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The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8 weeks, 3 days a week. Study variables were measured 48 hr before and after the intervention. After 8 weeks of multicomponent training, adropin (p =.01), nitric oxide (p =.01), and maximal oxygen uptake (VO2max; p =.002) increased, and glucose (p =.001), insulin (p =.001), insulin resistance (p =.01), systolic blood pressure (p =.01), and sleep disorders (p =.01) decreased significantly. Also, Pearson's test results showed a significant inverse relationship between adropin level (p =.01 and r = −.55) and glucose (p =.01 and r = −.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults. [ABSTRACT FROM AUTHOR]

This study investigated the test–retest reliability of running economy (RE) and metabolic and cardiorespiratory parameters related to endurance running performance using a multistage incremental treadmill test. On two occasions separated by 21–28 days, 12 male middle- and long-distance runners ran at 10, 11, 12, 13, and 14 km/hr for 8 min each stage, immediately followed by a ramp test to volitional exhaustion. Carbohydrate (10% maltodextrin solution) was consumed before and during the test to provide ∼1 g/min of exercise. RE, minute ventilation ( V ˙ E), oxygen consumption ( V ˙ O 2 ), carbon dioxide production ( V ˙ CO 2 ), respiratory exchange ratio (RER), heart rate (HR), ratings of perceived exertion (RPE), and blood glucose and lactate concentrations were recorded for each stage and at volitional exhaustion. Time-to-exhaustion (TTE) and peak oxygen consumption ( V ˙ O 2 peak) during the ramp test were also recorded. Absolute reliability, calculated as the coefficient of variation (CV) between repeated measures, ranged from 2.3% to 3.1% for RE, whereas relative reliability, calculated as the intraclass correlation coefficient (ICC), ranged from.42 to.79. V ˙ E , V ˙ O 2 , V ˙ O 2 peak , V ˙ CO 2 , RER, and HR had a CV of 1.1%–4.3% across all stages. TTE and RPE had a CV of 7.2% and 2.3%–10.8%, respectively, while glucose and lactate had a CV of 4.0%–17.8%. All other parameters, except for blood glucose, were demonstrated to have good-to-excellent relative reliability assessed by ICC. Measures of RE, V ˙ O 2 peak , and TTE were reliable during this two-phase multistage incremental treadmill test in a cohort of trained and highly trained male middle- and long-distance runners. [ABSTRACT FROM AUTHOR]

A plasma refractive index sensor based on metal–insulator–metal waveguide-coupled analogy T-shaped with double-ring resonators was designed. The transmission characteristics of the waveguide were investigated using the finite-difference time-domain method with perfectly matched layer absorbing boundary conditions. By optimizing the structure parameters, the sensor obtained the maximum sensitivity (S) of 1110 nm/RIU and the maximum figure of merit of 1904. The results demonstrate that this new structure can generate dual Fano resonances and exhibit typical refractive index sensing functionality, which provides valuable insights into the design and optimization of plasma refractive index sensors. Additionally, by measuring the concentration of plasma solution and glucose solution, it has been proven that the structure has the prospect of practical application. [ABSTRACT FROM AUTHOR]

Carbohydrate (CHO) supplementation during endurance exercise can improve performance. However, it is unclear whether low glycemic index (GI) CHO leads to differential ergogenic and metabolic effects compared with a standard high GI CHO. This study investigated the ergogenic and metabolic effects of CHO supplementation with distinct GIs, namely, (a) trehalose (30 g/hr), (b) isomaltulose (30 g/hr), (c) maltodextrin (60 g/hr), and (d) placebo (water). In this double-blind, crossover, counterbalanced, placebo-controlled study, 13 male cyclists cycled a total of 100 min at varied exercise intensity (i.e., 10-min stages at 1.5, 2.0, and 2.5 W/kg; repeated three times plus two 5-min stages at 1.0 W/kg before and after the protocol), followed by a 20-min time trial on four separated occasions. Blood glucose and lactate (every 20 min), heart rate, and ratings of perceived exertion were collected throughout, and muscle biopsies were taken before and immediately after exercise. The results showed that trehalose improved time-trial performance compared with placebo (total work done 302 ± 39 vs. 287 ± 48 kJ; p =.01), with no other differences between sessions (all p ≥.07). Throughout the 100-min protocol, blood glucose was higher with maltodextrin compared with the other supplements at all time points (all p <.05). Heart rate, ratings of perceived exertion, muscle glycogen content, blood glucose, and lactate were not different between conditions when considering the 20-min time trial (all p >.05). Trehalose supplementation throughout endurance exercise improved cycling performance and appears to be an appropriate CHO source for exercise tasks up to 2 hr. No ergogenic superiority between the different types of CHO was established. [ABSTRACT FROM AUTHOR]

This study sought to investigate the effect of cold ambient temperature on subcutaneous abdominal adipose tissue (SCAAT) lipolysis and blood flow during steady-state endurance exercise in endurance-trained cyclists. Ten males (age: 23 ± 3 years; peak oxygen consumption: 60.60 ± 4.84 ml·kg−1·min−1; body fat: 18.4% ± 3.5%) participated in baseline lactate threshold (LT) and peak oxygen consumption testing, two familiarization trials, and two experimental trials. Experimental trials consisted of cycling in COLD (3 °C; 42% relative humidity) and neutral (NEU; 19 °C; 39% relative humidity) temperatures. Exercise consisted of 25 min cycling at 70% LT and 25 min at 90% LT. In situ SCAAT lipolysis and blood flow were measured via microdialysis. Heart rate, core temperature, carbohydrate and fat oxidation, blood glucose, and blood lactate were also measured. Heart rate, core temperature, oxygen consumption, and blood lactate increased with exercise but were not different between COLD and NEU. SCAAT blood flow did not change from rest to exercise or between COLD and NEU. Interstitial glycerol increased during exercise (p <.001) with no difference between COLD and NEU. Fat oxidation increased (p <.001) at the onset of exercise and remained elevated thereafter with no difference between COLD and NEU. Carbohydrate oxidation increased with increasing exercise intensity and was greater at 70% LT in COLD compared to NEU (p =.030). No differences were observed between conditions for any other variable. Cycling exercise increased SCAAT lipolysis but not blood flow. Ambient temperature did not alter SCAAT metabolism, SCAAT blood flow, or fat oxidation in well-trained cyclists, though cold exposure increased whole-body carbohydrate oxidation at lower exercise intensities. [ABSTRACT FROM AUTHOR]

Purpose: Fran is one of the most popular CrossFit benchmark workouts used to control CrossFitters' improvements. Detailed physiological characterization of Fran is needed for a more specific evaluation of CrossFitters' training performance improvements. The aim of the study was to analyze the oxygen uptake ( V ˙ O 2 ) kinetics and characterize the energy system contributions and the degree of postexercise fatigue of the unbroken Fran. Methods: Twenty trained CrossFitters performed Fran at maximal exertion. V ˙ O 2 and heart-rate kinetics were assessed at baseline and during and post-Fran. Blood lactate and glucose concentrations and muscular fatigue were measured at baseline and in the recovery period. Results: A marked increase in V ˙ O 2 kinetics was observed at the beginning of Fran, remaining elevated until the end (V ˙ O 2 peak : 49.2 [3.7] mL·kg−1·min−1, V ˙ O 2 amplitude: 35.8 [5.2] mL·kg−1·min−1, time delay: 4.7 [2.5] s and time constant: 23.7 [11.1] s; mean [SD]). Aerobic, anaerobic lactic, and alactic pathways accounted for 62% (4%), 26% (4%), and 12% (2%) of energy contribution. Reduction in muscle function in jumping ability (jump height: 8% [6%], peak force: 6% [4%], and maximum velocity: 4% [2%]) and plank prone test (46% [20%]) was observed in the recovery period. Conclusions: The Fran unbroken workout is a high-intensity effort associated with an elevated metabolic response. This pattern of energy response highlights the primary contribution of aerobic energy metabolism, even during short and very intense CrossFit workouts, and that recovery can take >24 hours due to cumulative fatigue. [ABSTRACT FROM AUTHOR]

Background: Investigating the effects of breaking up sedentary behavior with short bouts of Yoga and Tai-Chi on glycemic control, concentration, and well-being in healthy individuals. Methods: In this randomized balanced incomplete block study, 15 adults (age = 26 [2.50] y, 8 females) completed 2 of 3 protocols: uninterrupted sitting (Control), sitting interrupted with 3 minutes of Yoga every 30 minutes, or with 3 minutes of Tai-Chi every 30 minutes. Protocols lasted 7.5 hours and included a standardized diet. Glucose was measured every 30 minutes with a glucometer (Abbott FreeStyle Libre). Concentration and well-being were recorded with self-reported ecological momentary assessment. Area under the curve was calculated for glucose data. Statistical analyses were performed as a hierarchical repeated-measures model. Results: Glucose area under the curve for the Yoga intervention (34.55 [3.12] mmol/L) was significantly lower than the Control (38.14 [3.18] mmol/L; P <.05). There was a trend toward lower glucose in the Tai-Chi group compared with the Control, but no significant differences were found (AUCTai-Chi = 36.64 [3.11] mmol/L; P =.57). Mean concentration in all groups decreased throughout the day, with the largest decrease in the Control. Well-being for the Yoga and Control groups decreased but increased with Tai-Chi. Concentration and well-being responses were not statistically significant between intervention groups. Conclusions: Breaking up sedentary behavior using 3-minute bouts of Yoga significantly lowers blood glucose in healthy individuals without compromising concentration or well-being. Tai-Chi did not provide the same significant effect on glucose levels but allowed better maintenance of concentration and well-being. These interventions provide effective ways to combat the deleterious effects of prolonged sedentary time while maintaining concentration and well-being. [ABSTRACT FROM AUTHOR]

Background: Physical activity of any amount results in substantial health benefits. However, public awareness of physical activity benefits in chronic diseases is inadequate in India. Prediabetes is a significant health issue on a global scale. Visceral fat (VF) is considered as an early predictor of prediabetes. Ethnicity and race have a substantial impact on VF. Hence, this study intended to evaluate the effect of a customized physical activity promotion program on VF and glycemic parameters in individuals with prediabetes. Methods: In the current, parallel group randomized controlled trial, a total of 158 participants were recruited: 79 in intervention and 79 in control group. The study included the prediabetes individuals based on American Diabetes Association criteria. Participants from the intervention group received the customized physical activity promotion program for 24 weeks. The primary outcome measures of the study were VF level and glycemic parameters that included fasting blood sugar and glycosylated hemoglobin. Two-way mixed analysis of variance was used to study the mean difference of an outcome between 2 groups over time. Results: The study found a statistically significant interaction between the intervention and times on VF level, F1,136 = 23.564, fasting blood sugar levels, F1,136 = 8.762, and glycosylated hemoglobin levels, F1,136 = 64.582 at the end of 24 weeks (P <.05). Conclusions: This study concluded that a customized physical activity promotion program was effective in reducing VF in individuals with prediabetes as compared with controls. It improved glycemic control by reducing fasting blood sugar and glycosylated hemoglobin levels. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the effect of exercise intensity on the proportion and rate of carbohydrate oxidation and glucoregulatory hormone responses during recovery from exercise. Six physically active participants completed 1 hr of low-intensity (LI; 50% lactate threshold) or moderate-intensity (MI; 100% lactate threshold) exercise on separate days following a randomized counterbalanced design. During exercise and for 6 hr of recovery, samples of expired air were collected to determine oxygen consumption, respiratory exchange ratio, energy expenditure, and substrate oxidation rates. Blood samples were also collected to measure glucoregulatory hormones (catecholamines, GH) and metabolites (glucose, free fatty acids, lactate, pH, and bicarbonate). During exercise, respiratory exchange ratio, energy expenditure, and the proportion and rate of carbohydrate (CHO) oxidation were higher during MI compared with LI. However, during recovery from MI, respiratory exchange ratio and the proportion and rate of CHO oxidation were lower than preexercise levels and corresponding LI. During exercise and early recovery, catecholamines and growth hormone were higher in MI than LI, and there was a trend for higher levels of free fatty acids in the early recovery from MI compared with LI. In summary, CHO oxidation during exercise increases with exercise intensity but there is a preference for CHO sparing (and fat oxidation) during recovery from MI exercise compared with LI exercise. This exercise intensity-dependent shift in substrate oxidation during recovery is explained, in part, by the pattern of change of key glucoregulatory hormones including catecholamines and growth hormone and plasma fatty acid concentrations. [ABSTRACT FROM AUTHOR]

Guarana (GUA) seed extract, containing caffeine (CAF) and additional bioactive compounds, may positively affect mental performance, but evidence regarding exercise is limited. This investigation assessed acute GUA ingestion compared with CAF on endurance performance. Eleven endurance-trained noncyclists and cyclists (V ˙ O 2 peak = 49.7 ± 5.9, 60.4 ± 4.6 ml·kg·min−1) completed a double-blind, crossover experiment after ingesting (a) 100 mg CAF, (b) 500 mg GUA (containing 130 mg CAF), or (c) placebo (P) prior to 60-min fixed cycling workload (FIX) + 15-min time trial. Oxygen uptake, heart rate, respiratory exchange ratio, blood glucose, and lactate were not different (p ≥.052) during FIX. A significant interaction (p =.042) for perceived exertion was observed at 50-min FIX with lower rating (p =.023) for GUA versus CAF but not compared with P. Work accumulated over 15-min time trial was greater (p =.038) for GUA versus P due to higher early (1–11 min) work outputs. Work performance favored (effect size = 0.18; 95% confidence interval [0.003, 0.355], p =.046) GUA (241.4 ± 39.9 kJ) versus P (232.1 ± 46.6 kJ), but CAF (232.3 ± 43.9) was not different from GUA (effect size = 0.19; 95% confidence interval [−0.022, 0.410], p =.079) or P. Postexercise strength loss was not attenuated with GUA (−5.6 ± 8.5%) or CAF (−8.3 ± 9.4%) versus P (−10.3 ± 5.1%). Acute GUA ingestion improved work performance relative to P, but effects were trivial to small and unrelated to altered substrate oxidation or muscular strength. Ergogenicity may involve central mechanisms reducing perceived effort with GUA (containing 130 mg caffeine). Due to issues related to identical matching of dosage, whether GUA confers additional benefits beyond its CAF content cannot be determined at present. [ABSTRACT FROM AUTHOR]

We designed to evaluate the effects of resistance elastic band exercises (REBEs) on cardiometabolic/obesity-related biomarkers in older females with osteosarcopenic obesity. Sixty-three patients (aged 65–80 years) with osteosarcopenic obesity and a body mass index exceeding 30 kg/m2 were enrolled in the study. The participants were randomly assigned to either an experimental group (REBE, n = 32) or a usual care group (n = 31). The experimental group completed a 12-week REBE program, three times a week and 60 min per session. There were decreases in lipid accumulation product (p =.033), visceral adipose index (p =.001), triglyceride-glucose-body mass index (p =.034), and atherogenic index of plasma (p =.028) in the experimental group compared with the usual care group. Our findings highlight the importance of an REBE program in improving combined cardiometabolic/obesity-related indices in older women with osteosarcopenic obesity. The incorporation of an REBE program may benefit individuals who are unable to tolerate or participate in more strenuous exercise programs. [ABSTRACT FROM AUTHOR]

Several randomized controlled trials (RCTs) have investigated the effects of fermented foods on metabolic outcomes in adult patients suffering from diabetes and prediabetes. However, the results of these RCTs are conflicting. This systematic review and meta-analysis was carried out on data from RCTs to evaluate the effects of fermented foods in patients with diabetes and prediabetes. The PubMed, Web of Science, Embase, the Cochrane Library and Scopus databases were searched up to 21 June, 2022. English-language RCTs of fermented foods consumption were included which gave metabolic outcomes on body composition, glucose control, insulin sensitivity, lipid profile, as well as blood pressure. Eighteen RCTs met the inclusion criteria and 843 participants were included in the final analysis. The pooled results showed a significant reduction of fasting blood glucose (FBG), the homeostatic model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), low density lipid cholesterol (LDL-C) and diastolic blood pressure (DBP) in the intervention group versus the control group. The results of this research showed that fermented foods have the potential to improve some metabolic outcomes, including FBG, HOMA-IR, TC, LDL-C, and DBP in patients with diabetes and prediabetes. [ABSTRACT FROM AUTHOR]

The question of whether zinc supplementation may improve cardio-metabolic health in patients with type 2 diabetes mellitus (T2DM) remains controversial and require further evaluation. This study aimed to summarize the effectiveness of oral zinc supplementation in improving cardio-metabolic risk markers in people with T2DM. We searched PubMed, Scopus, and Web of Science from inception to April 2023, for randomized controlled trials (RCTs). RCTs of type 2 diabetic adults (aged ≥18 years) comparing zinc supplementation with placebo were included. We excluded studies if not randomized, involved co-supplementation, and were conducted in children or pregnant women. Glycemic indices, lipid profiles, blood pressure, anthropometric measure, c-reactive protein (CRP), creatinine, and serum zinc were extracted. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods. We used a random-effect model to perform the dose-response analysis. Effect sizes were presented as mean difference (MD) and 95% confidence interval (CI). 22 studies (n = 1442 participants) were included. The certainty of the evidence was rated as moderate to high. Zinc supplementation significantly reduced glycemic indices: including two-hour postprandial glucose (2hpp) (mean difference (MD): −34.34 mg/dl; 95%CI: −51.61∼ −17.07), fast blood sugar (FBS) (MD: −23.32 mg/dl; 95% CI: −33.81∼ −12.83), and hemoglobin A1c (HbA1c) (MD: −0.47; 95% CI: −0.71∼ −0.23). Zinc had a favorable effect on lipid profiles low-density lipoprotein (LDL) (MD: −10.76 mg/dl; CI: −17.79∼−3.73), triglyceride (TG) (MD: −18.23 mg/dl; CI: −32.81∼−3.65), total cholesterol (TC) (MD: −12.74 mg/dl; CI: −21.68∼−3.80), VLDL (MD: −5.39 mg/dl; CI: −7.35∼−3.43) and high-density lipoprotein (HDL) (MD: 4.04 mg/dl; CI: 0.96 ∼ 7.12). Systolic blood pressure (SBP) (MD): −3.64 mmHg; 95% CI: −6.77∼ −0.52), weight (MD: 1.00 kg; 95% CI: 0.34∼1.66), CRP (MD: −3.37 mg/l, 95% CI: −4.05∼ −2.70), and serum zinc (MD: 15.38 µg/dl; 95% CI: 10.74∼ 20.02) changed to a statistically significant extent with zinc supplementation. There was also a linear association between additional 10 mg/d zinc treatment with FBS, HbA1c, HDL, LDL, TG, TC, and serum zinc. A non-linear dose-response gradient was seen for FBS, HDL, and SBP (p < 0.05). Egger's test showed no substantial publication bias. Our findings strongly suggest a potential beneficial effect of zinc supplementation on type 2 diabetic patients. Further high-quality research is needed to determine the optimal form, dosage, and duration of zinc supplementation for this population. [ABSTRACT FROM AUTHOR]

Pea (Pisum sativum L.), a widely cultivated legumes globally, is attracting interest as a functional food owing to its antioxidant properties derived from nutritional components such as polyphenols. We previously reported that yellow pea-based pasta (YPP) aids in controlling blood glucose and enhances the sensitivity to saltiness. This study examined the antioxidant effect of YPP and its effects on the salt intake and postprandial blood glucose levels by simulating a real-life scenario. In this open, parallel-group, randomized controlled trial, 40 healthy adult men and women aged 20–65 years, whose salt intake exceeded the target salt equivalent level of the Japanese dietary intake standard, were allocated to the following groups (n = 20): the group consuming one serving of YPP per day and the group maintaining their regular daily dietary habits. The participants who were allocated to the YPP group showed significantly improved oxidative stress markers (BAP/d-ROMs ratio change: control = − 0.11, YPP = 0.27, p = 0.044; lipid peroxide change: control = 0.11, YPP = − 0.25, p < 0.001) than control participants. The effects on salt intake and blood glucose levels were limited. In conclusion, YPP may serve as a functional staple food that improves oxidative stress. [ABSTRACT FROM AUTHOR]

Introduction: Contradictory claims about the efficacy of several medicinal plants to promote glycemic control in patients with type 2 diabetes mellitus (T2DM) have been explained by divergences in the administration form and by extrapolation of data obtained from healthy individuals. It is not known whether the antidiabetic effects of traditional herbal medicines are influenced by gelatin capsules. This randomized crossover trial aimed to evaluate the acute effect of a single dose of raw cinnamon consumed orally either dissolved in water as a beverage or as ordinary hard gelatin capsules on postprandial hyperglycemia (>140 mg/dL; >7.8 mmol/L) in T2DM patients elicited by a nutritionally-balanced meal providing 50 g of complex carbohydrates. Methods: Fasting T2DM patients (n = 19) randomly ingested a standardized meal in five experimental sessions, one alone (Control) and the other after prior intake of 3 or 6 g of crude cinnamon in the form of hard gelatin capsules or powder dissolved in water. Blood glucose was measured at fasting and at 0.25, 0.5, 0.75, 1, 1.5 and 2 hours postprandially. After each breakfast, its palatability scores for visual appeal, smell and pleasantness of taste were assessed, as well as the taste intensity sweetness, saltiness, bitterness, sourness and creaminess. Results: The intake of raw cinnamon dissolved in water, independently of the dose, decreased the meal-induced large glucose spike (peak-rise of +87 mg/dL and Δ1-hour glycemia of +79 mg/dL) and the hyperglycemic blood glucose peak. When cinnamon was taken as capsules, these anti-hyperglycemic effects were lost or significantly diminished. Raw cinnamon intake did not change time-to-peak or the 2-h post-meal glycaemia, but flattened the glycemic curve (lower iAUC) without changing the shape that is typical of T2DM patients. Conclusions: This cinnamon's antihyperglycemic action confirms its acarbose-like property to inhibit the activities of the carbohydrate-digesting enzymes α-amylases/α-glucosidases, which is in accordance with its exceptionally high content of raw insoluble fiber. The efficacy of using raw cinnamon as a diabetes treatment strategy seems to require its intake at a specific time before/concomitantly the main hyperglycemic daily meals. Trial registration: Registro Brasileiro de Ensaios Clínicos (ReBEC), number RBR-98tx28b. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion The aim of this study is to look into the clinical and biochemical outcomes of D3K2 supplementation in addition to nonsurgical periodontal treatment (NSPT) for patients suffering from diabetes mellitus (DM) and periodontitis.Thirty‐eight participants with DM and periodontitis were randomized into two different groups. The test group provided NSPT with D3K2 whereas the control group received NSPT with placebo. Clinical periodontal parameters were recorded and serum and gingival crevicular fluid (GCF) were sampled at baseline and at the third and the sixth months after treatment. Glycated hemoglobin A1c (HbA1c), fasting blood glucose (FBG), 25(OH)D3, parathyroid hormone (PTH), calcium (Ca) and magnesium (Mg) values were determined in blood samples. GCF and serum interleukin (IL)‐1β and IL‐10 levels were analyzed using enzyme‐linked immunosorbent assay.All clinical periodontal parameters were importantly decreased at the third and sixth months after treatment compared to baseline in both groups. At the sixth month, 25(OH)D3 levels in the test group were observed to be statistically significantly higher than in the control group (p = 0.02). Serum IL‐1β showed a statistically significant decrease at the sixth month compared to baseline and the third month in control group.According to this study, there is limited additional benefit of D3K2 given with NSPT in individuals with DM and periodontitis. [ABSTRACT FROM AUTHOR]

Background: Abnormalities in biochemical parameters and changes in eating habits are considered complications of obesity. Oleoylethanolamide (OEA), an endocannabinoid-like compound, has been shown to have protective effects on many metabolic disorders. Given this evidence, the present study aimed to assess the effects of OEA on lipid profile parameters, fasting blood sugar (FBS), and dietary habits in healthy obese people. Methods: In this randomized, double-blind, placebo-controlled clinical trial, which was carried out in 2016 in Tabriz, Iran, 60 obese people were enrolled in the study based on inclusion criteria. The intervention group consumed 125 mg of OEA capsules, and the placebo group received the same amount of starch twice for 8 weeks. Blood samples (5 mL) were taken at baseline and the end of the study in a fasting state. Serum concentrations of FBS, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC) were measured by enzymatic methods using commercial kits. The low-density lipoprotein cholesterol (LDL-C) concentration was obtained using the Friede-Wald formula. To assess dietary habits, a food frequency questionnaire (147 items) was used at baseline and the end of the study. A value less than < 0.05 was considered to indicate statistical significance. Results: The TG concentration decreased significantly in the intervention group (mean (SD): 166.29 (70.01) mg/dL to 142.22 (48.05) mg/dL, p = 0.047). Changes in the placebo group were not significant (p > 0.05). After adjusting for baseline values and demographic characteristics, the difference in TG between groups remained significant (p = 0.044). Changes in other biochemical parameters were not significant. There was no significant difference between or within groups in terms of food groups. Conclusion: OEA, as a complementary agent, plays a protective role in TG regulation. However, future studies with longer durations are needed to explore the impact of OEA on regulating dietary habits and to identify the mechanisms related to metabolic abnormalities in obese people. Trial Registration: The study was registered in the Iranian Registry of Clinical Trials (IRCT) center as IRCT201607132017N30 with URL. www.IRCT.IR in date 03/10/2016. [ABSTRACT FROM AUTHOR]

Latent Autoimmune Diabetes in Adults (LADA) is a type of diabetes mellitus often overlooked in clinical practice for its dual resemblance to Type 1 Diabetes Mellitus (T1DM) in pathogenesis and to Type 2 Diabetes Mellitus (T2DM) in clinical presentation. To better understand LADA's distinctiveness from T1DM and T2DM, we conducted a comprehensive review encompassing etiology, pathology, clinical features, treatment modalities, and prognostic outcomes. With this comparative lens, we propose that LADA defies simple classification as either T1DM or T2DM. The specific treatments for the disease are limited and should be based on the therapies of T1DM or T2DM that address specific clinical issues at different stages of the disease. It is crucial to identify LADA cases potentially misdiagnosed as T2DM, warranting prompt screening for poor blood sugar control, short-term blood sugar deterioration, and other conditions. If the prognosis for LADA is similar to T2DM, it can be managed as T2DM. However, if the prognosis fundamentally differs, early LADA screening is crucial to optimize patient outcomes and enhance research on tailored treatments. The pathogenesis of LADA is clear, so the prognosis may be the key to determining whether it can be classified as T2DM, which is also the direction of future research. On the one hand, this paper aims to provide suggestions for the clinical screening and treatment of LADA based on the latest progress and provide worthy directions for future research on LADA. [ABSTRACT FROM AUTHOR]

Background: To analyze the association between the hemoglobin glycation index (HGI) and the long-term prognosis of patients with coronary artery disease (CAD). Methods: HGI represented the difference between laboratory measured Hemoglobin A1c (HbA1c) and predicted HbA1c based on a liner regression between Hb1Ac and fasting plasma glucose (FPG). A total of 10 598 patients who treated with percutaneous coronary intervention (PCI) were stratified into three groups (low HGI group: HGI<-0.506, medium HGI group: -0.506 ≤ HGI < 0.179, and high HGI group: HGI ≥ 0.179). The primary endpoints includes all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs). Results: A total of 321 ACMs, 243 CMs, 774 MACEs, and 854 MACCEs were recorded during a 60-month follow-up period. After adjusting for confounders using a multivariate Cox regression analysis, the patients in the low HGI group had a significantly increased risk of ACM (adjusted HR = 1.683, 95%CI:1.179–2.404, P = 0.004) and CM (HR = 1.604, 95%CI:1.064–2.417, P = 0.024) as compared with patients in the medium HGI group. Similarly, the patients in the high HGI group had an increased risk of MACEs (HR = 1.247, 95% CI: 1.023–1.521, P = 0.029) as compared with patients in the medium HGI group. For ACM, CM, and MACEs, a U-shaped relation were found among these three groups. However, we did not find significant differences in the incidence of MACCEs among these three groups. Conclusion: The present study indicates that HGI could be an independent predictor for the risk of mortality and MACEs in patients with CAD. [ABSTRACT FROM AUTHOR]

Cellular bioenergetics and mitochondrial dynamics are crucial for the secretion of insulin by pancreatic beta cells in response to elevated levels of blood glucose. To elucidate the interactions between energy production and mitochondrial fission/fusion dynamics, we combine live-cell mitochondria imaging with biophysical-based modeling and graph-based network analysis. The aim is to determine the mechanism that regulates mitochondrial morphology and balances metabolic demands in pancreatic beta cells. A minimalistic differential equation-based model for beta cells is constructed that includes glycolysis, oxidative phosphorylation, calcium dynamics, and fission/fusion dynamics, with ATP synthase flux and proton leak flux as main regulators of mitochondrial dynamics. The model shows that mitochondrial fission occurs in response to hyperglycemia, starvation, ATP synthase inhibition, uncoupling, and diabetic conditions, in which the rate of proton leakage exceeds the rate of mitochondrial ATP synthesis. Under these metabolic challenges, the propensities of tip-to-tip fusion events simulated from the microscopy images of the mitochondrial networks are lower than those in the control group and prevent the formation of mitochondrial networks. The study provides a quantitative framework that couples bioenergetic regulation with mitochondrial dynamics, offering insights into how mitochondria adapt to metabolic challenges. A study combined experiments, image analysis and mathematical modeling to understand the coupling between bioenergetics and mitochondrial dynamics and investigates how excess nutrients and starvation affect mitochondrial morphology. [ABSTRACT FROM AUTHOR]

Diabetes self-care activities are essential for achieving optimal glycemic control. However, little investigation has been conducted in Ethiopia to evaluate the relationship between the rate glycemic controland self-care activities among patients with type 2 diabetes mellitus (T2DM). Therefore, this study was conducted to assess self -care activities and their association with glycemic control among patients with T2DM in Northwest Ethiopia general hospitals. This multicenter cross-sectional study was conducted in Northwest Ethiopia general hospitals diabetic clinics. Diabetes self-care activities were measured using the Amharic version of the Summary of Diabetes Self-Care Activities (SDSCA-Amharic). Glycated hemoglobin (HbA1c) were used to assess the rate of glycemic control. A linear regression model was used to identify predictors of self-care activities and glycemic control. P-value of < 0.05 at 95% confidence interval (CI) was considerd as statistically significant. Of 413 participants included in the final analysis, two-thirds (66.3%) had poor glycemic control, with a mean HbA1c of 7.94% (SD = 1.75). Blood glucose testing was the most important self-care activity domain for predicting better glycemic control [β=-0.36, 95% CI (-0.48, -0.24); P = 0.0001] followed by diet [β=-0.29, 95% CI (-0.39, -0.083); P = 0.0001], foot-care [β=-0.28, 95% CI (-0.3, -0.061); P = 0.003], and physical activity [β=-0.27, 95% CI (-0.29, -0.056); P = 0.004], respectively. Moreover, unable to read and write [β = 0.72, 95% CI (0.57, 3.8); P = 0.037], overweight [β = 0.32, 95% CI (0.011, 0.62); P = 0.042], obesity [β = 0.67, 95% CI (0.39, 0.94); P = 0.0001], and low level of medication adherence [β = 0.7, 95% CI (0.39, 1.1); P = 0.0001] were significant predictors of poor glycemic control. Previous diabetes education [β=-0.88, 95% CI (-1.2, -0.57); P=0.0001] was a significant predictor of good glycemic control. The prevalence of poor glycemic control and poor self-care activities were high among patients with T2DM. Self-care activities were independent predictors of glycemic control among patients with T2DM. Therefore, management interventions for patients with T2DM should focus on improving self-care activities and other predictor variables. [ABSTRACT FROM AUTHOR]

Type 2 diabetes is one of the most prevalent chronic diseases in the world, and more people than ever before have impaired glucose tolereance, or prediabetes. Many patients with impaired glucose tolerance and undiagnosed diabetes do not know that their glucose metabolism system has been in a state of disorder. Every year, about 5-10% of prediabetics develop diabetes. One of the important achieving factors may be the increase in blood lipids. However, it is not clear whether triglyceride is associated with impaired glucose tolerance and prediabetes in the Qatari population. Therefore, we investigated the relationship between the first several clinical variables and prediabetes status in normal and overweight populations. We conducted a cross-sectional study using data from the Qatar Biobank program. The study included 5,996 participants who were adults over the age of 20. We collected information about participants' fasting blood glucose levels with other clinical measurements and used various machine learning models and logistic regression to study the association between the clinical measurements and prediabetes for normal and overobese weight groups. The use of several machine learning models showed that, after adjusting the potential confounding factors such as age and sex, Triglyceride has been demonstrated to be positively correlated with prediabetes, and there was a special population dependence phenomenon. Among them, nonobese people (p < 0.05). The effect value and 95% confidence interval and OR of triglyceride on prediabetes was 2.79 and (e0.78, e1.28), respectively. [ABSTRACT FROM AUTHOR]

Background: Māori are over-represented in Aotearoa New Zealand morbidity and mortality statistics. Other populations with high health needs include Pacific peoples and those living with material deprivation. General practice has evolved into seven models of primary care: Traditional, Corporate, Health Care Home, Māori, Pacific, Trusts / Non-governmental organisations (Trust/NGOs) and District Health Board / Primary Care Organisations (DHB/PHO). We describe nurse work in relation to these models of care, populations with high health need and patient health outcomes. Methods: We conducted a cross-sectional study (at 30 September 2018) of data from national datasets and practices at patient level. Six primary outcome measures were selected because they could be improved by primary care: polypharmacy (≥ 65 years), glucose control testing in adults with diabetes, immunisations (at 6 months), ambulatory sensitive hospitalisations (0–14, 45–64 years) and emergency department attendances. Analysis adjusted for patient and practice characteristics. Results: Nurse clinical time, and combined nurse, nurse practitioner and general practitioner clinical time, were substantially higher in Trust/NGO, Māori, and Pacific practices than in other models. Increased patient clinical complexity was associated with more clinical input and higher scores on all outcome measures. The highest rates of preventative care by nurses (cervical screening, cardiovascular risk assessment, depression screening, glucose control testing) were in Māori, Trust/NGO and Pacific practices. There was an eightfold difference, across models of care, in percentage of depression screening undertaken by nurses and a fivefold difference in cervical screening and glucose control testing. The highest rates of nurse consultations afterhours and with unenrolled patients, improving access, were in PHO/DHB, Pacific, Trust/NGO and Māori practices. Work not attributed to nurses in the practice records meant nurse work was underestimated to an unknown degree. Conclusions: Transferring work to nurses in Traditional, Health Care Home, and Corporate practices, would release general practitioner clinical time for other work. Worse patient health outcomes were associated with higher patient need and higher clinical input. It is plausible that there is insufficient clinical input to meet the degree of patient need. More practitioner clinical time is required, especially in practices with high volumes of complex patients. [ABSTRACT FROM AUTHOR]

The incidence of diabetes mellitus, a pressing global health concern that is rapidly increasing, has prompted the exploration of medicinal plants for potential remedies, particularly those within the Rubus genus. This comprehensive review aims to connect traditional knowledge with scientific insights, shedding light on the antidiabetic properties of various Rubus species. An exhaustive exploration of the literature revealed that Rubus chingii Hu, Rubus idaeus, Rubus ulmifolius, Rubus fruticosus, Rubus amabilis, and some other Rubus species exhibited noteworthy antidiabetic effects, each operating via distinct mechanisms. Furthermore, Rubus species serve as abundant reservoirs of bioactive compounds, including flavonoids, phenolic acids, tannins, alkaloids, glycosides, antioxidants, triterpenoids, and sterols. As indicated by various in vivo and in vitro studies, these compounds notably improve insulin secretion, increase hepatic glycogen synthesis, inhibit key digestive enzymes, enhance the functions of β-cells in the pancreas, and effectively reduce blood glucose levels. This review, which describes the antidiabetic potential of Rubus species in terms of both pharmacological effects and traditional uses, offers valuable insights for future scientific initiatives in the development of innovative antidiabetic therapies. [ABSTRACT FROM AUTHOR]

ShenZhu TiaoPi granule (STG) is a compound prescription that is used in Chinese medicine for the treatment of type 2 diabetes mellitus (T2DM). Previous studies have indicated a hypoglycaemic effect, but the underlying mechanism remains unclear. Goto-Kakizaki (GK) rats were used to establish an in vivo T2DM model (Mod). The metformin (Met) and STG treatment time was 12 weeks. Fasting blood glucose (FBG) and insulin levels and the area under the glucose curve (GAUC) were measured. Intestinal pathology and permeability were observed. Microbial diversity analysis and metabolomics were used to investigate the underlying mechanisms. Compared with the Con group, the T2DM Mod group presented significant differences in weight, FBG, GAUC, and homeostasis model assessment-insulin resistance (HOMA-IR) indices (p < 0.01). Met and STG improved these indicators (p < 0.01). The pathological morphology and zonula occludens 1 protein levels in the intestines of the Mod group of rats were altered, leading to increases in the lipopolysaccharide (LPS) and interleukin-1ß (IL-1ß) levels. In the Met and STG groups, the intestinal conditions improved, and the LPS and IL-1ß levels significantly decreased (p < 0.01). Changes in the gut microbiota and metabolites occurred in the Mod group. In the STG group, the abundance of Intestinimonas increased, and the abundance of Eubacterium coprostanoligenes decreased significantly (p < 0.05). Moreover, STG also altered 2-deoxyglucose, beta-muricholic acid and dioxolithocholic acid production. In addition, the main metabolic pathways affected by STG were bile acid biosynthesis and cholesterol metabolism. Intestinimonas, D-maltose_and_ alpha-lactose may be potential biomarkers for the effects of STG. STG alleviates hyperglycaemia via the gut microbiota and metabolites in GK rats. [ABSTRACT FROM AUTHOR]

Glucagon-like peptide-1 receptor agonist (GLP-1RA), a novel hypoglycemic agent for the treatment of type 2 diabetes, has well-known effects such as lowering blood sugar, ameliorating inflammation, reducing weight, and lowering blood lipids. It has also been shown that it can influence the proliferation and survival of cells and has a certain effect on the prognosis of some neoplastic diseases. In this study, the potential effects of GLP-1RAs on the occurrence and development of tumors were reviewed to provide new ideas for the prevention and treatment of tumors in patients. [ABSTRACT FROM AUTHOR]

Objective: The long-term glucose monitoring is essential to the risk assessment of diabetic retinopathy (DR), the aim of this study was to investigate the predictive ability of visit-to-visit fasting blood glucose (FBG) indices on the risk of DR. Methods: This was a community-based, cohort study conducted from 2013 to 2021. DR was diagnosed by digital fundus photography. The FPG indices included FBG, var. Associations of each FBG indices and DR were estimated using multinomial logistic regression models adjusting for confounders, and discrimination was determined by area under the curve (AUC). Predictive utility of different models was compared by changes in AUC, integrated discrimination improvement (IDI), and net reclassification index (NRI). Results: This study analyzed 5054 participants, the mean age was 46.26 ± 11.44 years, and 2620 (51.84%) were women. After adjustment for confounders, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for FBG, SD, CV, VIM, ARV, M-FBG, and cumulative FBG load were 1.62 (1.52-1.73), 2.74 (2.38-3.16), 1.78 (1.62-1.95), 1.11 (0.95-1.29), 1.72 (1.56-1.91), 2.15 (1.96-2.36), and 2.57 (2.31-2.85), respectively. The AUC of the model with separate cumulative FBG load and classical risk factors was 0.9135 (95%CI 0.8890-0.9380), and no substantive improvement in discrimination was achieved with the addition of other FBG indices once cumulative FBG load was in the model. Conclusions: Cumulative FBG load is adequate for capturing the glucose-related DR risk, and the predictive utility of cumulative FBG load is not significantly improved by adding or replacing other FBG indices in the assessment of DR risk. [ABSTRACT FROM AUTHOR]

Purpose: Chewing duration can affect food particle size, gastric processing, and postprandial glycemia, but these effects have not been investigated with exercise. This study examined how the chewing duration of a food bar impacts glycemic and metabolic responses, gastrointestinal (GI) symptoms, psychological affect, and performance during endurance running. Methods: This randomized, unblinded, crossover study had 15 males (35.2 ± 7.4 years, VO2peak: 56.1 ± 5.2 ml/kg/min) attend three laboratory visits. Visit 1 required a VO2peak test, 10 min familiarization run at 60% VO2peak, and familiarization time-to-exhaustion (TTE) test (10 min at 90% VO2peak, followed by TTE at 100% VO2peak). Visits 2 and 3 consisted of a 60 min run at 60% VO2peak, followed by TTE testing. Participants were fed 45 g of a bar (180 kcal, 4 g fat, 33 g carbohydrate, 3 g protein, 1 g fiber) in 9 g servings 30 min before running, and 27 g of bar in 9 g servings at three timepoints during the 60 min run. Participants consumed the servings in 20 (20CHEW) or 40 (40CHEW) masticatory cycles, at 1 chew/second. Outcomes included blood glucose, substrate use, GI symptoms, perceived exertion (RPE), overall feeling, and TTE. Results: Post-prandial blood glucose, GI symptoms, and RPE increased over time, but there were no significant between-condition or condition-by-time effects. TTE showed no significant between-condition effect (20CHEW: 288 ± 133 s; 40CHEW: 335 ± 299 s; p = 0.240). Overall feeling demonstrated a time-by-condition effect (p = 0.006), suggesting possible better maintenance over time with 40CHEW. Conclusion: Cumulatively, the results suggest that extended chewing minimally impacts physiology, perceptions, and performance during 60 min moderate-intensity running. [ABSTRACT FROM AUTHOR]

Diabetes leads to testicular damage and infertility. Mesenchymal stem cells and their secretory trophic factors have shown potential as regenerative therapies for diabetes and its associated complications. This study examined the effects of conditioned medium derived from Wharton's jelly mesenchymal stem cells (WJMSCs‐CM) on sperm parameters, reproductive hormones, biochemical parameters, and histological changes in the testes of diabetic rats. Fifty‐six male Sprague–Dawley rats (250–300 g) were assigned to eight groups: control, diabetes, and six diabetic groups receiving early or late treatments with WJMSCs‐CM (D‐CME, D‐CML), insulin (D‐INSE, D‐INSL), or DMEM (D‐DME, D‐DML). In the early treatment groups, insulin (3 U/day, subcutaneously) and WJMSCs‐CM (10 mg/week, intraperitoneally) were administered immediately after diabetes induction; in the late treatment groups, these interventions began 30 days postinduction. Blood glucose and insulin levels, along with sperm parameters, were assessed. Sex hormones, testicular antioxidant enzyme activity, malondialdehyde (MDA), and glutathione (GSH) concentrations were measured using colorimetric methods. Real‐time PCR detected Bax, Bcl‐2, and tumor necrosis factor‐alpha (TNF‐α) gene expression. Our results showed that diabetes increased blood glucose levels, decreased insulin and sex hormone levels, induced testicular oxidative stress and apoptosis, and reduced sperm parameters compared to the control. WJMSCs‐CM significantly ameliorated hyperglycemia, increased insulin and sex hormone levels, and improved sperm quality. In WJMSCs‐CM‐treated diabetic rats, MDA levels were reduced, while GSH and antioxidant enzyme activity increased. Furthermore, WJMSCs‐CM decreased the testicular Bax/Bcl‐2 ratio and TNF‐α expression, as well as enhanced spermatogenic, Sertoli, and Leydig cells. In conclusion, WJMSC‐CM administration effectively mitigated diabetes‐induced testicular damage by reducing oxidative stress, inflammation, and apoptosis. Early treatment with WJMSCs‐CM was more effective than late treatment for diabetes‐induced reproductive dysfunction. [ABSTRACT FROM AUTHOR]

Objective: This work reported for the first time the synthesis of novel hybrids described as a five-membered ring with three heteroatoms fused on the 6,7-coumarin framework. This is an endeavor to discover adaptable and easily obtainable coumarin frameworks possessing a wide array of biomedical characteristics. Methods: Seven hybrids constructed from 1,3,2-dioxathiole-2-oxide and coumarin derivatives were fabricated through a three-step synthetic process originating from benzene 1,2,4-triole. Spectroscopic methodologies, encompassing 1H, 13C NMR, and FT-IR, were utilized to validate the structural framework of the synthesized hybrids. Their potential in the biomedical realm to function as antitumor agents, suppressors of inflammation, oxidative stress alleviators, and regulators of blood sugar levels was assessed. In addition, their cytosafety and in silico pharmacokinetic parameters were also investigated. Six cancerous cell lines were utilized to investigate the antitumor activity of the synthesized hybrids through the MTT-dependent assay, while three noncancerous cell lines were employed to examine the compounds' cytocsafety. The inflammatory suppressant potential was investigated against three inflammatory-related enzymes. The antioxidant activity was investigated in oxidative stress-induced human cells, while the antidiabetic potential was investigated through two carbohydrate-digesting enzymes. Finally, two web-based programs were utilized to reveal the pharmacokinetic profiles of the title hybrids. Results and Discussion: Four principal outcomes were reported based on the extracted findings. The dioxathiole-coumarin hybrids have encouraging and extensive biomedical impacts. Hybrid (DOT3) had potent antitumor, antioxidant, and cytosafety potentials. Compound (Precursor O-III) exhibited potent anti-inflammatory potential through the lipoxygenase-dependent pathway (IC50 = 9.22 ± 1.02 µg/mL). Compounds (DOT1) and (DOT2) have significant potential as antidiabetic agents, as evidenced by their potent inhibition capacities toward glucosidase and amylase. Conclusions: Compounds (DOT3), (Precursor O-III), (DOT1), and (DOT2) exhibited the potential to function as valuable scaffolds for screening novel medications with antitumor, antioxidant, anti-inflammatory, and antidiabetic properties in the foreseeable future. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To compare the effects of iGlarLixi versus insulin glargine 100 U/mL (iGlar) on residual hyperglycaemia in Chinese people with uncontrolled type 2 diabetes (T2D) on prior basal insulin (BI) therapy ± oral antidiabetic drugs in the LixiLan‐L‐CN study (NCT03798080).In this post hoc analysis, residual hyperglycaemia (i.e. HbA1c ≥ 7.0% [≥ 53 mmol/mol] and fasting plasma glucose [FPG] < 7.0 mmol/L) were assessed over 30 weeks. Outcomes were assessed at week 30 in participants with baseline residual hyperglycaemia, including changes from baseline in HbA1c, FPG, 2‐hour postprandial glucose (PPG) and daily BI dose, the proportion of participants with HbA1c less than 7.0% (< 53 mmol/mol) and FPG less than 7.0 mmol/L and the incidence of hypoglycaemia.Of 421 participants, 124 (29.5%) had baseline residual hyperglycaemia (iGlarLixi, n = 64 [31.7%]; iGlar, n = 60 [29.1%]). At week 30, the residual hyperglycaemia rate decreased to 7.0% with iGlarLixi and increased to 43.3% with iGlar. Among participants with baseline residual hyperglycaemia, a greater proportion achieved both HbA1c and FPG targets at week 30 with iGlarLixi versus iGlar (43.8% vs. 16.7%), and iGlarLixi provided greater reductions in HbA1c (least squares mean [LSM] difference, −0.9% [−9.4 mmol/mol]) and 2‐hour PPG (LSM difference, −4.7 mmol/L; both P < .001). Daily BI dose and incidence of hypoglycaemia were similar in the two groups.The findings of this post hoc analysis suggest that iGlarLixi had greater benefits than iGlar in reducing the rate of residual hyperglycaemia over 30 weeks in Chinese people with suboptimally controlled T2D on prior BI‐based therapy. [ABSTRACT FROM AUTHOR]

Metformin treatment decreases elevated concentrations of anterior pituitary hormones. The aim of this prospective, cohort study was to investigate whether hyperthyroidism modulates the impact of metformin on gonadotroph secretory function. The study population included 48 postmenopausal women with untreated type 2 diabetes or prediabetes, 24 of whom had coexisting grade 1 subclinical hyperthyroidism. Both groups were matched for age, insulin sensitivity, and gonadotropin levels. Over the entire study period, all participants were treated with metformin (2.55–3 g daily). Plasma glucose, insulin, thyroid‐stimulating hormone (TSH), total and free thyroid hormones, follicle‐stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin, adrenocorticotropic hormone (ACTH), and insulin‐like growth factor‐1 (IGF‐1) were assayed at entry and 6 months later. At baseline, the study groups differed in levels of TSH and thyroid hormones but not in body mass index, blood pressure, glucose homeostasis markers (fasting glucose, homeostatic model assessment 1 of insulin resistance ratio [HOMA1‐IR], and glycated hemoglobin [HbA1c]), and the remaining hormones. There were no differences between both groups in the degree of reduction in plasma glucose and HbA1c in response to metformin treatment. Although metformin decreased HOMA1‐IR in both groups, this effect was stronger in women with hyperthyroidism than with normal thyroid function (−50 ± 20% vs −30 ± 15%). Similar relationships were observed for FSH (−43 ± 21% vs −21 ± 12%). Only in hyperthyroid women did the drug reduce LH concentration (by 35 ± 17%). Metformin did not affect circulating levels of TSH, total and free thyroxine, total and free triiodothyronine, estradiol, prolactin, ACTH, and IGF‐1. The obtained results indicate that hyperthyroidism enhances the gonadotropin‐lowering effects of metformin, as well as the fact that this agent has a neutral effect on the hypothalamic–pituitary–thyroid axis in case of its overactivity. [ABSTRACT FROM AUTHOR]

Objective: A subgroup analysis of the Hypoglycemia Awareness Restoration Programme for people with type 1 diabetes and problematic hypoglycemia persisting despite optimized care (HARPdoc) trial was conducted to explore the impact of Blood Glucose Awareness Training (BGAT, a hypoglycemia awareness training program) and the HARPdoc (a psychoeducation addressing unhelpful hypoglycemia beliefs) in reducing severe hypoglycemia (SH) in individuals using advanced diabetes technologies (ADTs). Methods: Data from trial participants who utilized ADTs, including continuous glucose monitors or automated insulin delivery systems, were extracted. Generalized linear mixed-effects models with Poisson distribution or linear mixed-effects models were used to evaluate SH incidence, and Gold questionnaire, Attitudes to Awareness of Hypoglycemia (A2A), Problem Areas in Diabetes (PAID), Hospital Anxiety and Depress Scale (HADS)-anxiety, and HADS-depression scores as measures of hypoglycemia awareness, unhelpful hypoglycemia beliefs, diabetes distress, and anxiety and depression symptoms, respectively. Results: In the 45 participants using ADTs, the BGAT and HARPdoc interventions both reduced SH incidence by more than 50% (P < 0.0001) and yielded improvements in hypoglycemia awareness (P < 0.05). HARPdoc outperformed BGAT in reducing SH at month 24 (P = 0.01). HARPdoc also mitigated unhelpful hypoglycemia beliefs (P < 0.0001), diabetes distress (P < 0.05), and anxiety symptoms (P < 0.05); BGAT demonstrated no significant impacts in these respects. Neither HARPdoc nor BGAT had significant effects on depression symptoms. Conclusion: Psychoeducation (BGAT and HARPdoc) was effective in reducing SH in people using ADTs. HARPdoc may also provide greater long-term SH reduction and improves psychological well-being in this patient group. [ABSTRACT FROM AUTHOR]

Background: Subcutaneous continuous glucose monitoring (CGM) may facilitate glucose control in the ICU. We aimed to assess the accuracy of CGM (Dexcom G6) against arterial blood glucose (ABG) in adult critically ill patients receiving intravenous insulin infusion and vasopressor therapy. We also aimed to assess feasibility and tolerability of CGM in this setting. Methods: We included ICU patients receiving mechanical ventilation, insulin, and vasopressor therapy. Numerical accuracy was assessed by the mean absolute relative difference (MARD), overall, across arterial glucose strata, over different noradrenaline equivalent infusion rates, and over time since CGM start. MARD <14% was considered acceptable. Clinical accuracy was assessed using Clarke Error Grid (CEG) analysis. Feasibility outcome included number and duration of interrupted sensor readings due to signal loss. Tolerability outcome included skin reactions related to sensor insertion or sensor adhesives. Results: We obtained 2946 paired samples from 40 patients (18 with type 2 diabetes) receiving a median (IQR) maximum noradrenaline equivalent infusion rate of 0.18 (0.08–0.33) µg/kg/min during CGM. Overall, MARD was 12.7% (95% CI 10.7–15.3), and 99.8% of CGM readings were within CEG zones A and B. MARD values ≥14% were observed when ABG was outside target range (6–10 mmol/L [108–180 mg/dL]) and with noradrenaline equivalent infusion rates above 0.10 µg/kg/min. Accuracy improved with time after CGM start, reaching MARD values <14% after 36 h. We observed four episodes of interrupted sensor readings due to signal loss, ranging from 5 to 20 min. We observed no skin reaction related to sensor insertion or sensor adhesives. Conclusions: In our ICU cohort of patients receiving vasopressor infusion, subcutaneous CGM demonstrated acceptable overall numerical and clinical accuracy. However, suboptimal accuracy may occur outside glucose ranges of 6–10 mmol/L (108–180 mg/dL), during higher dose vasopressor infusion, and during the first 36 h after CGM start. [ABSTRACT FROM AUTHOR]

Background: Computer simulators of human metabolism are powerful tools to design and validate new diabetes treatments. However, these platforms are often limited in the diversity of behaviors and glycemic conditions they can reproduce. Replay methodologies leverage field-collected data to create ad hoc simulation environments representative of real-life conditions. After formal validations of our method in prior publications, we demonstrate its capacity to reproduce a recent clinical trial. Methods: Using the replay methodology, an ensemble of replay simulators was generated using data from a randomized crossover clinical trial comparing the hybrid closed loop (HCL) and fully closed loop (FCL) control modalities in automated insulin delivery (AID), creating 64 subject/modality pairs. Each virtual subject was exposed to the alternate AID modality to compare the simulated versus observed glycemic outcomes. Equivalence tests were performed for time in, below, and above range (TIR, TBR, and TAR) and high and low blood glucose indices (HBGI and LBGI) considering equivalence margins corresponding to clinical significance. Results: TIR, TAR, LBGI, and HBGI showed statistical and clinical equivalence between the original and the simulated data; TBR failed the equivalence test. For example, in the HCL mode, simulated TIR was 84.89% versus an observed 84.31% (P = 0.0170, confidence interval [CI] [−3.96, 2.79]), and for FCL mode, TIR was 76.58% versus 77.41% (P = 0.0222, CI [−2.54, 4.20]). Conclusion: Clinical trial data confirm the prior in silico validation of the UVA replay method in predicting the glycemic impact of modified insulin treatments. This in vivo demonstration justifies the application of the replay method to the personalization and adaptation of treatment strategies in people with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the independent effects of irisin on insulin resistance (IR) in ovary of polycystic ovary syndrome (PCOS) and explore possible pathways. Methods: We established PCOS medel using Poretsky L's method, then PCOS rats were randomly divided into model group (M) and irisin group (I), and normal rats (N) were used as the control. Then rats in the group I were injected with recombinant irisin. Then the levels of circulating fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of IR (HOMA‐IR) and PI3K/AKT and MAPK/ERK pathways in each group were observed, as well as the effects of irisin on the levels of circulating HOMA‐IR and PI3K/AKT and MAPK/ERK pathways in ovary of PCOS rats were evaluated. Results: Compared with normal group, levels of FBG, FINS, and HOMA‐IR of model group were significantly increased (p < 0.001, p < 0.001, and p < 0.001, respectively), levels of average optical density by IHC of p‐PI3K, PI3K, p‐AKT, and AKT (p = 0.015, p = 0.010, p = 0.005, and p = 0.009, respectively) and levels of mRNA concentration of PI3K and AKT (p = 0.001, and p = 0.005, respectively) were decreased, while the levels of average optical density of p‐ERK, ERK (p = 0.011, and p = 0.013, respectively) and level of mRNA concentration of ERK (p < 0.001) were increased in ovary. After irisin intervention, compared with model group, levels of FBG, FINS, and HOMA‐IR of rats in irisin group were significantly decreased (p = 0.001, p < 0.001, and p < 0.001, respectively), levels of average optical density by IHC of p‐PI3K, PI3K, p‐AKT, and AKT (p = 0.030, p = 0.024, p = 0.012, and p = 0.025, respectively) and levels of mRNA concentration of PI3K and AKT (p = 0.002, and p = 0.003, respectively) were significantly increased, while the levels of average optical density of p‐ERK, ERK (p = 0.004, and p = 0.026, respectively) and level of mRNA concentration of ERK (p = 0.001) were significantly decreased. Conclusion: Our study demonstrated that irisin could not only improve circulating insulin resistance, but may also improve ovarian IR through an increase in the activity of PI3K/AKT signaling and a decrease of MAPK/ERK signaling. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance (IR), hyperuricemia (HUA), and recurrent pregnancy loss (RPL) elevate the risk of cardiovascular disease and metabolic disorders, while also impacting reproductive health. The relationship between IR, HUA, and RPL has not been thoroughly investigated. This study investigates the relationship between four IR surrogates and the risk of HUA in RPL patients. Methods: Data from a real‐world study on RPL in China were analyzed using multivariable regression to determine the relationship between HUA and triglyceride and glucose (TyG) index, triglyceride glucose‐body mass index (TyG‐BMI), triglyceride to high‐density lipoprotein cholesterol (TG/HDL‐c) ratio, and metabolic score for insulin resistance (METS‐IR). The predictive ability of these surrogates for detecting HUA in RPL patients was evaluated using the area under the curve and receiver operating characteristic analysis. Sensitivity analysis was performed using bootstrapping resampling. Results: The study included 769 patients with a mean age of 30 ± 4 years old, 8.32% of whom had HUA. Four IR surrogates were closely related to HUA in patients of RPL after adjusting for age, menstrual cycle, creatinine, alanine transaminase, aspartate transaminase, total cholesterol, homocysteine, and low‐density lipoprotein, with area under the curve values of TyG index (OR = 0.693, 95% confidence interval [CI]: 0.626, 0.759), TyG‐BMI (OR = 0.731 95% CI: 0.657, 0.805), TG/HDL‐C (OR = 0.703, 95% CI: 0.641, 0.764), and METS‐IR (OR = 0.728, 95% CI: 0.655, 0.799). Bootstrap resampling yielded similar results. Conclusions: The TyG index, TyG‐BMI, TG/HDL‐c, and METS‐IR significantly correlated with HUA in patients with RPL. The TyG‐BMI had the highest predictive value of the four IR surrogates. [ABSTRACT FROM AUTHOR]

Red pitaya fruit has become a source of natural colorant, because it is rich in betalains, a pigment that imparts a red‐purple color that interests the food and cosmetics industries. This fruit also possesses high nutritional value, with a range of bioactive compounds known to confer potential health benefits and prevent chronic diseases, such as diabetes, which makes it useful for use as pharmaceutical agents and dietary supplements. In order to improve its technological and biological effects, a concentration will be required. Thus, the microfiltration, followed by vacuum concentration, can be an interesting strategy for this purpose. This study aimed to explore tangential microfiltration to produce microfiltered material, which is an important step to obtain the microfiltered red‐purple pitaya concentrate. Therefore, physicochemical and chemical characterization (including 1H NMR analysis) and biological properties (toxicity and diabetes) of this concentrate were assessed, using adult zebrafish as a model. The results show that microfiltration was carried out efficiently, with an average consumption of 95.75 ± 3.13 and 74.12 ± 3.58 kW h m−3, varying according to the material used ("unpeeled pitaya pulp" or "pitaya pulp with peel," respectively). The in vivo tests indicated non‐toxicity and hypoglycemic effect of the concentrate, since the blood glucose levels were significantly lower in the zebrafish groups treated with this concentrate in comparison with that of control group. Thus, this study suggests the potential of microfiltered red‐purple pitaya concentrate as a promising multifunctional food‐derived colorant, exhibiting beneficial biological effects far beyond its attractive color. Practical Application: Hylocereus polyrhizus (F.A.C. Weber) Britton & Rose has attracted attention as a potential source of natural colorants because of its red‐purple skin and flesh color. In addition, this fruit has a range of bioactive compounds, which make it a valuable resource for providing potential health benefits and preventing chronic diseases such as diabetes. In this paper, the microfiltered red‐purple pitaya concentrate showed beneficial biological effects far beyond its attractive color. Thus, this product can be considered a promising multifunctional food‐derived colorant to use in the food, pharmaceutical, or cosmetics industries. [ABSTRACT FROM AUTHOR]

Maternal glucose is the principal macronutrient that sustains fetal growth. Prolonged exposure of the fetus to hyperglycemia from the early stages of pregnancy accelerates the maturation of the stimulus–secretion coupling mechanism in β cell autoimmunity, which leads to early hyperinsulinemia in type 1 diabetes mellitus (T1DM). Nowadays, diabetes mellitus (DM) is the most common medical complication of pregnancy, and among young women, the prevalence of overt diabetes and undiagnosed hyperglycemia is rising. Even though conventional medication is effective in treating DM, it is expensive and has harmful side effects. Herbal medicine will thus incorporate alternative therapy and be more effective and less toxic. Due to their bioactive components, olive leaves (Olea europaea) are frequently used medicinally; however, little is known about how this plant affects the immune system when it comes to diabetes. The current study used a pregnant mother rat model of alloxan-induced T1DM to examine the antidiabetic properties and embryonic safety of olive leaves. Forty adult female Sprague Dawley rats were split up into four groups as follows: nondiabetic, diabetic, olive, and diabetic-olive groups. All the mother rats were sacrificed on the 20th day of pregnancy, and fetuses were collected for further investigations. In diabetic pregnant mothers, fetuses had systemic modulation-negative effects. These effects were significantly reversed when the diabetic groups were supplemented with extracts from olive leaves. The findings showed that the olive leaf extract inhibits the diabetogenic effect mediated by alloxan with effective and protective systemic immunomodulation during embryonic development. [ABSTRACT FROM AUTHOR]

Background and aims: This study aimed to examine the cumulative effects of body mass index (BMI), body roundness index (BRI), pulse pressure (PP), triglycerides (TG), high-density lipoprotein cholesterol (HDL) and fasting plasma glucose (FPG) on Type 2 diabetes (T2D) morbidity. Methods: A total of 78,456 participants aged older than 45 years were extracted from basic public health services in China. During the 2-year follow-up, 6,942 individuals had developed T2D. The binary logistic regression models and multinomial logistic regression models were conducted to investigate the effects of cumulative metabolic parameters on incident T2D, prediabetes regression and progression. Results: We found statistically deleterious impacts of exposure to high cumulative BMI, BRI, PP, TG and low cumulative HDL on T2D morbidity and prediabetes progression. Compared to the group with low cumulative of all five parameters, the adjusted ORs for new-onset T2D for participants presenting with 1–2, 3, and 4–5 elevated metabolic parameters were 1.41(1.31,1.52), 1.93(1.74,2.13) and 2.21(1.94,2.51), respectively. There was additive interaction between FPG level and cumulative metabolic parameters with T2D. Compared with participants with the lowest quartile of FPG and low cumulative of all 5 parameters, those with the highest quartile of FPG and high cumulative of 4–5 parameters had a 14.63 [95% CI (12.27, 17.42)] higher risk of incident T2D. Conclusions: Participants with more numbers of high-cumulative metabolic parameters were associated with a higher risk of incident T2D and prediabetes progression. A high level of normal FPG could enhance these risks. [ABSTRACT FROM AUTHOR]

Background: Insulin degludec/insulin aspart (IDegAsp) is a fixed‐ratio co‐formulation of insulin degludec and insulin aspart for the treatment of people with diabetes and suboptimal glycaemic control. Few real‐world studies of IDegAsp treatment have been conducted. Here, we report results from the Australian cohort of the global ARISE study of real‐world IDegAsp use. Aims: To investigate glycaemic control and other clinical outcomes in people with type 2 diabetes (T2D) treated with IDegAsp in a real‐world setting in Australia. Methods: A total of 183 adults with T2D initiating or switching to IDegAsp in the Australian cohort of the open‐label, non‐interventional ARISE study were followed for 26–36 weeks from August 2019 to December 2020. Results: IDegAsp was associated with significant reductions from baseline to end of study (EOS) in mean glycated haemoglobin (estimated change −0.8% (95% confidence interval (CI): −1.05 to −0.56; P < 0.0001)), fasting plasma glucose (−1.6 mmol/L (95% CI: −2.49 to −0.63; P = 0.0017)) and body weight (−2.6 kg (95% CI: −3.68 to −1.55; P < 0.0001)). In insulin‐experienced patients, the mean total daily insulin dose did not change significantly (estimated change from baseline to EOS 3.8 (95% CI: –3.70 to 11.21; P = 0.3202)). The proportion of patients experiencing hypoglycaemia numerically decreased during the study (non‐severe: 14.2–10.9%; nocturnal non‐severe: 4.9–2.2%; and severe: 2.2–0%). Conclusions: Initiating or switching to IDegAsp in a real‐world population of people with T2D in Australia was associated with significant improvements in glycaemic control and body weight, and numerically lower levels of hypoglycaemia compared with baseline. [ABSTRACT FROM AUTHOR]

Increased cardiometabolic risk among children is increasingly becoming a concern, with evidence indicating that obesity, diet, and serum 25-hydroxyvitamin D (25(OH)D) are associated with cardiometabolic risk. However, such studies among Malaysian children are scarce. Thus, this study explores the associations between adiposity, dietary quality, and 25(OH)D, with cardiometabolic risk factors among Malaysian children aged 4–12 years. Data of 479 children (mean age: 8.2 ± 2.3 years old, 52% females) from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia, were included in this analysis. Adiposity (percentage of body fat) was assessed with bioelectrical impedance technique. Dietary quality was assessed using 24 h dietary recall and calculated as mean adequacy ratio. Vitamin D was assessed based on serum 25-hydroxyvitamin D (25(OH)D). Measurements of cardiometabolic risk factors included waist circumference (WC), mean arterial pressure (MAP), fasting blood glucose (FBG), high-density lipoprotein (HDL), triglyceride, and high-sensitivity C-reactive protein, and cardiometabolic risk cluster score (siMS) was calculated. Overall, higher adiposity was positively associated with all cardiometabolic risk factors (WC, ß = 0.907; 95% CI = 0.865, 0.948; MAP, ß = 0.225; 95% CI = 0.158, 0.292; HDL, ß = −0.011; 95% CI = −0.014, −0.009; Triglyceride, ß = 0.012; 95% CI = 0.009, 0.016; FBG, ß = 0.006; 95% CI = 0.002, 0.011) and siMS score (ß = 0.033; 95% CI = 0.029, 0.037). Serum 25(OH)D was inversely associated with siMS score (ß = −0.002; 95% CI = −0.004, −0.000008) and positively associated with HDL (ß = 0.002; 95% CI = 0.0001, 0.003). Our findings suggest that adiposity is a key determinant of adverse cardiometabolic risk factors in children, while serum 25(OH)D may be associated with overall cardiometabolic health. Interventions to reduce obesity are needed to mitigate the deleterious consequences of cardiometabolic dysregulation in children. [ABSTRACT FROM AUTHOR]

The effects of exogenous ketones on appetite and food intake remain elusive, especially for people with type 2 diabetes (T2D). This study aimed to determine whether acute ingestion of an oral ketone monoester supplement (KME) affected appetite sensations, prospective food consumption and intake in T2D. Results showed that acute KME ingestion did not significantly alter appetite scores. However, there was a tendency for lower energy intake during an ad libitum meal 3 h following ketone ingestion compared to non-energetic placebo. Further research is warranted to understand the long-term effects of exogenous ketones for energy and macronutrient intake in T2D. [ABSTRACT FROM AUTHOR]

Aims/Introduction: History of coronary artery disease (CAD), cerebrovascular disease (CeVD), type 2 diabetes and their combined effect on cardiovascular disease are essential for cardiovascular risk management. We investigated the association of prior CAD, prior CeVD, type 2 diabetes and their combination with the risk of cardiovascular disease. Materials and Methods: This is a historical cohort study including 342,033 participants (aged 18–72 years) followed up for ≥5 years between 2008 and 2016. Participants were classified into eight groups (with or without prior CAD, prior CeVD and type 2 diabetes). Type 2 Diabetes was defined by fasting plasma glucose and glycated hemoglobin levels, and antidiabetic drug prescription. Prior and subsequent CAD and CeVD were identified according to claims using International Classification of Diseases 10th Revision codes, medical procedures and questionnaires. Cox regression models were used to evaluate the risk of cardiovascular events. Results: The median follow‐up period was 6.4 years. The incidence of composite cardiovascular events of CAD and CeVD in the CAD−/CeVD−, CAD+/CeVD−, CAD−/CeVD+ and CAD+/CeVD+ groups were 1.92 and 6.94, 25.14 and 31.98 per 1,000 person‐years in non‐diabetes participants, and 8.66, 18.04, 39.98 and 60.72 in type 2 diabetes patients, respectively. Hazard ratios of cardiovascular events compared with CAD−/CeVD−/non‐diabetes were 1.66 (95% confidence interval 1.55–1.78) in CAD−/CeVD−/type 2 diabetes and 1.84 (1.56–2.18) in CAD+/CeVD−/non‐diabetes. CeVD+ was linked to a 4‐7‐fold increase in the risk of cardiovascular events regardless of CAD+ or type 2 diabetes. Conclusions: Type 2 diabetes increased the risk of cardiovascular disease as high as a history of CAD, whereas prior CeVD alone increased the risk of future CeVD without additional effects by type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Blood glucose meters are commonly used at the bedside, but most of the meters used in Hung Vuong Hospital (Ho Chi Minh City, Vietnam) are built for self‐monitoring and might not be suitable for determining glucose levels in patients. In this study, we aimed to validate the performance of six frequently used meters in our hospital using the Clinical & Laboratory Standards Institute (CLSI) standard, and investigate the hematocrit impact on the accuracy of these meters. Materials and Methods: A total of 135 pregnant women who underwent a 75‐g oral glucose tolerance test consented to participate in the study at Hung Vuong Hospital. Whole blood glucose levels were measured in duplicate using meters, and hematocrit levels were measured using an Alinity h‐series analyzer. Within 5 min, plasma glucose levels were measured twice in a row using the Cobas c502 reference analyzer. For accuracy and precision, the hematocrit effect was assed using CLSI POCT12‐A3. Results: Out of six evaluated meters, three meters qualified. For CLSI criterion at glucose concentration of 5.55 mmol/L, Accu‐Chek Inform II, Accu‐Chek Performa and OneTouch VerioVue achieved 97.31%, 98.08% and 99.62%, respectively. For CLSI criterion at 4.17 mmol/L, these three achieved 100%. Accu‐Chek Inform II and Accu‐Chek Performa showed an inverse correlation between glucose level and hematocrit with slopes of −0.500 (95% confidence interval −0.678 to −0.322) and −0.396 (95% confidence interval −0.569 to −0.224), whereas OneTouch VerioVue was not affected by hematocrit, with a slope of 0.207 (95% confidence interval −0.026 to 0.440). Conclusions: Blood glucose meters' measurements can be affected by hematocrit, and might provide readings not within an acceptable bias. Medical organizations need to verify or validate before using on patients. [ABSTRACT FROM AUTHOR]

Introduction: The fasting blood glucose test is widely used for diabetes screening. However, it may fail to detect early‐stage diabetes characterized by elevated postprandial glucose levels. Hence, we developed and internally validated a nomogram to predict the diabetes risk in older adults with normal fasting glucose levels. Materials and Methods: This study enrolled 2,235 older adults, dividing them into a Training Set (n = 1,564) and a Validation Set (n = 671) based on a 7:3 ratio. We employed the least absolute shrinkage and selection operator regression to identify predictors for constructing the nomogram. Calibration and discrimination were employed to assess the nomogram's performance, while its clinical utility was evaluated through decision curve analysis. Results: Nine key variables were identified as significant factors: age, gender, body mass index, fasting blood glucose, triglycerides, alanine aminotransferase, the ratio of alanine aminotransferase to aspartate aminotransferase, blood urea nitrogen, and hemoglobin. The nomogram demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.824 in the Training Set and 0.809 in the Validation Set. Calibration curves for both sets confirmed the model's accuracy in estimating the actual diabetes risk. Decision curve analysis highlighted the model's clinical utility. Conclusions: We provided a dynamic nomogram for identifying older adults at risk of diabetes, potentially enhancing the efficiency of diabetes screening in primary healthcare units. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Chronic kidney disease (CKD) is a very important issue globally because of the risk of its progressing to end‐stage renal disease. We aimed to identify factors contributing to long‐term estimated glomerular filtration rate (eGFR) decline to determine an early diagnosis and prevent CKD progression. Materials and Methods: From January 2003 to December 2006, 5,507 individuals underwent health checkups at our hospital's Preventive Medicine Research Center. We ultimately enrolled 2,175 individuals. The eGFR was ≥60 mL/min/1.73 m2 at the start of observation period, which was 20 years. The event onset time was the day that the eGFR became <30 mL/min during the 20‐year period. Baseline risk factors – in particular, the effect of plasma glucose levels on the eGFR – were extracted and evaluated by using Fine and Gray analysis. Results: During the 20‐year observation, the hazard ratio (HR) of CKD progression was examined. A fasting plasma glucose (FPG) level ≥105 mg/dL was significantly associated with the risk of CKD progressing to an eGFR <30 mL/min. This trend was similar in the slope of eGFR. An FPG ≥105 mg/dL or an glycated hemoglobin level ≥6.5% was useful for intervening in CKD progression. Multivariate analysis showed that independent risk factors were an FPG level ≥105 mg/dL (HR 1.9; P < 0.001), age ≥60 years (HR 3.86; P < 0.001), obesity (HR 1.61; P < 0.01) and urinary protein (HR 1.55; P < 0.01). Conclusions: For early intervention against a reduction in the eGFR, detecting mild increases in FPG ≥105 mg/dL in patients with CKD with or without diabetes is useful. [ABSTRACT FROM AUTHOR]

Objective: We aim to investigate the association between prognosis and outcomes following myocardial ischemia-reperfusion injury, as well as peripheral blood levels of NLRP3 and the triglyceride-glucose index (TyG). Methods: A total of 100 patients who underwent emergency coronary intervention following myocardial infarction confirmed by coronary angiography at our hospital between October 2021 and May 2023 were included in this study. Patients were stratified into two groups based on their prognoses: the control group (n = 73), which did not experience new myocardial infarctions or require hospitalization for heart failure or suffer sudden cardiac death post-interventional treatment; and the observation group (n = 27), which experienced one or more cardiovascular events post-treatment. Patient demographics were obtained from clinical records while biochemical analyses assessed peripheral blood triglycerides, blood glucose levels, and TyG index. Additionally, ELISA measurements determined levels of NLRP3 as well as inflammatory factors IL-6, TNF-α, and CRP in peripheral blood samples. Cardiac function was evaluated according to NYHA standards. Univariable Cox regression analysis identified factors influencing patient prognosis while Pearson correlation analysis examined relationships among prognosis, outcomes following myocardial ischemia-reperfusion injury, TyG index, and peripheral blood NLRP3. Results: No significant differences were observed in the general characteristics between the two patient groups (P > 0.05). However, the observation group exhibited higher levels of peripheral blood triglycerides, blood glucose, and TyG index compared to the control group (P < 0.05). Additionally, levels of NLRP3 and inflammatory factors IL-6, TNF-α, and CRP were elevated in the observation group compared to the control group (P < 0.05). Cardiac function impairment was more pronounced in the observation group (P < 0.05). Notably, TyG index and peripheral blood NLRP3 demonstrated higher risk ratios compared to other biomarkers (P < 0.05), indicating their significance in prognosis and outcomes. Elevated levels of NLRP3 and TyG index were associated with poorer recovery of cardiac function, increased rehospitalization rates, and higher mortality (P < 0.05). Conclusion: Elevated NLRP3 levels and an increased TyG index are strongly associated with impaired cardiac function and heightened risk of cardiovascular events. These findings suggest that these biomarkers may serve as crucial prognostic indicators following myocardial ischemia-reperfusion injury. [ABSTRACT FROM AUTHOR]