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This non-randomized controlled trial aimed to compare the effect of the 5:2 diet on insulin levels as a primary outcome and markers of insulin secretion (connecting peptide (C-peptide) and insulin-like growth factor binding protein-1 (IGFBP-1)) and sensitivity (Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)), as well as body composition as secondary outcomes in overweight/obese individuals with and without type 2 diabetes (T2D). Ninety-seven participants (62% women), 35 with T2D and 62 BMI- and waist-matched controls without T2D, followed the 5:2 diet (two days per week of fasting) for six months with a 12-month follow-up. At six months, there was no loss to follow-up in the T2D group, whereas four controls discontinued this study. Overall, 82% attended the 12-month follow-up. After the intervention, insulin levels decreased in the control group and glucose decreased in the T2D group, while C-peptide, HOMA-IR, waist circumference, BMI, trunk, and total fat% decreased in both groups. Furthermore, low IGFBP-1, indicating hyperinsulinemia, improved in the T2D group. The changes in fasting glucose and waist measurement were significantly more improved in the T2D group than in the controls. Persistent positive effects were observed at the 12-month follow-up. The 5:2 diet for six months was feasible and efficient to reduce markers of insulin secretion and resistance and therefore holds promise as management of overweight/obesity in subjects with and without T2D. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum 25-hydroxyvitamin D [25 (OH)D], insulin growth factor binding protein 1 (IGFBP-1), signal transducer and activator of transcription 4 (STAT4) and spontaneous abortion in patients with severe preeclampsia (PE). Methods: 150 severe PE patients who were treated in the Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2022 were selected. Patients were divided into occurrence group (n=41) and non-occurrence group (n=109) according to whether spontaneous abortion occurred within 28 weeks of pregnancy. The levels of serum 25 (OH)D, IGFBP-1 and STAT4were compared between two groups. The clinical data in two groups were collected, and the influencing factors of spontaneous abortion in severe PE patients were analyzed by multivariate Logistic regression. The predictive value of serum 25 (OH)D, IGFBP-1 and STAT4 levels for spontaneous abortion in severe PE patients were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of 25 (OH)D and IGFBP-1 in occurrence group were lower than those in non-occurrence group, and the level of STAT4 was higher than that in non-occurrence group (P＜0.05). Spontaneous abortion in severe PE patients was not related to age, gestational age of PE onset, pre-pregnancy body mass index (BMI), delivery history, systolic blood pressure (SBP), diastolic blood pressure (DBP), platelet count (PLT) and creatinine (Scr) (P＞0.05), but was related to abortion history, D-dimer (D-D), albumin (ALB), homocysteine (Hcy) and fibrinogen (P＜0.05). Multivariate logistic regression analysis showed that, the decrease of 25 (OH)D, the decrease of IGFBP-1, the increase of STAT4, abortion history, the increase of D-D, the decrease of ALB and the increase of Hcy were the risk factors of spontaneous abortion in severe PE patients, while the increase of fibrinogen was the protective factor of spontaneous abortion in severe PE patients (P＜0.05). The area under the curve (AUC) of combined detection of serum 25 (OH)D, IGFBP-1 and STAT4 in predicting spontaneous abortion was 0.960, which was higher than that of single index prediction. Conclusion: The decrease of serum 25 (OH)D and IGFBP-1 and the increase of STAT4 level in severe PE patients are likely to lead to spontaneous abortion, the occurrence of spontaneous abortion is also relate to abortion history, D-D, ALB, Hcy, fibrinogen level and other factors. [ABSTRACT FROM AUTHOR]