dependent upon NRAMP. Pathogens evolve mutations to control the movement of calcium through external and internal channels. The host NRAMP as a metal transporter competes for divalent cations with the pathogen NRAMP in M tuberculosis (whether in latent, dormant, or active phase). This review paper summarizes mechanisms of pathogen offense and patient defense using inflow and efflux through divalent cation channels under the influence of parathyroid hormone vitamin D and calcitonin. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is one of the most common reproductive and endocrine disorders in women of childbearing age, and the pathogenesis is unknown. Insulin resistance, hyperandrogenism and obesity are important pathophysiological basis. Glucose-dependent insulinotropic peptide (GIP) is a gastrointestinal hormone involved in the regulation of insulin secretion. Literature studies have shown that GIP is correlated with insulin resistance, hyperandrogenism, obesity and other characteristic changes of PCOS, and it may contribute to the onset and progression of PCOS by affecting the function of hypothalamic-pituitary-ovarian axis, suggesting that GIP is associated with PCOS. This paper reviews the research progress of the correlation between GIP and PCOS. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is common and increasing in prevalence worldwide, with devastating public health consequences. While peripheral insulin resistance is a key feature of most forms of T2DM and has been investigated for over a century, research on brain insulin resistance (BIR) has more recently been developed, including in the context of T2DM and non-diabetes states. Recent data support the presence of BIR in the aging brain, even in non-diabetes states, and found that BIR may be a feature in Alzheimer’s disease (AD) and contributes to cognitive impairment. Further, therapies used to treat T2DM are now being investigated in the context of AD treatment and prevention, including insulin. In this review, we offer a definition of BIR, and present evidence for BIR in AD; we discuss the expression, function, and activation of the insulin receptor (INSR) in the brain; how BIR could develop; tools to study BIR; how BIR correlates with current AD hallmarks; and regional/cellular involvement of BIR. We close with a discussion on resilience to both BIR and AD, how current tools can be improved to better understand BIR, and future avenues for research. Overall, this review and position paper highlights BIR as a plausible therapeutic target for the prevention of cognitive decline and dementia due to AD. [ABSTRACT FROM AUTHOR]

Magnesium (Mg), an essential nutrient with a wide area of physiological roles, stands as a cofactor in over 600 enzymatic reactions involved in the synthesis of proteins and nucleic acids, DNA repair, neuromuscular functions, neuronal transmission, cardiac rhythm regulation, and the modulation of metabolic pathways, as well as acting as a natural blocker for the calcium channels. Our objective was to highlight the most recent clinical data with respect to daily Mg intake (DMI) and metabolic traits, particularly type 2 diabetes mellitus (DM). This was a PubMed-based review of the English-language medical papers across different key terms of search; the time frame was from January 2019 until April 2024. We included (clinically relevant) original studies and excluded cases reports, series, reviews, editorials, opinion, experimental studies, and non-human data as well as studies that did not specifically assessed DMI and only provided assays of serum Mg, studies on patients diagnosed with type 1 or secondary DM. A total of 30 studies were included and we organized the key findings into several sections as follows. Studies investigating DMI in relationship with the adherence to local recommendations in diabetic subjects (n = 2, one transversal and another retrospective cohort; N = 2823) found that most of them had lower DMI. Deficient DMI was correlated with the risk of developing/having DM across five studies (n = 5, one prospective and four of cross-sectional design; N = 47,166). An inverse correlation between DMI and DM prevalence was identified, but these data are presented amid a rather heterogeneous spectrum. Four novel studies (N = 7279) analysed the relationship between DMI and DM control according to various methods (HbA1c, fasting and postprandial glycaemia, and insulin); the association may be linear in diabetic subjects only at certain levels of DMI; additionally, the multifactorial influence on HBA1c should take into consideration this dietary determinant, as well, but there are no homogenous results. Three studies concerning DMI and diabetic complications (one cross-sectional, one prospective, and another case–control study) in terms of retinopathy (n = 1, N = 3794) and nephropathy (n = 2, N = 4805) suggested a lower DMI was associated with a higher risk of such complications. Additionally, two other studies (one prospective and one retrospective cohort) focused on mortality (N = 6744), which, taking only certain mortality indicators into consideration, might be decreased in the subgroups with a higher DMI. Seven studies (N = 30,610) analysed the perspective of DMI in the general population with the endpoint of different features amid glucose profile, particularly, insulin resistance. Concerning HOMA-IR, there were three confirmatory studies and one non-confirmatory, while fasting plasma glucose was highlighted as inversely correlated with a DMI (n = 1). The highest level of evidence regarding Mg supplementation effects on glucose metabolism stands on seven randomised controlled trials (N = 350). However, the sample size was reduced (from 14 to 86 individuals per study, either diabetic or pre-diabetic) and outcomes were rather discordant. These clinical aspects are essential from a multidisciplinary perspective and further trials are mandatory to address the current areas of discordant results. [ABSTRACT FROM AUTHOR]

The management of type 2 diabetes (T2D) often necessitates treatment intensification, and sometimes simplification to achieve glycaemic targets and mitigate complications. This expert opinion paper evaluates the use and positioning of the fixed-ratio combinations (FRCs) of basal insulin (BI) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in optimising T2D management. On the basis of the evidence presented and discussions, these FRCs offer a promising approach for both treatment intensification and simplification in people with suboptimal glucose control despite receiving various therapies. In treatment intensification, FRCs provide a synergistic effect by addressing multiple pathophysiological defects contributing to hyperglycaemia. These FRCs effectively control both fasting and postprandial glucose (PPG) excursions, offering significantly improved glycaemic control with a lower hypoglycaemia risk and weight neutrality compared to traditional or complex insulin regimens. Moreover, the reduced injection frequency (once daily) and flexibility in the dosing schedule (with any major meal of the day) help mitigate patient resistance to insulin initiation or titration. This further reduces treatment burden, facilitating treatment adherence and enhancing patient convenience. These key benefits of FRCs over complex insulin regimens play a crucial role in long-term glycaemic management and overall treatment outcomes. Hence, the timely use of FRCs in the treatment algorithm for people with T2D represents a valuable strategy for optimising glycaemic control, addressing treatment barriers and enhancing patient-reported outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Metformin is one of the most widely used drugs in the world, since its first use in the second part of the 1950s in France (Aron, 1957) and in the United Kingdom (Rona, 1958), and is on the World Health Organization's List of Essential Medicines. Traditionally, metformin is used in diabetes mellitus, mainly in overweight and obese subjects, but also in other conditions of impaired glucose metabolism, such as insulin resistance. In recent years, in vitro and in vivo data on this molecule as an antiproliferative modulator have suggested a series of clinical trials in several tumors that—at the moment—have not confirmed the expected positive results. The aim of this paper is to offer a double vision of this molecule, with a very light side about the metabolic aspects and a darker side concerning its antineoplastic activity, focusing on molecular and subcellular pathways involved in both fields and discussing the contrast between preliminary cellular data and real clinical outcomes in different neoplasms. The ancient Roman god Ianus was a mysterious divinity with two opposite faces, one looking at the past and the other looking to the future. Likewise, metformin is an "old" drug, with one side looking at the metabolic role and the other looking at the anti-proliferative mechanism; therefore, it represents a typical and ideal bridge between diabetes and cancer. Metformin (1,1-dimethylbiguanidine hydrochloride) is a drug that has long been in use for the treatment of type 2 diabetes mellitus, but recently evidence is growing about its potential use in other metabolic conditions and in proliferative-associated diseases. The aim of this paper is to retrace, from a historical perspective, the knowledge of this molecule, shedding light on the subcellular mechanisms of action involved in metabolism as well as cellular and tissue growth. The intra-tumoral pharmacodynamic effects of metformin and its possible role in the management of different neoplasms are evaluated and debated. The etymology of the name Ianus is probably from the Latin term ianua, which means door. How many new doors will this old drug be able to open? [ABSTRACT FROM AUTHOR]

Aims: Psychological insulin resistance is a common barrier to initiation and persistence with insulin therapy that affects approximately 42.7% of people living with type II diabetes mellitus, which may negatively impact self‐management. This study aimed to assess patients' levels of psychological insulin resistance and to identify factors associated with self‐management in patients with type II diabetes mellitus treated with insulin therapy. Methods: We adopted a cross‐sectional design. Subjects from the metabolism and endocrinology outpatient departments of a regional teaching hospital in central Taiwan were recruited by consecutive sampling. Patients were assessed for psychological insulin resistance and self‐management using the barriers to insulin treatment questionnaire and the partners in health scale. Results: A total of 222 patients with type II diabetes mellitus were recruited. Patients had an average psychological insulin resistance score of 3.14 (maximum of 8). Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age. Conclusion: Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy. Insulin therapy education should be offered to improve patients' beliefs about insulin therapy and enhance patients' ability to perform self‐management. Summary statement: What is already known about this topic? Psychological insulin resistance is a common psychological barrier to initiation and persistence with insulin therapy.Psychological insulin resistance causes poor glycaemic control and diabetes‐related complications.Psychological insulin resistance may negatively impact self‐management in patients with type II diabetes mellitus. What is the contribution of this paper? Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age.Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy.Patients with poor self‐management had statistically significantly higher levels of overall psychological insulin resistance, fear of injections and self‐testing, expectations regarding positive insulin‐related outcomes, and stigmatization by insulin injections, compared to those with appropriate self‐management. What are the implications of this paper? Knowing in advance the factors associated with diabetes self‐management will allow healthcare professionals prevent psychological insulin resistance in patients with type II diabetes mellitus treated with insulin therapy.Healthcare professionals can design and provide patient‐centred diabetes education based on education level to enhance self‐management. [ABSTRACT FROM AUTHOR]

Simple Summary: Obesity is a global concern within human, pet, and horse populations. A major consequence of obesity is a disruption to glucose and insulin metabolisms, leading to metabolic conditions including insulin resistance and/or diabetes. This paper discusses these consequences of obesity and excess adipose tissue both in idle and athletic subjects. Exercise conditioning can improve glucose metabolism and insulin sensitivity. Regular exercise can also facilitate weight loss, wherein the reduction of adipose tissue alleviates fat's negative impacts on metabolism, while also decreasing the mechanical load on a subject's limbs. These actions could result in better health, reduced incidence of metabolic disease, and, perhaps, improved performance. Obesity is an important health concern in horses, along with humans and companion animals. Adipose tissue is an inflammatory organ that alters the insulin-signaling cascade, ultimately causing insulin dysregulation and impaired glucose metabolism. These disruptions can increase the risk of metabolic disease and laminitis in horses and may also impact energy metabolism during exercise. A single bout of exercise, along with chronic exercise conditioning, increases insulin sensitivity and glucose disposal via both contraction- and insulin-mediated glucose uptake pathways. Regular exercise also increases calorie expenditure, which can facilitate weight (as body fat) loss. This paper explores the metabolic pathways affected by adiposity, as well as discusses the impact of exercise on insulin metabolism in horses. [ABSTRACT FROM AUTHOR]

Background:d-Chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders. Objectives: This perspective seeks to explore the mechanisms and functions of d-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation. Methods: A narrative review of all the relevant papers known to the authors was conducted. Outcome:d-Chiro-inositol acts through a variety of mechanisms, acting as an insulin sensitizer, inhibiting the transcription of aromatase, in addition to modulating white adipose tissue/brown adipose tissue transdifferentiation. These different modes of action have potential applications in a variety of therapeutic fields, including PCOS, dysmetabolism, obesity, hypoestrogenic/hyperandrogenic disorders, and bone health. Conclusions:d-Chiro-inositol mode of action has been studied in detail in recent years, resulting in a clear differentiation between d-chiro-inositol and its isomer myo-inositol. The insulin-sensitizing activities of d-chiro-inositol are well understood; however, its potential applications in other fields, in particular obesity and hyperestrogenic/hypoandrogenic disorders in men and women, represent promising avenues of research that require further clinical study. [ABSTRACT FROM AUTHOR]

Neonatal Respiratory Distress Syndrome (NRDS) in infants of diabetic mothers (IDMs) is significantly influenced by maternal hyperglycemia and hyperinsulinemia, which impair surfactant production necessary for lung function. It is known that NRDS occurs in preterm infants, but research is limited on whether this occurs in near-term to full-term IDMS, which is what we discuss further in this paper. Studies indicate that maternal diabetes, both type 1 and type 2, increases the risk of NRDS, with hyperinsulinemia in the fetus inhibiting surfactant synthesis and contributing to respiratory complications. Furthermore, while insulin therapy manages maternal glucose levels, it can also be a risk factor for NRDS. Effective prenatal care, proper glycemic control, and further research into maternal HbA1C levels and insulin's role in surfactant production are essential for reducing NRDS incidence. Improved diagnostic criteria for gestational diabetes and enhanced management strategies can potentially prevent NRDS, benefiting neonatal outcomes globally. [ABSTRACT FROM AUTHOR]

Introduction: Insulin resistance is a common condition affecting thousands of people worldwide. This paper aims to examine the mechanisms underlying insulin resistance among people suffering from obesity. Methods and Design: This study entailed identifying articles related to insulin resistance and obesity. The publications were obtained using different electronic databases, including PubMed, EBSCO, and LILACS. The search terms included "insulin", "resistance", "obesity", and "mechanisms". Boolean operators were used to combine terms and phrases. Results: Insulin resistance is a physiological condition characterized by the impaired action of insulin in the body. The association between obesity and insulin resistance is linked to inflammatory, neural, and endocrine pathways that affect the sensitivity of organs to the level of insulin in the body. Discussion: Molecular studies have helped discover some of the fundamental mechanisms leading to the development of insulin resistance. Further investigations are needed to enhance our understanding of the connections among the inflammatory, neural, and cellular processes underlying the association between insulin resistance and obesity. Conclusion: This study revealed that a complex correlation exists between insulin resistance and obesity. This relationship involves a wide range of inflammatory, neural, and endocrine processes. [ABSTRACT FROM AUTHOR]

Vitamin D is an indispensable fat-soluble vitamin in the human body, mainly in the form of vitamin D2 and vitamin D3,which can be synthesized by the skin and ingested in the diet. Vitamin D deficiency is currently a global public health problem, with approximately one billion people worldwide suffering from vitamin D deficiency, and pregnant women are at high risk. Gestational diabetes mellitus（GDM） refers to normal glucose metabolism before pregnancy, and abnormal glucose tolerance of different degrees occurs for the first time during pregnancy, which is one of the complications of pregnancy. Continuous studies have proved that vitamin D deficiency during pregnancy is closely related to GDM,which can affect glucose balance through various mechanisms, leading to an increased risk of GDM. In addition, GDM increases the incidence of maternal and infant complications such as hyperamniotic fluid, pregnancy-induced hypertension, premature rupture of membranes, premature delivery, macrosomia, low body weight, and teratoma, which threatens maternal and infant health. In recent years, the research on the correlation between vitamin D and GDM has been increasing, and its correlation has been paid more and more attention by more and more scholars. This paper reviewed the research progress on the correlation between vitamin D and GDM. [ABSTRACT FROM AUTHOR]

The International Journal of Molecular Sciences has published a Special Issue titled "New Advances in Metabolic Syndrome," which features high-quality original papers written by prominent leaders in the field. Metabolic syndrome (MetS) is a cluster of derangements that includes insulin resistance, central obesity, hyperglycemia, hypertension, and lipid abnormalities. The issue covers various topics, including genetic susceptibility, obesity features, novel management approaches, blood pressure findings in special populations, glucose disturbances, and the connection between MetS and liver dysfunction and neoplastic risk. Additionally, the issue includes reviews on the role of the gut microbiome in health and disease, gestational diabetes, and the link between MetS and Alzheimer's disease. The aim of the Special Issue is to provide an update on the latest research in MetS and contribute to future therapeutic breakthroughs. [Extracted from the article]

Purpose: Polycystic ovary syndrome (PCOS) is the most common endocrine-reproductive disease linked not just to infertility but also to serious comorbidities. There is a reported association between low vitamin D levels and multiple health conditions including PCOS. This narrative review aims to analyze the role of vitamin D in PCOS development, use of the vitamin D in the treatment of PCOS, and the molecular basis of these observations. Methods: A Medline and PubMed research was performed, during the years 1990–2023, using a combination of keywords on such topic. According to the author's evaluation and target, papers were identified and included for a narrative review. Results: There are associations between lower levels of vitamin D and PCOS, as well as with insulin resistance, metabolic syndrome, hyperandrogenemia, metabolic and endocrine disorders as well as the onset of oxidative stress and pro-inflammatory milieu, in PCOS women. Conclusion: Vitamin D has a role in pathologic changes linked to PCOS. Molecular and clinical investigations which give new information about the role of vitamin D in the development of PCOS and related endocrine and metabolic disturbance are further needed. [ABSTRACT FROM AUTHOR]

AbstractThe high prevalence of metabolic syndrome is threatening the health of populations all over the world. Contemporary work demonstrates that high leptin concentration is directly related to the development of metabolic syndrome such as obesity, fatty liver diseases, type 2 diabetes mellitus and cardiovascular diseases. Anthocyanins are a widespread group of dietary polyphenols, which can ameliorate chronic diseases related to metabolic syndrome. In addition, anthocyanins can regulate the leptin pathway in chronic metabolic diseases, however the potential mechanism between anthocyanin and leptin is complex and elusive. In this review paper, we have evaluated the bioactivity of anthocyanins on the mediation of leptin level and the upstream and downstream pathways in chronic metabolic diseases. Anthocyanins could regulate the hypertrophy of adipose tissue, and the expression of leptin level via mediating TNF-α, C/EBP, PPAR, CREB and SREBP-1. Anthocyanins promoted the leptin sensitivity by increasing the level of leptin receptor, phosphorylation of JAK2/STAT3, PI3K/AKT, and additionally ameliorated metabolic disorder related outcome, including oxidative stress, inflammation, lipid accumulation, insulin resistance and the balance of gut microbiota. However, direct evidence of anthocyanins treatment on leptin signal transduction is still limited which calls for future molecular binding and gene regulation test. [ABSTRACT FROM AUTHOR]

Epigenetics focuses on the study of changes in gene expression based on modifications that do not interfere with the DNA sequence, such as DNA methylation, post-translational histone modification, and non-coding RNA. Epigenetic changes regulate the expression of many genes, including inflammatory ones. Chronic inflammation is often accompanied by insulin resistance (IR), which is characteristic of inter alia type 2 diabetes. Recently, it has been reported that altered epigenetic signature in the promoter regions of inflammatory genes may contribute to the development of IR. Therefore, the aim of this review is to present the current state of knowledge regarding the epigenetic regulation of inflammation in IR. It includes original papers published from 2014 to 2022. It appears that hypomethylation of the SOCS3 gene increases the risk of IR, while the alteration of H3K4me in the NF-kB promoter promotes changes in inflammatory phenotype. Finally, in hyperglycemic states associated with IR, altered levels of H3K4/K9m3 and H3K9/K14ac result in increased expression of the inflammatory cytokine IL-6. In addition, numerous miRNAs have been identified that may become a target in the fight against diseases related to inflammation and IR. Future studies should examine the epigenetic modifications of IR inflammatory markers associated with environmental factors. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is a growing health concern with an estimated 462 million people having been diagnosed worldwide. T2D is characterized by chronically elevated blood glucose and insulin resistance, which culminate in a diminished function of the β-cell mass in its later stages. This can be perpetuated by and result in inflammation, excess reactive oxygen species production, obesity, and the dysregulation of multiple cellular pathways. Many naturally occurring small molecules have been investigated in terms of their roles in modulating glucose homeostasis and β-cell function. Many of these compounds can be found in commonly used sources of food and drink. Interestingly, a correlation has been observed between coffee consumption and T2D incidence. However, the specific compounds responsible for this correlation and their mechanisms are still somewhat undetermined. This paper reviews recent research findings on the effects of several polyphenols that are either found in coffee or are metabolites of compounds found in coffee (enterodiol, enterolactone, matairesinol, secoisolariciresinol, kaempferol, quercetin, and chlorogenic acid) on glucose homeostasis and health complications associated with glucose dysregulation, with a special emphasis on their potential anti-diabetic effects. The factors that affect polyphenol content in coffee are also addressed. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this systematic review and meta-analysis was to determine whether there is a connection between polycystic ovarian syndrome (PCOS)-affected women's levels of the anti-Mullerian hormone (AMH) and certain cardiometabolic indicators. Materials and Methods: To find pertinent recent research published between 2017 and 2023, a thorough search was done in PubMed. Studies were included if they looked into the relationship between PCOS-related women's AMH levels and cardiometabolic markers. To determine pooled effect estimates, data from the included studies were examined using random-effects models. Results: Five papers were included in the meta-analysis since they satisfied the inclusion requirements. The meta-analysis found substantial positive relationships between AMH levels and markers of insulin resistance, fasting blood sugar levels, and dyslipidemia measures such as total cholesterol (SMD: 0.68, 95% confidence interval: 0.34–1.00, P < 0.001). Conclusion: This systematic review and meta-analysis show that AMH levels in PCOS-affected women significantly positively correlate with markers of insulin resistance, fasting glucose levels, and dyslipidemia parameters. These findings imply that the pathogenesis of the cardiometabolic abnormalities seen in PCOS may include AMH. AMH may be used as a biomarker to estimate the cardiometabolic risk in PCOS-affected women, but more studies are required to determine its clinical applicability. [ABSTRACT FROM AUTHOR]

Background: While there have been several school‐based physical activity (PA) interventions targeting improvement in cardiovascular disease (CVD) risk factors, few have assessed long‐term effects. The aim of this paper was therefore to determine intervention effects on CVD risk factors 5 years after cessation. Methods: Two schools were assigned to intervention (n = 125) or control (n = 134). The intervention school offered 210 min/week more PA than the control school over two consecutive years (fourth and fifth grades). Follow‐up assessment was conducted 5‐year post‐intervention (10th grade) where 180–210 (73%–85%) children provided valid data. Outcomes were CVD risk factors: triglyceride, total‐to‐high‐density‐lipoprotein‐cholesterol ratio (TC:HDL ratio), insulin resistance, blood pressure (BP), waist circumference, and cardiorespiratory fitness (VO2peak). Variables were analyzed individually and as a composite score through linear mixed models, including random intercepts for children. Results: Analyses revealed significant sustained 5‐year intervention effects for HDL (effect sizes [ES] = 0.22), diastolic BP (ES = 0.48), VO2peak (ES = 0.29), and composite risk score (ES = 0.38). These effects were similar to the immediate results following the intervention. In contrast, while TC:HDL ratio initially decreased post‐intervention (ES = 0.27), this decrease was not maintained at 5‐year follow‐up (ES = 0.09), whereas WC was initially unchanged post‐intervention (ES = 0.02), but decreased at 5‐year follow‐up (ES = 0.44). Conclusion: The significant effects of a 2‐year school‐based PA intervention remained for CVD risk factors 5 years after cessation of the intervention. As cardiometabolic health can be maintained long‐term after school‐based PA, this paper demonstrates the sustainability and potential of schools in the primary prevention of future CVD risk in children. [ABSTRACT FROM AUTHOR]

Objective • The paper aimed to explore the effect of probiotic supplementation on nutrient intake, Ghrelin, and adiponectin concentrations in diabetic hemodialysis patients. Methods • A total of 86 patients with diabetic nephropathy who received hemodialysis treatment in the Department of Nephrology of the First People’s Hospital of Shanghai from May 2019 to March 2021 were selected as the research subjects, including 52 male patients and 34 female patients, with an average age of 56.57 ± 4.28. According to the research protocol, the patients were divided into the control group (n=30) and the observation group (n=56). In the control group, dietary soybean milk was used as a placebo. In the observation group, capsules containing probiotics Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium were taken with soybean milk. All patients signed an informed consent form before being included in the study. The results of the experimental biochemical analysis and the archived data counted the general data of the patients. Plasma adiponectin concentrations were measured with a commercially available human enzyme immunoassay kit. Ghrelin concentrations were estimated by specific commercial methods. Correlation software was used to calculate patient nutritional intake data. Serum creatinine, insulin resistance, fasting blood glucose, and levels of oxidative stress and inflammatory factors were measured using appropriate biochemical assays. Results •There was no difference in baseline characteristics between the two groups (P > .05). Before treatment, there was no difference in serum adiponectin concentration between the two groups (P > .05). After treatment, the serum adiponectin concentration in the observation group was lower than in the control group (P<.05). Before treatment, there was no difference in serum ghrelin levels between the two groups (P > .05). After treatment, serum ghrelin levels in the observation group were higher than in the control group (P<.05). Before treatment, there was no difference in nutrient intake between the two groups (P > .05). After treatment, the nutrient intake in the observation group was higher than in the control group (P < .05). Serum creatinine, fasting blood glucose, urine protein/creatinine ratio, and HOMA-IR in the observation group were lower than in the control group (P < .05). The serum levels of malondialdehyde, C-reactive protein, and TNF-α in the observation group were lower than those in the control group (P<.05), and the levels of glutathione in the observation group were higher than those in the control group (P<.05). Conclusion • Supplementation of probiotics in DN dialysis patients can increase serum ghrelin concentration, increase nutrient intake through appetite regulation, and reduce adiponectin level, which is beneficial to blood sugar control, insulin resistance, and renal function. Objective • The paper aimed to explore the effect of probiotic supplementation on nutrient intake, Ghrelin, and adiponectin concentrations in diabetic hemodialysis patients. Methods • A total of 86 patients with diabetic nephropathy who received hemodialysis treatment in the Department of Nephrology of the First People’s Hospital of Shanghai from May 2019 to March 2021 were selected as the research subjects, including 52 male patients and 34 female patients, with an average age of 56.57 ± 4.28. According to the research protocol, the patients were divided into the control group (n=30) and the observation group (n=56). In the control group, dietary soybean milk was used as a placebo. In the observation group, capsules containing probiotics Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium were taken with soybean milk. All patients signed an informed consent form before being included in the study. The results of the experimental biochemical analysis and the archived data counted the general data of the patients. Plasma adiponectin concentrations were measured with a commercially available human enzyme immunoassay kit. Ghrelin concentrations were estimated by specific commercial methods. Correlation software was used to calculate patient nutritional intake data. Serum creatinine, insulin resistance, fasting blood glucose, and levels of oxidative stress and inflammatory factors were measured using appropriate biochemical assays. Results •There was no difference in baseline characteristics between the two groups (P > .05). Before treatment, there was no difference in serum adiponectin concentration between the two groups (P > .05). After treatment, the serum adiponectin concentration in the observation group was lower than in the control group (P<.05). Before treatment, there was no difference in serum ghrelin levels between the two groups (P > .05). After treatment, serum ghrelin levels in the observation group were higher than in the control group (P<.05). Before treatment, there was no difference in nutrient intake between the two groups (P > .05). After treatment, the nutrient intake in the observation group was higher than in the control group (P < .05). Serum creatinine, fasting blood glucose, urine protein/creatinine ratio, and HOMA-IR in the observation group were lower than in the control group (P < .05). The serum levels of malondialdehyde, C-reactive protein, and TNF-α in the observation group were lower than those in the control group (P<.05), and the levels of glutathione in the observation group were higher than those in the control group (P<.05). Conclusion • Supplementation of probiotics in DN dialysis patients can increase serum ghrelin concentration, increase nutrient intake through appetite regulation, and reduce adiponectin level, which is beneficial to blood sugar control, insulin resistance, and renal function. [ABSTRACT FROM AUTHOR]

This review offers an in-depth exploration of Nicotinamide Adenine Dinucleotide Phosphate (NADPH) in metabolic health. It delves into how NADPH affects insulin secretion, influences insulin resistance, and plays a role in ferroptosis. NADPH, a critical cofactor in cellular antioxidant systems and lipid synthesis, plays a central role in maintaining metabolic homeostasis. In adipocytes and skeletal muscle, NADPH influences the pathophysiology of insulin resistance, a hallmark of metabolic disorders such as type 2 diabetes and obesity. The review explores the mechanisms by which NADPH contributes to or mitigates insulin resistance, including its role in lipid and reactive oxygen species (ROS) metabolism. Parallelly, the paper investigates the dual nature of NADPH in the context of pancreatic β-cell health, particularly in its relation to ferroptosis, an iron-dependent form of programmed cell death. While NADPH's antioxidative properties are crucial for preventing oxidative damage in β-cells, its involvement in lipid metabolism can potentiate ferroptotic pathways under certain pathological conditions. This complex relationship underscores the delicate balance of NADPH homeostasis in pancreatic health and diabetes pathogenesis. By integrating findings from recent studies, this review aims to illuminate the nuanced roles of NADPH in different tissues and its potential as a therapeutic target. Understanding these dynamics offers vital insights into the development of more effective strategies for managing insulin resistance and preserving pancreatic β-cell function, thereby advancing the treatment of metabolic diseases. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a prevalent gynecological endocrine disorder characterized by menstrual disorders, infertility, hirsutism, acne and obesity. The precise pathogenesis of PCOS remains unclear. Recent evidence has demonstrated the involvement of endoplasmic reticulum stress in its pathological process, suggesting the potential of endoplasmic reticulum stress as a novel therapeutic target for PCOS. Endoplasmic reticulum stress refers to the state where the endoplasmic reticulum is in a state of steady imbalance and the accumulation of incorrectly folded or unfolded proteins in the endoplasmic reticulum. Moderate endoplasmic reticulum stress contributes to the development and maturation of follicles. Sustained endoplasmic reticulum stress leads to the abnormal follicle development, hormonal and insulin synthesis and secretion disorders in PCOS patients by inducing granulosa cell apoptosis and mediating processes such as steroid hormone metabolism, glucose metabolism and lipid metabolism, thereby impairing female fertility. This paper provides an overview of the relationship between endoplasmic reticulum stress and various pathogenic factors associated with PCOS, to offer fresh insights into its etiology and treatment. [ABSTRACT FROM AUTHOR]

Individuals experiencing obesity or overweight conditions frequently encounter difficulties in managing their appetite. The sustained practice of resistance training over an extended duration presents a potential avenue for regulating appetite among this demographic. Despite the extensive examination of long-term resistance training in existing literature, a consensus on pertinent issues remains elusive, necessitating a comprehensive review. This paper aims to evaluate empirical studies examining alterations in energy intake and appetite among obese or overweight individuals engaging in prolonged resistance training regimens. Information was gathered from databases including EBSCOhost, Science Direct, PubMed, and Web of Science. Search queries were executed on Google Scholar and other sources, utilizing key terms pertinent to energy intake (or appetite), resistance training, and overweight (or obesity) for identifying relevant studies. A comprehensive evaluation of 38 full-text articles was conducted, resulting in the inclusion of eight articles in the review. The PEDro scale was utilized to assess bias and completeness risk, with no exclusion of any articles during this process. The impact of resistance training on energy intake in overweight or obese individuals was observed through sessions lasting 35-45 minutes conducted twice a week over a nine-month period. The exercise significantly influenced parameters such as energy intake, glucose levels, leptin concentrations, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Neuropeptide Y (NPY), and adiponectin. However, no significant effects were noted on perceived fullness and hunger, ghrelin PP, or PYY. Resistance training has the potential to impact energy intake and appetite regulation in overweight or obese individuals. Further research is warranted, particularly in exploring its effects on female and adolescent populations, implementing a sample size calculation strategy, conducting comparisons across three intensities, and undertaking a comprehensive analysis of relevant variables. [ABSTRACT FROM AUTHOR]

BACKGROUND: Macrophage subtypes exhibit tissue heterogeneity, and the adipose tissue macrophage phenotype is largely influenced by obesity. Local and systemic inflammatory responses caused by obese adipose tissue macrophages are considered a vital pathological mechanism of obesity-associated metabolic diseases. OBJECTIVE: To summarize the inflammatory characteristics of different macrophage subtypes in adipose tissue and their relationship with obesity-associated metabolic diseases, aiming to provide a reference basis for targeting specific macrophage subtypes to explore preventive and treatment strategies for obesityassociated metabolic diseases. METHODS: Literature retrieval was conducted in CNKI and PubMed using Chinese and English search terms “obesity, adipose tissue, adipose tissue macrophage, macrophage polarisation, metabolic diseases.” The search results were accepted or excluded according to the inclusion criteria. Ninety-one papers that met the criteria were finally included for review. RESULTS AND CONCLUSION: (1) Macrophages have tissue heterogeneity. Under normal conditions, adipose tissue macrophages are mainly composed of antiinflammatory M2 resident macrophages, which maintain tissue inflammation homeostasis. Under obese conditions, a large number of foreign infiltrating macrophages surround hypertrophic adipocytes, and most of them exhibit pro-inflammatory characteristics. Therefore, it is believed that adipose tissue macrophages of pro-inflammatory M1 type may actually be a collection of multiple pro-inflammatory subtypes. Further understanding of the characteristics of various pro-inflammatory subtypes helps us to gain a deeper understanding of the mechanisms underlying inflammatory disorders in obese adipose tissue. (2) In obesity, foreign infiltrating macrophages form crown-like structures around hypertrophic adipocytes. Currently, six different subtypes of the crown-like structure have been identified, most of which exhibit pro-inflammatory properties and a few of which possess anti-inflammatory characteristics. Thus, taking full advantage of the anti-inflammatory subtypes while inhibiting the differentiation of the pro-inflammatory subtypes may be a new target for alleviating inflammatory damage in obese adipose tissue. (3) M3, MMe, CD9+ and LAM adipose tissue macrophage subtypes have been found to be involved in the occurrence and development of metabolic diseases such as atherosclerosis, diabetes, insulin resistance, and cancer. DARC+ and MFehi adipose tissue macrophage subtypes play a vital role in the treatment of non-alcoholic fatty liver disease, obesity insulin resistance, iron death, and other related metabolic diseases. The above studies further suggest that inflammatory disorders caused by externally infiltrated macrophages in obese adipose tissue are an important pathological basis for obesity-induced metabolic diseases. Further in-depth research on the characteristics of various subtypes has important theoretical and practical significance. [ABSTRACT FROM AUTHOR]

Background/aim: Obesity is the fifth largest risk factor of death in the world. The ceramide produced by obesity is closely related to insulin resistance (IR) caused by obesity. At present, the commercially available weight loss products have large side effects and limited therapeutic effects. Therefore, it is particularly important to find effective natural nontoxic products to treat obesity and explore its possible pathways and mechanisms. Materials and methods: In this paper, a high-fat diet (HFD) mice model was established by intragastric administration of high-fat emulsion to investigate the intervention effect of Gooseberry anthocyanins (GA) on IR in HFD mice. We used molecular docking technology to find the binding sites and binding energy of anthocyanins on CerS6. Real-time PCR was used to detect the effect of GA on the expression of IL-6 and TNF-a mRNA in HFD mice. The expression of S1P/Cer signaling pathway in HFD mice with IR was detected by Western Blot. Results: The results showed that GA could effectively inhibit visceral fat, liver index, the level of TC, TG and the level of LDL-C (p < 0.05), and improved HDL-C, GSH-Px and SOD (p < 0.05). GA decreased the level of insulin sensitivity index from -5.15 to -4.54 and improved insulin sensitivity and IR in HFD mice. The binding energy of anthocyanins on CerS6 was in the range of -8.2 to 5.2 kcal/mol, with low energy parameters and good binding positions. GA could reduce mRNA levels of inflammatory factors IL-6 and TNF-a (p < 0.05), inhibit the expression of CerS6, PKCζ, PPARγ, CD36 (p < 0.05), and enhance the expression of SphK2, Akt, p-Akt/Akt, ISR (p < 0.05). Conclusion: This study investigated the effect and mechanism of GA on reducing ceramide content and reducing IR in mice, and provided an experimental basis for the prevention and treatment of obesity-related diseases. [ABSTRACT FROM AUTHOR]

There have been many studies on the association between vitiligo and metabolic syndrome, while only few scientific papers on vitiligo and insulin resistance. In recent years, there have been significant developments in research to trace and understand the aetiology of both conditions. In this article we have analysed pathophysiological mechanisms and the association of insulin resistance (as a component of metabolic syndrome) and vitiligo. [ABSTRACT FROM AUTHOR]

Aim: Numerous studies have demonstrated a clear relationship between high triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) and decreased insulin sensitivity, nonalcoholic fatty liver disease, and metabolic syndrome. Dysglycemia may result from increased insulin sensitivity. No study has examined the relationship between this ratio and dysglycemia in the literature. In this study, we aimed to determine if the TG/HDL-C ratio of 2.27 would serve as a marker for detecting dysglycemia in the oral glucose tolerance test (OGTT). Materials and Methods: This study consists of a retrospective and cross-sectional analysis of 101 patients aged 8.93-17.79 years who were assessed for overweight and obesity in pediatric endocrine outpatient clinics and underwent oral glucose tolerance test as a screening tool for prediabetes and/or type 2 diabetes. The patients' anthropometric, physical examination, radiological and laboratory data were collected from the electronic and paper-based patient records. Results: In overweight and obese children, the TG/HDL-C ratios of 2.27 and higher were correlated with HOMA-IR and insulin levels, similar to previous studies (p <0.05). While basal fasting glucose was significantly higher in patients with dysglycemia (p< 0.05), there was no correlation between basal fasting insulin, HbA1C, TG/HDL-C ratio, BMI-SDS and dysglycemia. Conclusion: Although it was shown in this study that there is a relationship between an increased TG/HDL-C ratio and insulin level, no relationship was found with dysglycemia. [ABSTRACT FROM AUTHOR]

Skeletal muscle atrophy in type 2 diabetic patients causes loss of muscle strength and function, which has a serious impact on the physical and mental health of diabetic patients, further affecting their daily activities and leading to a reduced quality of life. skeletal muscle atrophy is induced by the presence of insulin resistance, chronic inflammation, and disorders of energy metabolism in type 2 diabetic patients, as well as by diabetic peripheral neuropathy. Mitochondria can produce reactive oxygen species to regulate apoptosis, which is also involved in skeletal muscle atrophy in diabetic patients. Therefore, this paper reviews the mechanisms related to diabetes-induced skeletal muscle atrophy and the research progress of exercise intervention in diabetic skeletal muscle atrophy at home and abroad, aiming to provide a theoretical basis for clinical and basic medical research on diabetic skeletal muscle atrophy. [ABSTRACT FROM AUTHOR]

Mild autonomous cortisol secretion (mACS) is a state of cortisol excess usually associated with existence of adrenal incidentaloma. Because of the lack of symptoms of the disease, the biochemical evaluation is the most important to determine a diagnosis. However, scientific societies have different diagnostic criteria for mACS, which makes the treatment of this disease and using results of original papers in daily practice more difficult. Chronic hypercortisolemic state, even if mild, may lead to diseases that are mostly connected with overt Cushing's syndrome. Some of them can cause a higher mortality of patients with mACS and those problems need to be addressed. In this review we describe the comorbidities associated with mACS: cardiovascular disorders, arterial hypertension, diabetes mellitus, insulin resistance, dyslipidemia, obesity, metabolic syndrome, non-alcoholic fatty liver disease, vertebral fractures and osteoporosis. The point of this paper is to characterise them and determine if and how these conditions should be managed. Two databases – PubMed and Web of Science were searched. Even though the evidence are scarce, this is an attempt to lead clinicians through the problems associated with this enigmatic condition. [ABSTRACT FROM AUTHOR]