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Type 2 diabetes mellitus (T2DM) has become a global epidemic. To effectively control T2DM, individuals must adhere to a high-quality diet that encompasses not only healthy dietary patterns but also promotes positive eating behaviors. We conducted a cross-sectional study on 314 patients with T2DM, and we evaluated the diet quality and also examined the associations between eating behavior, diet quality, and anthropometric and clinical factors in T2DM patients. We used the Diet Quality Index-International and Dutch Eating Behavior Questionnaire to assess dietary characteristics. We found that women had a significantly higher diet quality than men (61.40 vs. 58.68, p = 0.002) but were also more prone to emotional eating (2.00 vs. 1.53, p < 0.001) and restrained eating (2.39 vs. 2.05, p = 0.002). Restrained eating correlated with duration of diabetes (r = −0.169, p = 0.003), body mass index (r = 0.182, p = 0.001), and external eating with glycated hemoglobin (r = 0.114, p = 0.044). Patients with emotional eating had a higher vitamin C adequacy score (β = 0.117, p = 0.045). External eating was positively associated with grain adequacy (β = 0.208, p < 0.001) and negatively associated with empty-calorie food moderation score (β = −0.125, p = 0.032). For restrained eating, we found associations with vitamin C adequacy (β = −0.138, p = 0.017) and fruit adequacy (β = 0.125, p = 0.033). In conclusion, the results of this study provide valuable insight into dietary behavior and emphasize the importance of promoting healthy eating habits for T2DM patients. [ABSTRACT FROM AUTHOR]

Healthy dietary patterns during pregnancy are crucial for ensuring maternal and foetal health outcomes. Numerous methodologies exist for assessing the diet of pregnant women, including dietary patterns and various appraisal tools of diet quality. This study aimed to assess the dietary patterns and diet quality of pregnant women and to investigate the relationship between dietary patterns, diet quality estimators, and the adequacy of nutrient intake. EPIC FFQ was applied to a sample of 251 pregnant women, and questionnaires were interpreted with the FETA program. Dietary patterns were then determined by means of principal component analysis. Our results showed a substantial association between dietary patterns and total diet quality, as measured by the Diet Quality Index for Pregnancy (DQI-Pc), PURE Healthy Diet Score, and FIGO Diet Quality Score. We also found correlations between certain dietary patterns and particular nutrient intakes recommended by the European Food Safety Authority during pregnancy. The most deficient intake was registered for iron (86.1%), zinc (87.3%) and magnesium (79.3%), posing a threat to normal bone development, anaemia prophylaxis, and immune status. These results highlight the importance of assessing and understanding eating habits during pregnancy in order to achieve optimal outcomes for both the mother and the foetus. [ABSTRACT FROM AUTHOR]

Diet and eating behavior both play a crucial role in the prevention and management of type 2 diabetes mellitus (T2DM). The main objective of this study was to investigate the relationship between dietary intake and eating behavior in a population of patients with T2DM. A cross-sectional study was performed using 416 patients with T2DM and their dietary intake and eating behavior were assessed with validated questionnaires. Women scored significantly higher than men for emotional and restrained eating (p < 0.001). Correlation analyses showed that emotional eaters consumed significantly more calories (r = 0.120, p = 0.014) and fat (r = 0.101, p = 0.039), as well as non-alcoholic beverages for women (r = 0.193, p = 0.003) and alcohol for men (r = 0.154, p = 0.038). Also, individuals who ate based on external cues consumed significantly more calories (r = 0.188, p < 0.001) and fat (r = 0.139, p = 0.005). These results demonstrate that eating behavior influences dietary intake. Understanding this relationship could optimize diabetes management and allow for more individualized nutritional guidance. [ABSTRACT FROM AUTHOR]

The significance of dietary patterns during pregnancy is highlighted by accumulating evidence, emphasizing their pivotal role in promoting a healthy pregnancy for both the mother and the child. This study aimed to assess the current dietary patterns of pregnant women, compare the energy and nutrient intake of two distinct groups with a 10-year interval, and identify changes in dietary patterns. EPIC FFQ was applied, and its data were interpreted with the FETA program version 6 (CAMB/PQ/6/1205). By means of principal component analysis, three different food patterns were identified in each study group: vegetarian, balanced, and traditional (2013); and prudent, vegetarian, and modern (2023). Analyzing the relationship between food groups and gestational weight, we found that gestational weight gain in 2013 was positively correlated with eggs and egg dishes and milk and milk products, whereas in 2023, gestational weight gain was positively correlated with fats and oils, non-alcoholic beverages, and the modern pattern. Additionally, in 2023, pre-gestational BMI correlated positively with eggs and egg dishes. The balanced pattern emerged as a predictor for a lower likelihood of inadequate gestational weight gain in both groups. Furthermore, normal and overweight pregnant women showed a reduced likelihood of excessive gestational weight gain. [ABSTRACT FROM AUTHOR]

Obesity affects more than one billion people worldwide and often leads to cardiometabolic chronic comorbidities. It induces senescence-related alterations in adipose tissue, and senescence is closely linked to obesity. Fully elucidating the pathways through which vitamin D exerts anti-inflammatory effects may improve our understanding of local adipose tissue inflammation and the pathogenesis of metabolic disorders. In this narrative review, we compiled and analyzed the literature from diverse academic sources, focusing on recent developments to provide a comprehensive overview of the effect of vitamin D on inflammation associated with obesity and senescence. The article reveals that the activation of the NF-κB (nuclear factor kappa B subunit 1) and NLRP3 inflammasome (nucleotide-binding domain, leucine-rich-containing, pyrin domain-containing-3) pathways through the toll-like receptors, which increases oxidative stress and cytokine release, is a common mechanism underlying inflammation associated with obesity and senescence, and it discusses the potential beneficial effect of vitamin D in alleviating the development of subclinical inflammation. Investigating the main target cells and pathways of vitamin D action in adipose tissue could help uncover complex mechanisms of obesity and cellular senescence. This review summarizes significant findings related to opportunities for improving metabolic health. [ABSTRACT FROM AUTHOR]

Our paper proposes the first machine learning model to predict long-term mortality in patients with diabetic foot ulcers (DFUs). The study includes 635 patients with DFUs admitted from January 2007 to December 2017, with a follow-up period extending until December 2020. Two multilayer perceptron (MLP) classifiers were developed. The first MLP model was developed to predict whether the patient will die in the next 5 years after the current hospitalization. The second MLP classifier was built to estimate whether the patient will die in the following 10 years. The 5-year and 10-year mortality models were based on the following predictors: age; the University of Texas Staging System for Diabetic Foot Ulcers score; the Wagner–Meggitt classification; the Saint Elian Wound Score System; glomerular filtration rate; topographic aspects and the depth of the lesion; and the presence of foot ischemia, cardiovascular disease, diabetic nephropathy, and hypertension. The accuracy for the 5-year and 10-year models was 0.7717 and 0.7598, respectively (for the training set) and 0.7244 and 0.7087, respectively (for the test set). Our findings indicate that it is possible to predict with good accuracy the risk of death in patients with DFUs using non-invasive and low-cost predictors. [ABSTRACT FROM AUTHOR]

Cognitive disorders and dementia are still one of the most important cause of death and major disability globally, having an enormous financial and social burden on the healthcare system worldwide. Vitamin D is a secosteroid hormone that has antiinflammatory, antioxidant and regulates neurotransmitters and neurotrophins, by increasing neurotrophic factors such as nerve growth factor which further promotes brain health. Moreover, it is also helpful in the prevention of amyloid accumulation and promotes amyloid clearance. Besides the classical risk factors, vitamin D has been researched and studied as an etiology, prognosis factor and maybe a treatment resource in cognitive disfunctions, especially in dementia and Alzheimer’s disease. Its neuroprotective, neuroplasticity and neurotrophic effects have been already demonstrated and so, the aim of this review was to focus on recent studies and trials in order to synthesize the evidence about the possible contribution of low vitamin D in the etiology of cognitive disorders like dementia and Alzheimer’s disease and the effect of vitamin D supplementation in prevention and treatment of these conditions. [ABSTRACT FROM AUTHOR]

(1) Background: This study examines the survival of patients after their first presentation with diabetic foot ulcers (DFUs) to the regional Diabetes, Nutrition, and Metabolic Diseases Clinic within the Emergency Clinical Hospital "Sf. Spiridon", Iaşi, and analyzes the factors associated with this outcome. (2) Methods: In this retrospective study, patients with DFUs consecutively referred between 1 January 2007 and 31 December 2017 were followed up until 31 December 2020 (for 13 years). The study group included 659 subjects. (3) Results: During the study period, there were 278 deaths (42.2%) and the average survival time was 9 years. The length of hospitalization, diabetic nephropathy, chronic kidney disease, glomerular filtration rate, cardiovascular disease, hypertension, anemia, and DFU severity were the most significant contributors to the increase in mortality. Patients with severe ulcers, meaning DFUs involving the tendon, joint, or bone, had a higher mortality risk than those with superficial or pre-ulcerative lesions on initial presentation (Texas classification HR = 1.963, 95% CI: 1.063–3.617; Wagner–Meggitt classification HR = 1.889, 95% CI: 1.024–3.417, SINBAD Classification System and Score HR = 2.333, 95% CI: 1.258–4.326) after adjusting for confounding factors. (4) Conclusions: The findings of this study suggested that patients presenting with severe ulcers involving the tendon, joint, or bone exhibited a significantly higher risk of mortality, even when potential confounders were taken into consideration. [ABSTRACT FROM AUTHOR]

Modern lifestyles have led to sedentary behavior, lower participation in active movement and physical activities during leisure time, unhealthy diets, and increased exposure to stress. It is important to examine the interaction of several lifestyle risk factors instead of focusing on one alone. The purpose of this study was to identify lifestyle patterns in a group of patients with type 2 diabetes and the associations of its components with certain metabolic parameters. Using principal component analysis, we identified three dietary patterns: the prudent pattern (fat, oil, cereals, potatoes, vegetables, fish, nuts, seeds and fruits), the Western pattern (meat and meat products, eggs and soft drinks) and the traditional pattern (milk and its derivatives, soups and sauces, with a low intake of sugar/snacks). In addition, using the same method of analysis, we identified two lifestyle patterns: the inadequate lifestyle pattern (Western dietary pattern, increased hours of sleep and lower levels of stress) and the traditional lifestyle pattern (traditional dietary pattern, increased physical activity (PA) and non-smoking status). The inadequate lifestyle pattern was associated with younger age, hypertension and diabetic neuropathy. The traditional lifestyle pattern was related to lower postprandial blood glucose levels. Sedentary individuals were more likely to be over 65 years old and to have higher glycated hemoglobin (HbA1c). Smokers were also more likely to have inadequate glycemic and lipid profile control. [ABSTRACT FROM AUTHOR]

Intermittent fasting (IF) has been promoted as an alternative to dietary caloric restriction for the treatment of obesity. IF restricts the amount of food consumed and improves the metabolic balance by synchronizing it with the circadian rhythm. Dietary changes have a rapid effect on the gut microbiota, modulating the interaction between meal timing and host circadian rhythms. Our paper aims to review the relationships between IF and human gut microbiota. In this study, the primary area of focus was the effect of IF on the diversity and composition of gut microbiota and its relationship with weight loss and metabolomic alterations, which are particularly significant for metabolic syndrome characteristics. We discussed each of these findings according to the type of IF involved, i.e., time-restricted feeding, Ramadan fasting, alternate-day fasting, and the 5:2 diet. Favorable metabolic effects regarding the reciprocity between IF and gut microbiota changes have also been highlighted. In conclusion, IF may enhance metabolic health by modifying the gut microbiota. However additional research is required to draw definitive conclusions about this outcome because of the limited number and diverse designs of existing studies. [ABSTRACT FROM AUTHOR]

Hepatic diseases pose a significant public health concern. Regardless of the severity of hepatic fibrosis, treatment is recommended for all chronic hepatitis C virus (HCV) subjects. However, fibrosis and steatosis assessment remains crucial for evaluating the prognosis, progression, and hepatic disease monitoring, particularly following the treatment with direct-acting antivirals (DAAs). The aim of our study was to evaluate the impact of metabolic factors and the extent of hepatic fibrosis and fat accumulation in chronic HCV infection subjects. Additionally, another objective was to investigate modifications regarding fibrosis and steatosis three months after a successful sustained viral response (SVR). A total of 100 patients with compensated cirrhosis and chronic hepatitis C (CHC) were included in our study. These patients received treatment with DAA and underwent Fibromax assessment before and three months post SVR. After DAA treatment, a significant decrease was observed in the degree of hepatic fibrosis and hepatic steatosis. This regression was evident three months following the achievement of SVR. Chronic viral hepatitis C may trigger risk factors for metabolic syndromes, such as obesity and type 2 diabetes mellitus. Conclusions: It is crucial to monitor metabolic factors and take timely measures to prevent or treat metabolic syndrome in patients with chronic viral hepatitis C. [ABSTRACT FROM AUTHOR]

Background and Objectives: Non-alcoholic fatty liver disease is a worldwide significant public health problem, particularly in patients with type 2 diabetes mellitus. Identifying possible risk factors for the disease is mandatory for a better understanding and management of this condition. Patatin-like phospholipase domain-containing protein 3 (PNPLA3) has been linked to the development and evolution of fatty liver but not to insulin resistance. The aim of this study is to evaluate the relationships between PNPLA3 and fatty liver, metabolic syndrome and subclinical atherosclerosis. Materials and Methods: The study group consisted of patients with type 2 diabetes mellitus without insulin treatment. The degree of liver fat loading was assessed by ultrasonography, and subclinical atherosclerosis was assessed using carotid intima-media thickness (CIMT). PNPLA3 rs738409 genotype determination was performed by high-resolution melting analysis that allowed three standard genotypes: CC, CG, and GG. Results: Among the 92 patients, more than 90% showed various degrees of hepatic steatosis, almost 62% presented values over the normal limit for the CIMT. The majority of the included subjects met the criteria for metabolic syndrome. Genotyping of PNPLA3 in 68 patients showed that the difference between subjects without steatosis and subjects with hepatic steatosis was due to the higher frequency of genotype GG. The CC genotype was the most common in the group we studied and was significantly more frequent in the group of subjects with severe steatosis; the GG genotype was significantly more frequent in subjects with moderate steatosis; the frequency of the CG genotype was not significantly different among the groups. When we divided the group of subjects into two groups: those with no or mild steatosis and those with moderate or severe steatosis it was shown that the frequency of the GG genotype was significantly higher in the group of subjects with moderate or severe steatosis. PNPLA3 genotypes were not associated with metabolic syndrome, subclinical atherosclerosis, or insulin resistance. Conclusions: Our results suggest that PNPLA3 does not independently influence cardiovascular risk in patients with type 2 diabetes mellitus. The hypothesis that PNPLA3 may have a cardioprotective effect requires future confirmation. [ABSTRACT FROM AUTHOR]

Diabetes mellitus has a major impact on metabolism, inducing many complications and contributing to increased mortality. Such complications often represent complex disorders, such as the diabetic foot, one of the major causes of non-traumatic lower limb amputation. Bone turnover and skeletal integrity can be affected in diabetes, with diabetic bone disease as a long-standing complication of it. Alveolar bone loss is one of the main features of periodontal disease, and diabetes is one of the risk factors for this condition. The present review provides complex, up-to-date information on possible common pathogenic ways related to bone turnover in these two chronic conditions, and also on the direct link between persistent hyperglycaemia, inflammation and alveolar bone loss. [ABSTRACT FROM AUTHOR]

We conducted a narrative review on the interaction between dietary patterns with demographic and lifestyle variables in relation to health status assessment. The food pattern has the advantage of taking into account the correlations that may exist between foods or groups of foods, but also between nutrients. It is an alternative and complementary approach in analysing the relationship between nutrition and the risk of chronic diseases. For the determination of dietary patterns one can use indices/scores that evaluate the conformity of the diet with the nutrition guidelines or the established patterns (a priori approach). The methods more commonly used are based on exploratory data (a posteriori): cluster analysis and factor analysis. Dietary patterns may vary according to sex, socio-economic status, ethnicity, culture and other factors, but more, they may vary depending on different associations between these factors. The dietary pattern exerts its effects on health in a synergistic way or even in conjunction with other lifestyle factors, and we can therefore refer to a 'pattern of lifestyle'. [ABSTRACT FROM AUTHOR]

The white adipose tissue is no longer regarded as merely a means of storing excess energy. Presently recognized for their active and dynamic secretory activity, adipocytes are capable of releasing a plethora of molecules involved in maintaining global homeostasis. Connective tissue diseases, such as systemic lupus erythematosus, idiopathic inflammatory myopathies and systemic sclerosis encompass potentially severe multi-system involvement achieved through intricate pathogenic mechanisms. Autoimmunity holds a clear and central part in the development of these conditions. Adipokines (or adipocytokines) are peptides or proteins released by the adipose tissue. Data regarding the influence of adipokines on the pathogenesis of connective tissue diseases is currently insufficient, studies often reporting discrepant results. However, the proven impact of adipokines on the modulation of inflammatory processes raises the issue of developing new therapeutic solutions with potentially beneficial effects on disease-related changes under autoimmune conditions. [ABSTRACT FROM AUTHOR]

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aims. Risk score questionnaires for the screening of type 2 diabetes mellitus (DM) present high accuracy, especially the Finnish Diabetes Risk Score (FINDRISC). The aim of the study was to assess the FINDRISC score and its correlations with multiple markers of subclinical atherosclerosis in an asymptomatic urban population. Material and Methods. In the current prospective study, 111 randomized asymptomatic subjects, aged 35-75, were evaluated. FINDRISC score, the cardiovascular and metabolic risk profile were evaluated. Multiple markers of subclinical atherosclerosis were assessed including carotid intima-media thickness (IMT), ankle-brachial index (ABI), pulse wave velocity (PWV) and left ventricular mass index (LVMI). Results. Mean age was 51.87 ± 10.64 years while FINDRISC score was 10.53 ± 4.53. 77% of the subjects were overweight and all parameters of obesity were well associated with FINDRISC score (p<0.001). This asymptomatic population was dyslipidemic (total cholesterol 212.79±44.99 mg/dl). DM risk correlated with age, blood pressure, fasting plasma glucose and glomerular filtration rate. Increased FINDRISC was associated with IMT (r=0.24, p=0.01), PWV (r=0.26, p=0.008) or LVMI (r=0.23, p=0.01). Conclusions. This asymptomatic population was metabolically uncontrolled. Easily administered type 2 DM screening questionnaires should be routinely performed as increased risk score values are associated with subclinical atherosclerosis. [ABSTRACT FROM AUTHOR]

Background and aims. The aim of the study is to evaluate fluid intake during adolescence and correlate it with weight status. Material and methods. We assessed fluid intake using a validated questionnaire in a group of 106 adolescent students (22 boys - 20.8%), aged 15-19 years. Weight status was evaluated with the BMI-for-age values,using growth normograms. Results. There were no statistically significant differences in the frequency of water intake between sexes (p>0.05). Water intake at least 3 times a day was declared by 72.16% of normal weight students and in 66% of overweight and obese, the difference being statistically significant (p=0.003). Boys consumed larger amounts of water (p=0.042) than girls. Intake of 100% natural fruit juice was significantly higher in boys compared to girls (p=0.002). A significantly higher percentage of normal weight adolescents consumed≤500 mL/day non-carbonated (p=0.004) and carbonated (p<0.001) sugar-sweetened beverages compared to the overweight or obese, who consumed ≥500 mL/day. Conclusions. The quantitative and qualitative assessment of fluid intake among adolescents is a mandatory step in the assessment of calorie and nutritional intake. Promoting low-calorie fluid intake in this age group, along with the principles of healthy eating, could contribute to achieving an optimal weight status. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess nutritional status in a group of institutionalized elderly and to establish correlations between nutritional screening score and anthropometric parameters. We analyzed a sample of 156 seniors, 62 (39.7%) men, 94 (60.3%) women, to whom we performed nutritional screening using Mini Nutritional Assessment - MNA and we evaluated anthropometric parameters (body mass index - BMI, waist circumference - WC, calf circumference - CC and mid-upper arm circumference - MUAC). In the group of elderly institutionalized to whom the MNA has been applied, 69.2% had optimal nutritional status, 24.4% had a score of screening indicating risk of malnutrition and 6.4% had a screening score corresponding to malnutrition. A significantly higher percentage of women had a screening score indicating malnutrition (9.6% vs. 1.6%) and a screening score showing risk of malnutrition (26.6% vs. 21%) (p=0.029). Analysis by gender showed strong correlation between BMI and WC value (r = 0.869) in men, and between MUAC and CC value (r = 0.838) in women (p<0.001). Nutritional screening score was positively correlated with all anthropometric parameters (r>0.400, p<0.001), the strongest correlation being recorded with CC (r = 0.528). MNA short form (MNA-SF) represents a useful tool for rapid nutritional screening of elderly, enabling the identification of individuals at risk for malnutrition and those with a score indicating malnutrition. Calf circumference is a parameter which is positively correlated with nutritional screening score in institutionalized elderly population, and can be proposed as a starting point in nutritional assessment algorithm. [ABSTRACT FROM AUTHOR]

(1) Background: Obesity, part of the triple global burden of disease, is increasingly attracting research on its preventive and curative management. Knowledge of eating behavior can be useful both at the individual level (to individualize treatment for obesity) and the population level (to implement more suitable food policies). The Dutch Eating Behavior Questionnaire (DEBQ) is a widely used international tool to assess eating behavior, i.e., emotional, external and restricted eating styles. The aim of this study was to validate the Romanian version of DEBQ, as obesity is a major concern in Romania. (2) Methods: Our study tested the psychometric properties of the Romanian version of DEBQ on an adult population and explored the associations of eating behavior with weight status (3) Results: The study showed a factor load similar to the original version of the questionnaire and a very good internal validity (Cronbach's alpha fidelity coefficient greater than 0.8 for all scales of the questionnaire) for the Romanian version of DEBQ and showed that all of the scales positively correlated with body mass index in both men and women. (4) Conclusions: This study will enable the use of the DEBQ Romanian version on the adult population of Romania where the findings could be incorporated into developing better strategies to reduce the burden of nutrition-related diseases. [ABSTRACT FROM AUTHOR]

Connective tissue diseases (CTD) are a clinically and serologically diverse group of chronic immuno-inflammatory conditions whose complex pathomechanisms remain largely undefined. Adipokines (adipocitokines) are peptides or proteins which exhibit potential immunomodulatory properties. Recently, it has been stated that the secretory activity of white adipose tissue could play a notable role in the development or progression of certain types of disease-related organ injury in CTD, as demonstrated in both human subjects as well as animal models. In systemic lupus erythematosus, cathepsin-S and chemerin titers have been found to be higher in patients with neuropsychiartric manifestations, whereas omentin-1 levels has been found to have a lower expression in patients without kidney involvement. Moreover, the blockade of the cathepsin-S signaling pathway has been shown to associate with favorable outcomes in murine models of lupus nephritis. Research showed that patients with dermatomyositis may exhibit elevated circulating values of adiponectin and resistin, but not leptin. Additionally, visfatin gene expression was found to be higher in both adult and pediatric patients with dermatomyositis compared to healhy controls. In animal models of systemic sclerosis, adiponectin (which is thought to be a predominantly anti-inflammatory adipokine) has been associated with reduced fibrotic changes. While the results reported in the currently available literature do not imply causation, the issue of elucidating the link between adipokine expression and CTD pathogenesis remains intriguing. [ABSTRACT FROM AUTHOR]