Adiponectin as a potential mediator of the pro-cognitive effects of physical exercise on Alzheimer's disease

Alzheimer's disease is the primary cause of dementia and imposes a significant socioeconomic burden globally. Physical exercise, as an effective strategy for improving general health, has been largely reported for its effectiveness in slowing neurodegeneration and increasing brain functional plasticity, particularly in aging brains. However, the underlying mechanisms of exercise in cognitive aging remain largely unclear. Adiponectin, a cell-secreted protein hormone, has recently been found to regulate synaptic plasticity and mediate the antidepressant effects of physical exercise. Studies on the neuroprotective effects of adiponectin have revealed potential innovative treatments for Alzheimer's disease. Here, we reviewed the functions of adiponectin and its receptor in the brains of human and animal models of cognitive impairment. We summarized the role of adiponectin in Alzheimer's disease, focusing on its impact on energy metabolism, insulin resistance, and inflammation. We also discuss how exercise increases adiponectin secretion and its potential benefits for learning and memory. Finally, we highlight the latest research on chemical compounds that mimic exercise-enhanced secretion of adiponectin and its receptor in Alzheimer's disease.

Public Policy and Health System Responses to Diabetes Mellitus in Nigeria: A Call for Reform

Diabetes mellitus, once a rare diagnosis in precolonial and early post-colonial Nigeria, now has the highest prevalence and fatality rates in sub-Saharan Africa. This increased prevalence is attributed to rising population affluence characterized by sedentary lifestyles and higher consumption of processed and ultra-processed foods. The burden is further exacerbated by a poorly responsive healthcare system. Currently, less than 50% of affected individuals are aware of their condition. Factors such as misconceptions about the disease, a preference for unproven traditional herbal treatments, and the high cost of treatment hinder effective secondary responses. Health system challenges in diabetes management in Nigeria include inadequate implementation of existing policies and guidelines, high out-of-pocket payments, poor quality of healthcare, and limited public education about the disease. To address these issues, we recommend a policy focus on:  1) Implementing actionable policies and guidelines for diabetes prevention and care; 2) Improving the pre-paid care system to reduce out-of-pocket payments; 3) Enhancing the quality of services at all healthcare levels, with the establishment of centers of excellence for specialized diabetes management; 4) Continuing the training, retraining, motivation, and expansion of the workforce responsible for diabetes care; and 5) Health promotion and health awareness aimed at the public to address inaccurate beliefs and practices about diabetes. Addressing these multifaceted factors will help to reduce the rising incidence of diabetes in Nigeria.

How Health Systems World-wide Fail Type 2 Diabetics

For over 50 years, health systems the world over have failed people with type 2 diabetes mellitus (T2DM). The WHO documents a quadrupling of people with diabetes in a 34-year period to 422 million in 2014, the overwhelming majority of whom were T2DM. This happened despite extensive scientific literature on the causes of, as well as proven treatments for, this disease. Using a health systems prism to review the extensive medical and nutritional T2DM published research, we identified three main shortcomings of health systems in T2DM: (i) failure in early detection; (ii) failure in understanding the actionable lifestyle drivers; and (iii) subsidizing the causes of the disease. Although small-scale success stories in T2DM control exist, the lack of documented evidence of any country-wide health system's successful attempt to address this epidemic is alarming. The immense and ever-growing health and economic burdens of T2DM should provide all the motivation needed for national and global efforts to counteract the political-economy constraints standing in the way of successful whole-of-system approaches to T2DM.

Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND

The six global nutrition targets (GNTs) related to low birthweight, exclusive breastfeeding, child growth (ie, wasting, stunting, and overweight), and anaemia among females of reproductive age were chosen by the World Health Assembly in 2012 as key indicators of maternal and child health, but there has yet to be a comprehensive report on progress for the period 2012 to 2021. We aimed to evaluate levels, trends, and observed-to-expected progress in prevalence and attributable burden from 2012 to 2021, with prevalence projections to 2050, in 204 countries and territories.

METHODS

The prevalence and attributable burden of each target indicator were estimated by age group, sex, and year in 204 countries and territories from 2012 to 2021 in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, the most comprehensive assessment of causes of death, disability, and risk factors to date. Country-specific relative performance to date was evaluated with a Bayesian meta-regression model that compares prevalence to expected values based on Socio-demographic Index (SDI), a composite indicator of societal development status. Target progress was forecasted from 2021 up to 2050 by modelling past trends with meta-regression using a combination of key quantities and then extrapolating future projections of those quantities.

FINDINGS

In 2021, a few countries had already met some of the GNTs: five for exclusive breastfeeding, four for stunting, 96 for child wasting, and three for child overweight, and none met the target for low birthweight or anaemia in females of reproductive age. Since 2012, the annualised rates of change (ARC) in the prevalence of child overweight increased in 201 countries and territories and ARC in the prevalence of anaemia in females of reproductive age decreased considerably in 26 countries. Between 2012 and 2021, SDI was strongly associated with indicator prevalence, apart from exclusive breastfeeding (|r-|=0·46-0·86). Many countries in sub-Saharan Africa had a decrease in the prevalence of multiple indicators that was more rapid than expected on the basis of SDI (the differences between observed and expected ARCs for child stunting and wasting were -0·5% and -1·3%, respectively). The ARC in the attributable burden of low birthweight, child stunting, and child wasting decreased faster than the ARC of the prevalence for each in most low-income and middle-income countries. In 2030, we project that 94 countries will meet one of the six targets, 21 countries will meet two targets, and 89 countries will not meet any targets. We project that seven countries will meet the target for exclusive breastfeeding, 28 for child stunting, and 101 for child wasting, and no countries will meet the targets for low birthweight, child overweight, and anaemia. In 2050, we project that seven additional countries will meet the target for exclusive breastfeeding, five for low birthweight, 96 for child stunting, nine for child wasting, and one for child overweight, and no countries are projected to meet the anaemia target.

INTERPRETATION

Based on current levels and past trends, few GNTs will be met by 2030. Major reductions in attributable burden for exclusive breastfeeding and anthropometric indicators should be recognised as huge scientific and policy successes, but the comparative lack of progress in reducing the prevalence of each, along with stagnant anaemia in women of reproductive age and widespread increases in child overweight, suggests a tenuous status quo. Continued investment in preventive and treatment efforts for acute childhood illness is crucial to prevent backsliding. Parallel development of effective treatments, along with commitment to multisectoral, long-term policies to address the determinants and causes of suboptimal nutrition, are sorely needed to gain ground.

FUNDING

Bill & Melinda Gates Foundation.

Prenatal loss of control eating is associated with psychiatric symptoms and distress among individuals with elevated BMI

PURPOSE

Loss of control while eating (LOC) or feeling unable to control the amount or type of food consumed during an eating episode, is the core psychopathology in binge eating disorders. Yet, the impact of LOC on other psychiatric symptoms during pregnancy is not known. This study evaluated the contribution of prenatal LOC to psychological distress and disordered eating attitudes.

METHODS

Pregnant individuals with BMI ≥ 25 (N = 312) recruited for a perinatal health promotion trial self-reported past-month LOC; eating, shape, and weight concerns; prenatal depressive symptoms, anxiety, and stress. Propensity scores were used to reduce bias associated with cross-sectional data.

RESULTS

Overall, 34.3% (n = 107) reported LOC. Individuals with prenatal LOC, relative to those without, endorsed more eating disorder symptoms (ps<.001) as well as more symptoms of depression (7.1± 0.3 vs. 5.4± 4.9) and anxiety (38.1 ± 11.7 vs. 33.4 ± 11.7) and greater perceived stress (25.0 ± 7.9 vs. 22.0± 9.9, ps<.001). LOC frequency was associated with significantly more prenatal psychological distress, beyond the effect of other factors that increase the likelihood of LOC. (ps<.005).

CONCLUSIONS

Among individuals with elevated BMI, prenatal LOC is common and relates to eating disorder and other psychiatric symptoms. Prenatal LOC may represent a behavioral mechanism for improved psychological health.

Joint impacts of air pollution and healthy lifestyles on kidney function decline: insights from a nationwide cohort study

Long-term exposure to ambient air pollution is a recognized environmental risk factor for chronic kidney disease (CKD), but its dynamic effects on kidney function remain incompletely understood. This nationwide longitudinal study included 5,306 participants from the China Health and Retirement Longitudinal Study (CHARLS) to examine associations between five major air pollutants (PM1, PM2.5, PM10, NO2, and O3) and kidney function decline, measured by the annual slope of estimated glomerular filtration rate (eGFR). Air pollutant exposures were assessed both as continuous variables and dichotomized by median levels. Higher exposure to PM1, PM2.5, PM10, and NO2 was consistently associated with faster eGFR decline. In fully adjusted models, each 1 μg/m3 increase in PM2.5 corresponded to a steeper decline in eGFR (β = -0.02; 95% CI: -0.03 to -0.02), while participants in high PM2.5 areas had an annual decline of -0.51 mL/min/1.73 m2 (95% CI: -0.72 to -0.31). O3 showed a significant association only in binary models. Weighted quantile sum regression identified PM2.5 and PM1 as dominant contributors. A favorable lifestyle markedly mitigated pollution-related decline; under high PM1 exposure, eGFR declined by -0.69 (95% CI: -1.06 to -0.33) in those with favorable lifestyles versus -2.20 (95% CI: -2.65 to -1.75) in those with unfavorable lifestyles. These findings were robust across multiple sensitivity analyses. These findings emphasize the adverse impact of long-term air pollution exposure on kidney function and suggest that healthy lifestyle behaviors may offer significant protective benefits.

Prophylactic effects of nutrition, dietary strategies, exercise, lifestyle and environment on nonalcoholic fatty liver disease

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease and its prevalence has risen sharply. However, whether nutrition, dietary strategies, exercise, lifestyle and environment have preventive value for NAFLD remains unclear.

METHODS

Through searching 4 databases (PubMed, Web of Science, Embase and the Cochrane Library) from inception to January 2025, we selected studies about nutrition, dietary strategies, exercise, lifestyle and environment in the prevention of NAFLD and conducted a narrative review on this topic.

RESULTS

Reasonable nutrient intake encompassing macronutrients and micronutrients have an independent protective relationship with NAFLD. Besides, proper dietary strategies including mediterranean diet, intermittent fasting diet, ketogenic diet, and dietary approaches to stop hypertension diet have their inhibitory effects on the developmental process of NAFLD. Moreover, right exercises including walking, jogging, bicycling, and swimming are recommended for the prevention of NAFLD because they could effectively reduce weight, which is an important risk factor for NAFLD, and improve liver function. In addition, embracing a healthy lifestyle including reducing sedentary behavior, not smoking, sleeping well and brushing teeth regularly is integral since it not only could reduce the risk of NAFLD but also significantly contribute to overall prevention and control. Finally, the environment, including the social and natural environments, plays a potential role in NAFLD prevention.

CONCLUSION

Nutrition, dietary strategies, exercise, lifestyle and environment play an important role in the prevention of NAFLD. Moreover, this review offers comprehensive prevention recommendations for people at high risk of NAFLD.

Obstetric and neonatal outcomes of extremely obese pregnant women after late preterm gestation

OBJECTIVE

To determine the obstetric and neonatal outcomes of pregnant women with extreme obesity at birth after late preterm gestation.

METHODS

This was a retrospective study on extremely obese pregnant women with body mass index (BMI) ≥ 40.0 kg/m2 (obesity stage III according to the BMI classification of the World Health Organization) who had delivered at Seoul National University Bundang Hospital between September 2003 and February 2023. Fetal death in utero and preterm births before 34 weeks of gestation were excluded. Obstetric and neonatal outcomes were reviewed.

RESULTS

A total of 94 extremely obese pregnant women were included and the median value of BMI at delivery was 42.4 kg/m2. When analyzed according to the obesity II category of pre-pregnancy BMI, the rate of chronic hypertension was higher in the alleged extreme obese women than those with lower pre-pregnancy BMI (34% vs. 10%, p = 0.012). However, preterm labor with tocolytics was higher in the group with lower BMI than 35.0 kg/m2 (26% vs. 5%, p = 0.007). The proportion of adverse neonatal outcomes such as neonatal intensive care unit admission, the use of respiratory support (including positive pressure ventilation, continuous positive airway pressure, and mechanical ventilator), and jaundice were higher in the group with pre-pregnancy BMI < 35.0 kg/m2 than that with BMI ≥ 35.0 kg/m2 group (all p-value < 0.05). The use of neonatal respiratory support increased as the category of pre-pregnancy BMI was lower and as the degree of weight gain during pregnancy was higher.

CONCLUSIONS

In extremely obese women (stage III) at delivery in late preterm gestation, the obstetric outcomes such as use of tocolytics for preterm labor and adverse neonatal respiratory outcomes seemed to be higher for the women who were not that much obese before pregnancy than those who were already extremely obese. Therefore, weight gain during pregnancy needs to be closely monitored for pregnant women especially when obese.

Archaea methanogens are associated with cognitive performance through the shaping of gut microbiota, butyrate and histidine metabolism

The relationship between bacteria, cognitive function and obesity is well established, yet the role of archaeal species remains underexplored. We used shotgun metagenomics and neuropsychological tests to identify microbial species associated with cognition in a discovery cohort (IRONMET, n = 125). Interestingly, methanogen archaeas exhibited the strongest positive associations with cognition, particularly Methanobrevibacter smithii (M. smithii). Stratifying individuals by median-centered log ratios (CLR) of M. smithii (low and high M. smithii groups: LMs and HMs) revealed that HMs exhibited better cognition and distinct gut bacterial profiles (PERMANOVA p = 0.001), characterized by increased levels of Verrucomicrobia, Synergistetes and Lentisphaerae species and reduced levels of Bacteroidetes and Proteobacteria. Several of these species were linked to the cognitive test scores. These findings were replicated in a large-scale validation cohort (Aging Imageomics, n = 942). Functional analyses revealed an enrichment of energy, butyrate, and bile acid metabolism in HMs in both cohorts. Global plasma metabolomics by CIL LC-MS in IRONMET identified an enrichment of methylhistidine, phenylacetate, alpha-linolenic and linoleic acid, and secondary bile acid metabolism associated with increased levels of 3-methylhistidine, phenylacetylgluamine, adrenic acid, and isolithocholic acid in the HMs group. Phenylacetate and linoleic acid metabolism also emerged in the Aging Imageomics cohort performing untargeted HPLC-ESI-MS/MS metabolic profiling, while a targeted bile acid profiling identified again isolithocholic acid as one of the most significant bile acid increased in the HMs. 3-Methylhistidine levels were also associated with intense physical activity in a second validation cohort (IRONMET-CGM, n = 116). Finally, FMT from HMs donors improved cognitive flexibility, reduced weight, and altered SCFAs, histidine-, linoleic acid- and phenylalanine-related metabolites in the dorsal striatum of recipient mice. M. smithii seems to interact with the bacterial ecosystem affecting butyrate, histidine, phenylalanine, and linoleic acid metabolism with a positive impact on cognition, constituting a promising therapeutic target to enhance cognitive performance, especially in subjects with obesity.

Drivers of food acquisition practices among adolescents in suburban food environments of Lao People's Democratic Republic

BACKGROUND

Dietary shifts among adolescents in low- and middle-income countries are exacerbating the double burden of malnutrition. Understanding the drivers of adolescent food acquisition and consumption practices and their lived experiences of the food environment is crucial for the effective development of targeted interventions and policies.

OBJECTIVE

To explore drivers of food acquisition and consumption practices among adolescents from two suburban schools in the food environments of Phonhong District, Lao People's Democratic Republic.

METHODS

We implemented a Qualitative-Geographical Information System methodology, featuring participatory photography, follow-up photo-elicitation interviews and focus group discussions with 30 adolescents from April to July 2022. Thematic analysis triangulated key themes from photos, maps, and transcripts.

RESULTS

Drivers of food acquisition and consumption included interactions across external, interpersonal, and intrapersonal domains. The six key themes were food availability and accessibility, product properties and convenience, peers and social media, caregivers and household practices, affordability, desirability, and autonomy, and perceptions, beliefs, and social norms. Consumption of ultra-processed foods was driven by the availability and accessibility of these affordable products in schools. By contrast, consumption of fruits and vegetables was driven by parental food practices at home.

CONCLUSION

A comprehensive multi-scalar approach is required to improve adolescent diets and nutrition in the suburban food environment of Lao PDR. This includes restricting the sale of ultra-processed foods in schools, promoting home gardening, increasing caregivers' awareness and engagement with adolescents about the benefits of healthy food choices, and leveraging social media to encourage healthy eating behaviors.

Activation of CXCR7 exerts an inhibitory effect on adipogenesis through regulation of β-arrestin2/Wnt and AKT signalling

CXCR7, an alternative receptor for the inflammatory chemokine SDF-1, is involved in cell proliferation and migration. Recent studies have reported that CXCR7 also plays a role in adipose tissue. However, evidence regarding the role of CXCR7 and its ligands in adipocyte differentiation is limited. In this study, we aimed to elucidate changes in CXCR7 expression during adipocyte differentiation and the role of the SDF-1/CXCR7/CXCR4 axis in adipogenesis using recombinant SDF-1, the CXCR7 ligand CCX771, and small interfering RNAs. The results indicated that the levels of SDF-1 and its receptors, CXCR7 and CXCR4, decreased during the early stages of adipogenesis. Treatment with recombinant SDF-1 and CCX771 inhibited adipogenesis and lipid accumulation by inducing β-arrestin2, Wnt expression, and AKT phosphorylation and downregulating C/EBPα, PPARγ, and FABP4 expression. In contrast, knockdown of SDF-1 and CXCR7 in preadipocytes downregulated the β-arrestin2/Wnt and AKT pathway, leading to the induction of adipogenesis. Meanwhile, knockdown of CXCR4 had no significant effect. In mice, basal gene expression levels of SDF-1 and CXCR7 were higher in the stromal vascular fraction compared to mature adipocytes and were significantly upregulated by a high-fat diet. Our results provide new insights into the local role of the SDF-1-CXCR7 axis in adipocytes and offer additional benefits for the prevention of obesity-related metabolic disorders.

Is lean mass quantity or quality the determinant of maximal fat oxidation capacity? The potential mediating role of cardiorespiratory fitness

BACKGROUND

Impaired fat oxidation is linked to cardiometabolic risk. Maximal fat oxidation rate (MFO) reflects metabolic flexibility and is influenced by lean mass, muscle strength, muscle quality - defined as the ratio of strength to mass - and cardiorespiratory fitness. The relationship between these factors and fat oxidation is not fully understood. The aim is to analyze the associations of lean-mass, muscle strength and quality with fat oxidation parameters in young adults, considering the mediating role of VO2max.

METHODS

A cross-sectional observational study. Eighty-one adults (50 males, 31 females; age 22.8 ± 4.4, BMI 25.70 ± 5.75, lean-mass 54.19 ± 8.78, fat-mass 18.66 ± 11.32) Body composition assessment by bioimpedance determine fat and lean-mass. Indirect calorimetry at rest and exercise was used for the calculation of fat oxidation. An incremental exercise protocol in a cycle ergometer with two consecutive phases was performed. The first to determine MFO consisted of 3 min steps of 15W increments with a cadence of 60rpm. The test was stopped when RQ ≥ 1. After 5 min rest, a phase to detect VO2max began with steps of 15W/min until exhaustion. Muscular strength was assessed by handgrip dynamometry and the standing longitudinal jump test. A strength cluster was calculated with handgrip and long jump adjusted by sex and age. Data were analyzed using multiple linear regression and mediation analyses.

RESULTS

Total lean-mass and leg lean-mass were not associated with MFO. Long jump, relativized by lean-mass and by leg lean-mass have a standardized indirect effect on MFO of 0.50, CI: 0.32-0.70, on MFO/lean-mass 0.43, CI:0.27-0.60 and MFO/leg lean-mass 0.44, CI: 0.30-0.06, which VO2max mediated, VO2max/lean-mass and VO2max/leg lean-mass, respectively (all p < 0.01). The handgrip/arm lean-mass had an indirect effect of 0.25 (CI: 0.12-0.38) on MFO/leg lean-mass, with VO2max/leg lean-mass as the mediator (p < 0.01). The Cluster/lean-mass and Cluster/Extremities lean-mass have a standardized indirect effect on MFO/lean-mass (0.34, CI: 0.20-0.48) and MFO/leg lean-mass (0.44, CI: 0.28-0.60), mediated by VO2max/lean-mass and VO2max/leg lean-mass (p < 0.01).

CONCLUSIONS

Muscular strength and quality have an indirect effect on MFO mediated by VO2max. These findings suggest the importance of muscle quality on MFO.

Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours

Background: Individuals impacted by adverse childhood experiences (ACEs) are at greater risk of developing obesity, however, few studies have prospectively measured ACEs and obesity during childhood. Associations with the adoption of obesogenic behaviours during childhood, which directly contribute to obesity are also understudied.Objective: To examine associations between individual and cumulative ACEs, obesity, and obesogenic behaviours during childhood.Methods: Data came from Growing Up in New Zealand. The study sample was restricted to those who provided obesity data at age 8 and one child per mother, resulting in an analytic sample of 4895 children. A newly developed ACEs index consisted of nine individual ACEs and cumulative ACEs scores (0, 1, 2, 3, 4+ ACEs), two obesity measures (BMI and waist circumference/height ratio), and eight obesogenic behaviours including unhealthy dietary behaviours, inadequate sleep duration, excessive screen time, and physical inactivity were included in the analyses.Results: ACEs were prevalent among this cohort of NZ children. By age eight, 87.1% of children experienced at least one ACE and 16% experienced at least 4 ACEs. Six individuals assessed ACEs showed significant associations with childhood obesity (AORs ranging from 1.22 to 1.44). A significant dose-response effect was observed where the experience of a higher number of ACEs was associated with greater risk for obesity (AORs increased from 1.78 for one ACE to 2.84 for 4+ ACEs). Further, a significant dose-response relationship was found between experiencing two or more ACEs and higher odds of adopting obesogenic behaviours (AORs ranging from 1.29 for physical inactivity to 3.16 for no regular breakfast consumption).Conclusions: ACEs exposure contributes to population-level burden of childhood obesity. Our findings highlight the importance of a holistic understanding of the determinants of obesity, reinforcing calls for ACEs prevention and necessitating incorporation of ACEs-informed services into obesity reduction initiatives.

Concepts of healthy and environmentally sustainable diets clash with a life in transition - Findings from a qualitative study in urban Burkina Faso

BACKGROUND

Sub-Saharan African countries like Burkina Faso face a dietary transition and are experiencing a shift in disease burden.

OBJECTIVE

We explored perceptions of healthy and environmentally sustainable dietary habits in urban Burkina Faso in order to tailor nutritional interventions to the local population and ultimately improve public and planetary health.

METHODS

We conducted an exploratory qualitative study with semi-structured face-to-face interviews in three informal and two formal neighborhoods of Ouagadougou. The sample comprised 36 adult participants. The interviews were conducted in Mooré and French, audio-recorded, and transcribed verbatim. Data were analysed inductively, using thematic analysis.

RESULTS

Participants described their ideal healthy and environmentally sustainable diet as traditional, local, natural, pure, organic, and transparent in terms of food production, processing, and preparation. Perceived barriers to achieve such diets were: limited financial resources, reduced availability of products and limited time for food preparation. Furthermore, participants highlighted discordant food preferences in the family, and a lack of understanding around the interconnection between nutrition, health and the environment as barriers. Most of these barriers were aggravated by the experience of a life in transition due to modernizing lifestyles, globalizing food systems, and a changing environment.

CONCLUSIONS

Participants' ideal of a healthy and environmentally sustainable diet clashed with a life in transition. To improve public and planetary health, interventions should aim to empower individuals, alleviate financial constraints, and shape global and local food environments.

Interkingdom signaling between gastrointestinal hormones and the gut microbiome

The interplay between the gut microbiota and gastrointestinal hormones plays a pivotal role in the health of the host and the development of diseases. As a vital component of the intestinal microecosystem, the gut microbiota influences the synthesis and release of many gastrointestinal hormones through mechanisms such as modulating the intestinal environment, producing metabolites, impacting mucosal barriers, generating immune and inflammatory responses, and releasing neurotransmitters. Conversely, gastrointestinal hormones exert feedback regulation on the gut microbiota by modulating the intestinal environment, nutrient absorption and utilization, and the bacterial biological behavior and composition. The distributions of the gut microbiota and gastrointestinal hormones are anatomically intertwined, and close interactions between the gut microbiota and gastrointestinal hormones are crucial for maintaining gastrointestinal homeostasis. Interventions leveraging the interplay between the gut microbiota and gastrointestinal hormones have been employed in the clinical management of metabolic diseases and inflammatory bowel diseases, such as bariatric surgery and fecal microbiota transplantation, offering promising targets for the treatment of dysbiosis-related diseases.

Association between salivary /microbiological parameters, oral health and eating habits in young athletes

BACKGROUND

Athletes' oral health can impact overall well-being and sports performance. This study aimed to evaluate the interactions between eating habits and oral health of 120 young athletes as compared to 30 age-matched individuals not practicing sports based on a questionnaire and the analysis of saliva.

METHODS

One hundred twenty subjects practicing various sports activities (test group) and 30 subjects not practicing sports (control group) were selected. A self-administered questionnaire was used to obtain personal data, hours and frequency of weekly training, complete pathological history, history of hard and soft tissues of the oral cavity, family history, and oral hygiene practices. The eating habits of the young participants were analyzed by investigating the number of daily meals; use and frequency in sports practice of supplements/energy drinks, fruit/juices, snacks, chocolate; daily diet; and differences between usual diet and pre-competition diet. At baseline (T0), each participant was clinically assessed for the determination of the number of decayed, missing, and filled teeth (DMFT), Silness & Löe Plaque Index (PI), and the Löe & Silness Gingival Index (GI) and qualitative analysis for the presence/absence of stains and dental erosions. At T0, before (T1) and after training sessions (T2), saliva was collected to determine resting pH, Streptococcus mutans, and Lactobacillus spp counts.

RESULTS

Test groups were trained more than 2 h, 5 times a week. Soccer players and skiers had a high percentage of caries; water polo players demonstrated the highest percentage of erosions and dental stains. Salivary resting pH showed statistically different values in three different observations between the groups. S. mutans was harbored by 60% of soccer and 70% of water polo players, while Lactobacillus spp in 43.33% of the swimmers and soccer players. Combining all the 56 variables including the clinical examination, self-reported parameters, and salivary analysis, we have identified water polo players as a distinct at-risk group for developing dental defects, expressed as an aggregate disease score. In particular, we have found that energy snacks/chocolate intake is strongly associated with ratio of S. mutans/Lactobacillus spp and that S. mutans is linked to dental defects (R = 0.88). Linear regression analysis indicates that energy snacks/chocolate intake in the study population represents a strong driver for oral dysbiosis and dental disease.

CONCLUSIONS

Our study clearly shows that athletes should follow a balanced diet that not only satisfies their nutritional needs but also avoids oral dysbiosis and subsequent dental damage.

Secular trends in BMI, excess weight and body fat skinfolds in Peruvian children living at high altitude

BACKGROUND

There is limited evidence on secular trends in adiposity among high-altitude children.

AIMS

To describe secular trends in body mass index (BMI), excess weight and body fat skinfolds (SKF) among Peruvian children living at high altitude and to investigate the risk for excess weight in 2019 relative to 2009.

SUBJECTS AND METHODS

We sampled 1585 Peruvians aged 6-11 years from the Junín region. Height and weight were measured, and BMI was calculated. WHO cut-offs were used to classify children by weight status. The sum of SKF was used for analysis. BMI and sum SKF were log-transformed. Two-factor ANOVA and post-hoc contrasts were used together with trend plots for BMIlog and SKFlog. Relative risks for excess weight were estimated with 95% confidence intervals. All analyses were done in STATA.

RESULTS

BMIlog and SKFlog means increased in both sexes from 2009 to 2019, with age-specific variation. Between 2009 and 2019, BMI values shifted from near P50 to P75 on WHO percentiles for both sexes in most age groups. The risk of excess weight was not significantly higher for most children in 2019 compared to 2009.

CONCLUSIONS

Positive secular trends in BMIlog and SKFlog were observed, with significant increases at specific ages.

Association of mean arterial pressure and in-hospital mortality in critically ill patients with acute pancreatitis-associated acute kidney injury: a retrospective cohort study

Acute pancreatitis (AP) is a common gastrointestinal disorder, and acute kidney injury (AKI) is a frequent and severe complication, significantly increasing mortality risk. Mean arterial pressure (MAP) is crucial for maintaining organ perfusion in critically ill patients. However, the optimal MAP target for minimizing mortality in AP patients complicated by AKI (AP-AKI) remains unclear. This retrospective cohort study analyzed data from the MIMIC-IV database, including 934 critically ill adult patients diagnosed with AP-AKI between 2008 and 2019. We investigated the relationship between MAP and in-hospital mortality using logistic regression models, adjusting for demographics, comorbidities, disease severity scores and intensive care interventions. Smooth curve fitting was used to explore potential non-linear associations. Subgroup analyses were performed to assess the impact of MAP across different clinical and demographic groups. Our analysis revealed a non-linear, L-shaped relationship between MAP and in-hospital mortality, with an inflection point at 71.32 mmHg. Below this threshold, increasing MAP was associated with significantly decreased odds of mortality (OR: 0.93, 95% CI: 0.87-0.99, p = 0.026). However, above this threshold, the association was no longer significant (OR: 1.015, 95% CI: 0.98-1.03, p = 0.699). Subgroup analyses showed consistent trends across most subgroups, with the benefit of maintaining MAP above the threshold being most pronounced in AKI stage 1 and 2 patients. This study suggests a potential association between maintaining specific MAP levels, particularly above 71.32 mmHg, and reduced in-hospital mortality in critically ill AP-AKI patients.

Efficacy of time restricted eating and resistance training on body composition and mood profiles among young adults with overweight/obesity: a randomized controlled trial

BACKGROUND/OBJECTIVE

Dietary restriction or exercise regimens can promote weight loss or physical fitness among patients with obesity. However, intervention-associated adverse effects may impede patients' motivation to participate in dietary/exercise interventions. We examined the effects of time restricted eating (TRE) with or without resistance training (RT) on body composition, mood profile, and sleep quality in young college adults with overweight or obesity.

METHODS

Fifty-four young college students with overweight/obesity were randomized into control (CON), TRE, RT, and TRE plus RT (TRE+RT) trials. The TRE trials restricted to an eating window of 10-hour/day for 8-week. The RT trials performed supervised resistance exercise, while the control trial maintained a regular lifestyle. Changes in body composition variables, blood pressure, mood status, and sleep quality were measured before and after the intervention.

RESULTS

TRE intervention alone or in combination with RT significantly (p < 0.01) decreased body weight (>2 kg) and BMI (~1 kg/m2) in adults with overweight/obesity. Both RT alone and combined with TRE substantially decreased fat mass by 1.1 ± 0.5 and 3.2 ± 0.4 kg, respectively. The decreased fat mass was greater in the combination trial than in the RT trial, whereas TRE alone had no effect. In contrast, fat-free mass was significantly (p < 0.01) decreased with TRE (-2.3 ± 06 kg), increased with RT (1.6 ± 0.3 kg), and was stably maintained with combination interventions. The reduced waist and hip circumferences in the TRE (p < 0.01) were similar to those in the TRE+RT trials, however, RT alone had no effect. Time and group interaction showed a large effect size (partial eta squared) for all body composition variables. In addition, RT with or without TRE notably decreased diastolic blood pressure (RT: -5.5 ± 1.9 mmHg, TRE+RT: -4.1 ± 1.5 mmHg, p < 0.05). Mild anxiety levels at baseline in RT (4.8 ± 2.6) and TRE+RT (4.1 ± 3) trials were found to be normal at postintervention in TRE+RT (3.6 ± 1.7) but not in RT (5.6 ± 3.5). No depression or stress was recorded among the participants during the intervention. The reported poor sleep quality among participants at baseline was significantly improved with RT (4.8 ± 2.9; p < 0.05), and tended to improve with TRE+RT interventions (4.5 ± 1.9).

CONCLUSIONS

10-hour TRE is beneficial for weight/fat loss without affecting mood status. However, TRE combined with RT might be more effective for weight/fat loss, maintaining muscle mass, and good quality of sleep among young adults with overweight or obesity.

Gut microbiome shifts in adolescents after sleeve gastrectomy with increased oral-associated taxa and pro-inflammatory potential

Bariatric surgery is highly effective in achieving weight loss in children and adolescents with severe obesity, however the underlying mechanisms are incompletely understood, and gut microbiome changes are unknown. Here, we show that adolescents exhibit significant gut microbiome and metabolome shifts several months after laparoscopic vertical sleeve gastrectomy (VSG), with increased alpha diversity and notably with enrichment of oral-associated taxa. To assess causality of the microbiome/metabolome changes in phenotype, pre-VSG and post-VSG stool was transplanted into germ-free mice. Post-VSG stool was not associated with any beneficial outcomes such as adiposity reduction compared pre-VSG stool. However, post-VSG stool exhibited a potentially inflammatory phenotype with increased intestinal Th17 and decreased regulatory T cells. Concomitantly, we found elevated fecal calprotectin and an enrichment of proinflammatory pathways in a subset of adolescents post-VSG. We show that in some adolescents, microbiome changes post-VSG may have inflammatory potential, which may be of importance considering the increased incidence of inflammatory bowel disease post-VSG.

Association between visceral adiposity index and prostate cancer in men aged 40 years and older: a nationwide cross-sectional study

OBJECTIVES

This study aimed to elucidate the correlation of Visceral Adiposity Index (VAI) with prostate cancer (PCa) among men aged 40 years and older in the United States.

METHODS

Analysis included multivariate linear and logistic regression, smoothing curve fitting, and threshold effect evaluation using 2003-2010 National Health and Nutrition Examination Survey (NHANES) data. The stability of this relationship across demographic groups was assessed via subgroup analyses and interaction tests.

RESULTS

Among 2,768 participants, those with elevated VAI displayed lower total prostate-specific antigen (tPSA) levels and reduced PCa risk. Each VAI unit elevation corresponded to a 0.075 ng/mL tPSA reduction [-0.075 (-0.145, -0.005)] and 18.8% PCa risk reduction [0.812 (0.687, 0.960)]. Top-quartile VAI individuals exhibited 0.282 ng/mL reduced tPSA [-0.282 (-0.557, -0.007)] and 49.7% reduced PCa risk [0.503 (0.282, 0.896)] relative to bottom-quartile counterparts. This inverse relationship was more pronounced in men ≥70 years. Moreover, VAI-tPSA in other races demonstrated a U-shaped pattern, with a 2.09 inflection point. At the same time, a Mexican American subgroup exhibited an inverted U-shape for VAI and PCa risk, with a 1.42 inflection point.

CONCLUSION

In men aged ≥70, VAI indicates an inverse PCa relationship. However, PSA-based PCa screening may be influenced in visceral-obese individuals aged <70.

Gut microbiome changes with micronutrient supplementation in children with attention-deficit/hyperactivity disorder: the MADDY study

Micronutrients have demonstrated promise in managing inattention and emotional dysregulation in children with attention-deficit/hyperactivity disorder (ADHD). One plausible pathway by which micronutrients improve symptoms is the gut microbiome. This study examines changes in fecal microbial composition and diversity after micronutrient supplementation in children with ADHD (N = 44) and highlights potential mechanisms responsible for the behavioral improvement, as determined by blinded clinician-rated global improvement response to micronutrients. Participants represent a sub-group of the Micronutrients for ADHD in Youth (MADDY) study, a double blind randomized controlled trial in which participants received micronutrients or placebo for 8 weeks, followed by an 8-week open extension. Stool samples collected at baseline, week 8, and week 16 were analyzed using 16S rRNA amplicon sequencing targeting the V4 hypervariable region. Pairwise compositional analyses investigated changes in fecal microbial composition between micronutrients versus placebo and responders versus non-responders. A significant change in microbial evenness, as measured by alpha diversity, and beta-diversity, as measured by Bray-Curtis, was observed following micronutrients supplementation. The phylum Actinobacteriota decreased in the micronutrients group compared to placebo. Two butyrate-producing bacterial families: Rikenellaceae and Oscillospiraceae, exhibited a significant increase in change following micronutrients between responders versus non-responders. These findings suggest that micronutrients modulated the composition of the fecal microbiota and identified specific bacterial changes associated with micronutrient responders.

Construction of a risk prediction model for adverse pregnancy outcomes in primipara with gestational diabetes mellitus combined with pregnancy-induced hypertension syndrome

OBJECTIVE

This study aims to identify risk factors for adverse pregnancy outcomes in primipara with gestational diabetes mellitus (GDM) combined with pregnancy-induced hypertension syndrome (PIH) and to develop a predictive model for such outcomes.

METHODS

A total of 120 primipara with GDM and PIH, admitted from January 2019 to May 2023, were divided into two groups: the adverse group (n = 57) and the good group (n = 63), based on pregnancy outcomes. Multivariate logistic regression analysis was used to identify independent risk factors for adverse outcomes. A nomogram was constructed based on these factors, and its efficacy was validated through internal evaluation.

RESULTS

The adverse group had higher proportions of elderly parturients, higher pre-pregnancy BMI, and more weight gain during pregnancy. Additionally, the adverse group showed a higher incidence of family history of diabetes, and more severe types of PIH. Biochemical markers such as HbA1c and total cholesterol (TC) were higher in the adverse group, while high-density lipoprotein cholesterol (HDL-C) was lower (p < .01, p < .05). Multivariate logistic regression revealed that advanced maternal age, pre-pregnancy BMI, family history of diabetes, preeclampsia/chronic hypertension complicated by preeclampsia, and elevated HbA1c were independent risk factors for adverse pregnancy outcomes (p < .01). A nomogram prediction model was developed, with an AUC of 0.821. Bootstrap internal validation confirmed the model's robust discriminative ability.

CONCLUSION

Advanced maternal age, pre-pregnancy BMI, family history of diabetes, preeclampsia, and elevated HbA1c are significant risk factors for adverse pregnancy outcomes in GDM combined with PIH. The nomogram model provides an effective tool for predicting such outcomes.

Causal associations of metabolic dysfunction-associated steatotic liver disease with gestational hypertension and preeclampsia: a two-sample Mendelian randomization study

BACKGROUND

Hypertensive disorders of pregnancy (HDPs), which include gestational hypertension (GH) and preeclampsia (PE), are the primary causes of maternal morbidity and mortality worldwide. Recent studies have found a correlation between metabolic dysfunction-associated steatotic liver disease (MASLD) and HDPs, but the causality of this association remains to be identified. Therefore, this study aims to evaluate the causal relationship between MASLD and HDPs through Mendelian randomization (MR) analysis.

METHODS

The summary statistics from genome-wide association studies were employed to conduct a two-sample MR analysis. Five complementary MR methods, including inverse variance weighting (IVW), MR-Egger, weighted median, simple mode and weighted mode were performed to assess the causality of MASLD on GH and PE. Furthermore, we conducted various sensitivity analyses to ensure the stability and reliability of the results.

RESULTS

Genetically predicted MASLD significantly increased the risk of GH (IVW: OR = 1.138, 95% CI: 1.062-1.220, p < 0.001), while there was little evidence of a causal relationship between MASLD and PE (IVW: OR = 0.980, 95% CI: 0.910-1.056, p = 0.594). The sensitivity analyses indicated no presence of heterogeneity and horizontal pleiotropy.

CONCLUSION

This MR study provided evidence supporting the causal effect of MASLD on GH. Our findings underscore the significance of providing more intensive prenatal care and early intervention for pregnant women with MASLD to prevent potential adverse obstetric outcomes.

Discovery of lignans as the effective inhibitors of CES1A alleviate lipid droplets formation

ER carboxylesterase 1A (CES1A) is an important metabolic enzyme involved in lipid metabolism. Targeting the CES1A is a promising approach for diseases associated with disorders of lipid metabolism therapy. In this study, screening of 26 natural lignans, three of them were found displaying potent inhibition on CES1A and high specificity over other serine hydrolases. Inhibition kinetic analyses demonstrated that Schisandrin C and Anwuligan were mixed-type inhibitors, while Magnolol acts as a competitive inhibitor. Further investigation showed that they were cell permeable and exhibited minimal cytotoxicity and mitochondrial toxicity, as well as capable of inhibiting intracellular CES1A in living cells. Further investigation found that three Schisandras decreased the number of lipid droplets (LDs) in free fatty acid (FFA)-treated HepG2 cells. Collectively, our findings suggest that Schisandrin C is a potent and highly selective inhibitor of CES1A, which can be served as a promising lead compound.

Targeting oxidative stress in preeclampsia

Preeclampsia is a complex condition characterized by elevated blood pressure and organ damage involving kidneys or liver, resulting in significant morbidity and mortality for both the mother and the fetus. Increasing evidence suggests that oxidative stress, often caused by mitochondrial dysfunction within fetal trophoblast cells may play a major role in the development and progression of preeclampsia. Oxidative stress occurs as a result of an imbalance between the production of reactive oxygen species (ROS) and the capacity of antioxidant defenses, which can lead to placental cellular damage and endothelial cell dysfunction. Targeting oxidative stress appears to be a promising therapeutic approach that has the potential to improve both short- and long-term maternal and fetal outcomes, thus reducing the global burden of preeclampsia. The purpose of this review is to provide a comprehensive account of the mechanisms of oxidative stress in preeclampsia. Furthermore, it also examines potential interventions for reducing oxidative stress in preeclampsia, including natural antioxidant supplements, lifestyle modifications, mitochondrial targeting antioxidants, and pharmacological agents.A better understanding of the mechanism of action of proposed therapeutic strategies targeting oxidative stress is essential for the identification of companion biomarkers and personalized medicine approaches for the development of effective treatments of preeclampsia.

Microbial succinate promotes the response to metformin by upregulating secretory immunoglobulin a in intestinal immunity

Metformin is the first-line pharmacotherapy for type 2 diabetes mellitus; however, many patients respond poorly to this drug in clinical practice. The potential involvement of microbiota-mediated intestinal immunity and related signals in metformin responsiveness has not been previously investigated. In this study, we successfully constructed a humanized mouse model by fecal transplantation of the gut microbiota from clinical metformin-treated - responders and non-responders, and reproduced the difference in clinical phenotypes of responsiveness to metformin. The abundance of Bacteroides thetaiotaomicron, considered a representative differential bacterium of metformin responsiveness, and the level of secretory immunoglobulin A (SIgA) in intestinal immunity increased significantly in responder recipient mice following metformin treatment. In contrast, no significant alterations in B. thetaiotaomicron and SIgA were observed in non-responder recipient mice. The study of IgA-/- mice confirmed that downregulated expression or deficiency of SIgA resulted in non-response to metformin, meaning that metformin was unable to improve dysfunctional glucose metabolism and reduce intestinal and adipose tissue inflammation, ultimately leading to systemic insulin resistance. Furthermore, supplementation with succinate, a microbial product of B. thetaiotaomicron, potentially reversed the non-response to metformin by inducing the production of SIgA. In conclusion, we demonstrated that upregulated SIgA, which could be regulated by succinate, was functionally involved in metformin response through its influence on immune cell-mediated inflammation and insulin resistance. Conversely, an inability to regulate SIgA may result in a lack of response to metformin.

Psychosocial interventions for psoriasis: a Bayesian network meta-analysis

BACKGROUND

Psoriasis impacts patients' mental and physical health, prompting interest in psychosocial interventions.

AIM

To compare and rank different psychosocial interventions for psoriasis and their effects on well-being and mental health.

METHODS

A systematic search was conducted using Cochrane Library, EMBASE, Medline, and PsycINFO (via the OVID) from their inception to 6 February 2024. Trials investing in psychosocial therapy in psoriasis patients were included using A random-effects network meta-analysis (NMW) within a Bayesian framework focusing on dermatology life quality index (DLQI), depression, and anxiety, along with adherence to treatment. The risk of bias was assessed by the Cochrane Handbook.

RESULTS

Thirteen studies with 6 treatments and 1233 patients were included. The quality of the included studies was low. For DLQI, 9 studies were eligible, mindfulness + treatment as usual (TAU) was better than TAU (MD = -7.21, 95%CI [-14.89, 0.54]). Cognitive behavioral therapy (CBT) + TAU were more effective in improving HADS-anxiety (MD = -2.17, 95%CI [-3.86, -0.49]) and HADS-depression (MD = -1.58, 95%CI [-3.65, 0.68]). Regarding adherence, CBT + TAU (MD = 0.84, 95%CI [-0.62, 2.27]) ranked first, followed by motivational interviewing + TAU.

CONCLUSION

We confirmed the effectiveness of psychosocial interventions on patients' well-being and mental health and recommended several interventions for clinical practice. However, the results should be cautiously interpreted, due to lacking high-quality and more replication studies.

Sustainability in food-based dietary guidelines: a review of recommendations around meat and dairy consumption and their visual representation

BACKGROUND

The transition away from high meat and dairy consumption and towards more plant-based diets is vital for environmental sustainability targets, including reducing greenhouse gas (GHG) emissions and land use associated with food. Food-based dietary guidelines (FBDG) communicate nutrition information to a country's general public. However, it is unknown how different countries' FBDG communicate reducing meat and dairy intake in the context of sustainability.

METHODS

To address this gap, we reviewed global consumer-facing FBDG (n = 58) in middle- and high-income countries to examine recommendations and information around meat and dairy consumption, and to explore the pictorial representation of these foods.

RESULTS

Few countries used a sustainability argument to recommend reducing meat (6/58) or dairy consumption (2/58). The proportion of dairy images within food guides was consistently higher than meat images. Some countries' guidelines are starting to consider meat intake in the context of sustainability and implementing meat reduction recommendations. However, this is not the case for dairy, potentially due to complex nutritional implications.

CONCLUSION

Overall, our review shows that very few countries recommend reducing either meat or dairy consumption. To reduce the environmental impact of food systems, clearer guidelines backed by current evidence are needed, which provide justification behind recommendations, actionable advice for how to meet the recommendations, and appropriate quantified food targets or limits. This well-rounded advice is imperative to empower citizens to take action on their dietary habits, to reduce global meat and dairy consumption and replace these with more sustainable alternatives for human and planetary health.

Association of antidepressant use with obesity risk in pregnant women: a retrospective cohort study

OBJECTIVE

This study evaluated the relationship between treatment for depression and anxiety in pregnancy and the risk of obesity.

DESIGN

Multivariate logistic regression analysis, nested case control study design.

SETTING

Births occurring 2008-2022 at an outer-suburban, lower socioeconomic maternity hospital in Australia. Population: 75,308 eligible births. Main outcome measures: BMI ≥ 30 (obesity), BMI ≥ 35 (severe obesity/obesity class II and III).

RESULTS

In this analysis, we found an adjusted OR of 1.56 of BMI ≥ 30, p < .000 with CI (1.35-1.80) in women taking antidepressants in pregnancy, OR 1.56 of BMI ≥ 35, p < .000, CI (1.31-1.84). Within this dataset, a cohort of 7559 women with a history or current diagnosis of depression or anxiety were found; adjusted OR of 1.40 of BMI ≥ 30, p < .000, CI (1.22-1.60) in women within this group taking antidepressants. Rates of severe obesity were similar in this cohort, BMI ≥ 35; OR 1.39, p < .000; CI 1.18-1.62).

CONCLUSIONS

These results suggest an increase in rates of obesity in women taking antidepressants in pregnancy not accounted for by other risks for obesity which might accrue from current mental ill-health or other cohort effects such as genetic vulnerability or lifestyle factors. This outcome is important in relation to the care of pregnant women with depression and anxiety. In view of current high rates of prescribing of antidepressants in pregnancy and the postpartum, this research may help inform clinician decision-making for women at risk of obesity in pregnancy.

Targeted modulation of intestinal barrier and mucosal immune-related microbiota attenuates IgA nephropathy progression

IgA nephropathy (IgAN) is related to the balance of gut microbiota. However, it is unclear whether changes in the gut microbiota can cause IgAN or attenuate its progression. This study employed IgAN and human microbiota-associated (HMA)-IgAN models to investigate the impact of IgAN on gut microbiota alteration and the mechanisms by which gut microbiota might trigger IgAN. Furthermore, this study examined the effects of chitooligosaccharides (COS) and COS formulation (COSF) with microbiota-targeting function on enhancing intestinal barrier and renal functions. These results revealed that IgAN led to a reduction in α-diversity and structural alterations in the gut microbiota, characterized by an increase in Shigella sonnei, Streptococcus danieliae, Desulfovibrio fairfieldensis, and a decrease in Bifidobacterium pseudolongum and Clostridium leptum. There was also an imbalance in intestinal B-cell immunity and a decrease in the level of tight junction proteins (ZO-1 and Occludin). Intestinal barrier and mucosal immune-related microbiota (Clostridium leptum, unclassified Lachnospiraceae NK4Al36 group, unclassified Clostridia vadinBB60 group, unclassified Oscillospiraceae, and unclassified Roseburia) were enriched through targeted modulation with COS/COSF, enhancing intestinal ZO-1 expression and reducing APRIL/BAFF overexpression, thereby reducing renal damage in IgAN. In conclusion, this study clarified the kidney-gut crosstalk between gut microbiota and IgAN, providing scientific evidence for developing microbiota-targeted food interventions to improve IgAN outcomes.

Inflammatory and metabolic markers mediate the association of hepatic steatosis and fibrosis with 10-year ASCVD risk

BACKGROUND AND AIMS

Liver steatosis and fibrosis increase the predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk, though the roles of chronic inflammation and metabolic dysregulation remain unclear. This cross-sectional study quantitatively assesses this association and evaluates the mediating effects of metabolic dysregulation and chronic inflammation.

METHODS

In this study, we enrolled 6110 adults from ten communities in Canton, China. Hepatic steatosis and fibrosis were assessed using vibration-controlled transient elastography (VCTE) through controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), while predicted 10-year ASCVD risk was calculated using the China-PAR project model. Associations between CAP/LSM values and predicted 10-year ASCVD risk were analyzed. Mediation analysis quantified the effects of high-sensitivity C-reactive protein (hs-CRP), homeostasis model assessment of insulin resistance (HOMA-IR), remnant cholesterol (RC), and non-high-density lipoprotein cholesterol (non-HDL-C). The main statistical methods used included logistic regression, restricted cubic splines (RCS) analysis, interaction calculations, and mediation analysis to examine the relationships and mediators.

RESULTS

The study population had a mean age of 50.1 years (SD = 9.7), with 3927 females (64.3%) and 2183 males (35.7%). Additionally, 808 participants (13.2%) had type 2 diabetes, and 1911 participants (31.3%) had hypertension. Compared to the first CAP quartile (Q1), higher CAP quartiles showed increased odds ratios (OR) for predicted moderate to high 10-year ASCVD risk: 1.14 (0.89, 1.45), 1.37 (1.08, 1.73), and 2.44 (1.93, 3.10). Mediation analysis showed hs-CRP and HOMA-IR mediated CAP's link to ASCVD risk, with mediation proportions of 15.40% and 27.37%. RC and non-HDL-C mediated this association at 7.12% and 6.26%. Among patients with hepatic steatosis (CAP ≥ 248 dB/m), LSM Q4 participants had a significantly higher predicted 10-year ASCVD risk than those in LSM Q1 (OR 2.22, [1.52, 3.25]), with hs-CRP and HOMA-IR mediating 2.62% and 13.75%, respectively.

CONCLUSION

Liver steatosis and fibrosis were associated with the increased predicted ASCVD risk, with mediation effects from hs-CRP, HOMA-IR, RC, and non-HDL-C.

Causal impact of elevated body mass index on diabetic kidney disease: an integrated Mendelian randomization and Global Burden of Disease Study 2021 analysis

BACKGROUND

Elevated body mass index (BMI) has been implicated in the pathogenesis of diabetic kidney disease among patients with type 2 diabetes mellitus (T2DKD). However, establishing a causal relationship and quantifying the resultant global health impact remain challenging.

METHODS

A two-sample Mendelian randomization (MR) analysis was conducted using summary-level data obtained from the IEU database. Multiple MR approaches, including inverse variance weighted (IVW), MR-Egger regression, weighted median, weighted mode, and simple mode methods, were implemented to ensure robust causal inference. In parallel, Global Burden of Disease Study (GBD) 2021 were analyzed to determine the trends in mortality and disability-adjusted life years (DALYs) in T2DKD attributable to high BMI (HBMI-T2DKD) from 1990 to 2021. Joinpoint regression was used to estimate the average annual percent change (AAPC). Bayesian age-period-cohort (BAPC) models were then applied to project the disease burden through 2049.

RESULTS

MR analyses provided strong evidence for a causal relationship between elevated BMI and T2DKD. The GBD analysis revealed a sustained global increase in HBMI-T2DKD burden over the past three decades. Between 1990 and 2021, the result of AAPC indicated a persistent upward trend. The burden was particularly high among older adults, with the highest impact observed in East Asia and middle Socio-Demographic Index (SDI) region. By 2049, HBMI-T2DKD-related disease burden were projected to continue rising.

CONCLUSIONS

Elevated BMI is a significant causal risk factor for T2DKD. The integration of MR and GBD 2021 data underscores the urgent need for targeted public health interventions to reduce BMI levels, especially in high-risk regions and aging populations.

The burden of diseases attributable to high body mass index in Asia from 1990 - 2019: results from the global burden of disease study 2019

AIM

Our study aimed to report the burden of diseases attributable to high body mass index (BMI) in Asia from 1990 to 2019.

METHODS

Utilizing data from the Global Burden of Disease (GBD) Study 2019, we calculated disability-adjusted life years (DALYs) and deaths, with trends quantified by the estimated annual percentage change (EAPC). We also made projections for selected countries and estimated the relationship between the Sociodemographic Index (SDI) and high BMI-related disease burden.

RESULT

From 1990 to 2019, high BMI-related diseases observed significant increases in the absolute number of deaths and DALYs, with EAPCs of 4.62 and 4.69, respectively, while the age-standardized rates of both deaths and DALYs also showed upward trends, with EAPCs of 1.39 and 1.80. Cardiovascular diseases, diabetes and kidney diseases, and neoplasms were the major contributors to the high BMI-related burden. The burden of high BMI-related diseases generally tended to be greater among males and older age groups. Predictions for selected countries indicated a continued rise in the number of deaths and DALYs for high BMI-related diseases, with a stabilization in the age-standardized rate. There was no significant association between SDI levels and the burden of high BMI-related diseases in Asia (coefficient=0.13, p = 0.39).

CONCLUSION

The burden of high BMI-related diseases, a major public health issue, was increasing in Asia. To address this problem, coordinated action by governments, civil society and other key stakeholders should be taken to enhance awareness of the risks associated with high BMI and effectively reduce its impact.

Excessive bile acids level predisposes to adverse perinatal outcomes in women with abnormal pre-pregnancy body mass index

BACKGROUND

Both low/high pre-pregnancy body mass index (BMI) and increased bile acid levels during pregnancy (known as gestational hypercholanemia) were risk factors for adverse pregnancy outcomes, with limited information on their joint effects.

METHODS

A total of 63,066 pregnant women were involved in a large retrospective cohort study from May 2014 to December 2018 in Shanghai, China. Data of pregnancy outcomes including hypercholanemia, hypertensive disorders in pregnancy (HDP), preterm delivery, and small for gestation age (SGA), were obtained for multivariable logistic analysis.

RESULTS

Pre-pregnancy BMI was negatively associated with serum total bile acid (TBA) concentrations during gestation and the risk of hypercholanemia (p < 0.001). Low pre-pregnancy BMI and hypercholanemia coexisting were related to a 2.71-fold risk (95% confidence intervals [CI], 2.10-3.50) of SGA. Whereas, overweight/obese (OWO) with hypercholanemia are associated with 5.34-fold risk (95% CI 3.93-7.25) of HDP when compared with normal weight women without hypercholanemia. Women with excessive gestational weight gain (GWG) and hypercholanemia had a higher risk of HDP (odds ratio [OR] 3.56, 95% CI 2.91-4.36), and macrosomia (OR 2.95, 95% CI 2.42-3.60), compared with non-hypercholanemia women with adequate GWG. Whereas, women with inadequate GWG and hypercholanemia had increased risks of preterm delivery (OR 1.87, 95% CI 1.44-2.43), and SGA (OR 2.32, 95% CI 1.82-2.96).

CONCLUSIONS

Low maternal BMI before pregnancy was an independent risk factor for hypercholanemia. Additionally, pre-pregnancy underweight or OWO may amplify the effect of hypercholanemia on adverse pregnancy outcomes. Thus, pre-pregnancy BMI should be considered in the management of adverse perinatal outcomes related to gestational hypercholanemia.

Antrum Preservation Versus Antrum Resection in Laparoscopic Sleeve Gastrectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PURPOSE

To compare the effects of laparoscopic sleeve gastrectomy (LSG) with antrum preservation (AP) and antrum resection (AR) on weight loss and postoperative complications.

METHODS

A meta-analysis of randomized controlled trials (RCTs) followed PRISMA guidelines. The databases searched included PubMed, Web of Science, Embase Medline, and the Cochrane Library up to October 2022. Extracted data included operation time, hospital stay, excess weight loss, total weight loss, body mass index (BMI), weight, and complications.

RESULTS

Eleven RCTs were included with 843 patients: 422 with AR and 421 with AP. The AR group exhibited higher total weight loss at 3 months (p = 0.02), 6 months (p < 0.001), and 1 year (p < 0.001) postoperatively. They also showed greater excess weight loss at 6 months (p < 0.001), 1 year (p < 0.001), and 2 years (p = 0.03). BMI reduction was more significant in the AR group at 3 (p = 0.007) and 6 months (p < 0.001). The AR group lost weight more rapidly at 3 months (p = 0.05), 6 months (p = 0.04), and 1 year (p < 0.001). No significant differences were found in operation time, hospital stay, bleeding, staple line disruption, Clavien-Dindo complications, or remission rates of diabetes, hypertension, arthritis/back pain, hyperlipidemia, or gastroesophageal reflux disease (p > 0.05).

CONCLUSION

LSG with AR offers better short-term weight loss than AP without increasing surgical complications, but the long-term effects and complications need further investigation in larger RCTs.

Hyperbaric oxygen therapy for male infertility: a systematic review and meta-analysis on improving sperm quality and fertility outcomes

Hyperbaric oxygen therapy has emerged as a potential adjunctive treatment for male infertility, as it targets various sperm abnormalities and improves fertility outcomes. This systematic review and meta-analysis synthesized data from randomized controlled trials to evaluate the efficacy of hyperbaric oxygen therapy in treating male infertility. A comprehensive literature search identified nine eligible studies, which were assessed for quality using the Jadad scale and analyzed for heterogeneity. The meta-analysis revealed significant improvements in sperm survival, density, morphology, normal sperm rates, and motility following hyperbaric oxygen therapy, with an increased clinical pregnancy rate. Subgroup analyses based on infertility etiology and treatment duration further elucidated the heterogeneity of male infertility stemming from the etiology of infertility. Despite the high robustness of the meta-analysis results, the study is limited by the small number of included trials and potential publication bias. In conclusion, when combined with conventional treatments, hyperbaric oxygen therapy significantly enhances sperm parameters and fertility, underscoring its role as an effective adjunctive therapy for male infertility.

Waist-to-hip ratio better reflect beta-cell function and predicts diabetes risk in adult with overweight or obesity

OBJECTIVE

Controversy remains as to which obesity measures better predict type 2 diabetes (T2D) risk in overweight or obese individuals. The objective of this study is to determine which commonly used obesity measures better reflect beta cell function and predict T2D risk in participants with overweight or obesity and to validate the findings using prospective cohort data.

PATIENTS AND METHODS

Cross-sectional data from the Obesity Clinic of the Xiangya Hospital of the Central South University and prospective cohort from UK Biobank. BMI, waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR) were measured. Primary outcomes included beta cell function indices in the cross-sectional study and the occurrence of diabetes obtained from UK Biobank data.

RESULTS

One thousand four hundred and ninety-seven participants with overweight or obesity (median age 29 years, 41% males) and 322,023 UK Biobank participants without diabetes at baseline (mean age 56.83 years, 50.4% males) were studied. WHpR had a stronger association with beta cell function and central body fat distribution than the other three obesity measures irrespective of glucometabolic states. WHpR associated positively with diabetes risk in participants using the hazard ratio scale (HR per SD increase of WHpR, 2.311, 95% CI 2.250-2.374).

CONCLUSIONS

WHpR is a superior index in reflecting central body obesity, estimating beta cell function, and predicting T2D risk in people with overweight or obesity compared to BMI, WC, and WHtR.

Developing capacity in identifying cost-effective interventions to prevent and reduce obesity in China

Obesity is associated with multiple noncommunicable diseases and has increased rapidly worldwide. Population obesity in China grew fourfold between 1993 and 2015, increasing most rapidly among children and adolescents. Cost-effective policies and programs delivered over time and at scale are required to change this trajectory, yet application of methodologies to identify such interventions have been sparse. UNICEF China and Peking University together identified the need to strengthen the intervention evidence available to policymakers and to build stakeholders' knowledge and skills. Investment cases combine a review of intervention evidence, policy landscape assessment, and economic modelling to identify cost-effective interventions suited to a specific context. A training and mentorship program aimed to build awareness, knowledge, and skills about this methodology to encourage its use to support decision making and planning to address obesity. Program participants reported increased knowledge of analytical methods to identify contextually relevant cost-effective obesity interventions (92% of evaluation respondents), and 82% reported increased knowledge of evidence-based obesity interventions. 79% reported confidence to apply the learning in their job roles. Training and mentorship can enhance stakeholder knowledge, skills, and confidence to apply investment case methodology to develop economic evidence to strengthen the basis of obesity policy and program commissioning.

Linking Chronic Obstructive Pulmonary Disease and Asthma with Gallstones: Evidence from a Cross-Sectional Study and Mendelian Randomization

OBJECTIVE

To investigate whether chronic obstructive pulmonary disease (COPD) and asthma increase the risk of gallstones based on the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR).

METHODS

Data from the NHANES 2017-2023 were included in the cross-sectional study. Diagnoses of COPD, asthma and gallstones were obtained from self-report questionnaires. Multivariate logistic regression, subgroup analyses and interaction tests were applied to explore these associations. Data for MR analysis were obtained from the Finnish cohort and the Integrative Epidemiology Unit (IEU). The inverse variance weighting (IVW) estimate was applied as the main approach to determine the causality of associations.

RESULTS

A total of 8,728 participants were enrolled in the cross-sectional study. Both COPD (OR 1,842, 95% CI 1.144, 2.968, p = 0.015) and asthma (OR 1.434, 95% CI 1.093, 1.883, p = 0.012) were associated with increased gallstone risk before and after covariate adjustments, and diabetes history may interact with the COPD-gallstone association (p = 0.020). In MR analysis, although a causal association was observed between COPD and gallstones (OR 1.216, 95% CI 1.023, 1.445; p = 0.026), leave-one-out analysis suggested that the causal association disappeared without serpin family A member 1 (SERPINA1). No causal association was observed between asthma and gallstones (OR 1.016, 95% CI 0.932, 1.108; p = 0.718).

CONCLUSIONS

Although both COPD and asthma were positively associated with gallstones based on NHANES, the COPD-gallstone association was largely driven by SERPINA1, and no causality was observed in asthma-gallstone association. The available evidence provided limited support for causal associations between obstructive lung diseases and gallstones.

Comparison of concurrent, resistance, or aerobic training on body fat loss: a systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis compared the differential effects of resistance training (RT), aerobic training (AT), and concurrent training (CT) on body mass and body fat loss in metabolically healthy individuals.

METHODS

A systematic search of PubMed, SportDiscus, and Web of Science databases for randomized controlled trials published between January 1980 and January 2023, comparing RT, AT, and CT in healthy adults was conducted. Primary outcomes of interest included changes in fat mass and body fat percentage; secondary outcomes were body mass and fat-free mass (FFM). Sub-analyses on intervention duration (< or ≥ 10 weeks), CT timing (aerobic and resistance exercises done on the same day versus different days within a week), and workload matching (equating workloads between AT, RT, and CT), were conducted. Study protocols followed PRISMA 2020 guidelines and were pre-registered on PROSPERO (CRD42023396530).

RESULTS

In total, 36 studies with 1564 participants were included in the systematic review, with only 31 studies included in the meta-analysis due to missing data. For studies lasting at least 10 weeks, AT outperformed RT in reducing body mass (mean difference (MD) = -1.82 kg [95% CI = -2.72 to -0.93]; p < 0.001) and fat mass (MD = -1.06 kg [95% CI = -1.88 to -0.24]; p = 0.01) but led to less FFM retention (MD = - 0.88 kg [95% CI = -1.73 to -0.03], p = 0.04). CT reduced significantly more fat mass compared to RT (MD: -1.09 kg [95% CI = -0.27 to -1.91]; p = 0.009). No significant differences were found between CT, AT, and RT in altering body fat percentage (p > 0.05). For studies shorter than 10 weeks, no significant differences were noted across exercise modalities (p > 0.05). Under conditions where AT, RT, and CT workloads were matched, similar fat mass, body mass, body fat percentage, and FFM changes were observed between exercise modalities (p > 0.05). Similar body mass and body fat percentage loss was observed between same-day and different-day CT (p > 0.05); body fat mass loss only differed in a single study (n = 1) when comparing RT to different-day CT (aerobic and resistance exercises done on different days within a week).

CONCLUSIONS

While there are no differences in percent body fat loss between exercise modes, AT and CT are more effective than RT alone in reducing absolute fat mass; however, RT neither improved nor impeded fat mass loss when incorporated into CT. Combining aerobic and resistance exercises on the same-day or different-day does not appear to influence the effectiveness of CT. When exercise interventions are short in duration (<10 weeks), there does not appear to be a difference in fat loss between exercise modalities. These results support the concurrent use of aerobic and resistance exercises for fat mass reduction, as well as an emphasis on workload and duration when programming exercise for fat loss.

Prevalence and risk factors of gestational diabetes mellitus among pregnant women in northern Vietnam: a cross-sectional study

BACKGROUND

Gestational diabetes mellitus (GDM) increases adverse neonatal and maternal outcomes. Understanding the prevalence and risk factors of GDM is necessary to plan health care interventions and policy.

OBJECTIVE

To determine the prevalence and risk factors of GDM in Thai Binh, Vietnam.

METHODS

A cross-sectional study was conducted in two health facilities in Thai Binh, Vietnam, with the participation of 1,106 pregnant women. Women were recruited at their first antenatal care visit where face-to-face interviews about socioeconomic and reproductive factors were performed. A 2-hour 75 g oral glucose tolerance test was conducted at 24-28 weeks of gestation. GDM was diagnosed according to the World Health Organization 2013 criteria. Logistic regression analyses were used to assess the factors associated with GDM.

RESULTS

The prevalence rate of GDM was 27.1%. Multivariate logistic regression analysis showed maternal age from 25 to 34 (adjusted OR 2.0; 95%CI 1.3-2.9), maternal age ≥ 35 (adjusted OR 3.0; 95%CI 1.7-5.4), pregestational body mass index ≥ 23 (adjusted OR 1.6; 95%CI 1.1-2.3), family history of diabetes (adjusted OR 1.9; 95%CI 1.3-2.9), fertility treatment (adjusted OR 2.3; 95%CI 1.3-3.8), and previous GDM (adjusted OR 3.1; 95%CI 1.4-6.9) were associated with increased odds of GDM.

CONCLUSIONS

More than one-fourth of pregnant women in Thai Binh, Vietnam, may have GDM. Advanced maternal age, high pregestational body mass index, family history of diabetes, and previous GDM were associated with increased risk of GDM. Additionally, fertility treatment appears to be strongly associated with an increased risk of GDM.

Assessing health lifestyles in contemporary China: Patterns, transitions, and socioeconomic antecedents

Health lifestyles in China reflect complex interplays of various structural forces, yielding intricate and evolving patterns. Leveraging data from the 2004-2015 China Health and Nutrition Survey (N = 9,986), this study discerns latent health lifestyles, tracks transitional dynamics, and probes socioeconomic disparities in these shifts. Three distinct lifestyle categories emerge: 'high risk', 'overall healthy but inactive', and 'modernized and active'. Notably, the prevalent trend favours the 'overall healthy but inactive' lifestyle, steadily expanding over time, followed by the 'high-risk' group. Conversely, the 'modernized and active' lifestyle, while being the least common, exhibits a modest decline. Individuals engaged in primary industries are more likely to sustain an overall healthy but inactive lifestyle. Socioeconomic advantages, particularly in education and income, were linked to maintaining or transitioning into a modernised and active lifestyle, while lower income and unemployment were more prone to maintaining high-risk behaviours. These findings illuminate the intricate dynamics of health lifestyles in China's rapidly evolving landscape, highlighting socioeconomic influences on lifestyle transitions.

Roseburia hominis improves host metabolism in diet-induced obesity

Next-generation live biotherapeutics are promising to aid the treatment of obesity and metabolic diseases. Here, we reported a novel anti-obesity probiotic candidate, Roseburia hominis, that was depleted in stool samples of obese subjects compared with lean controls, and its abundance was negatively correlated with body mass index and serum triglycerides. Supplementation of R. hominis prevented body weight gain and disorders of glucose and lipid metabolism, prevented fatty liver, inhibited white adipose tissue expansion and brown adipose tissue whitening in mice fed with high-fat diet, and boosted the abundance of lean-related species. The effects of R. hominis could be partially attributed to the production of nicotinamide riboside and upregulation of the Sirtuin1/mTOR signaling pathway. These results indicated that R. hominis is a promising candidate for the development of next-generation live biotherapeutics for the prevention of obesity and metabolic diseases.

Bacteroides uniformis-generated hexadecanedioic acid ameliorates metabolic-associated fatty liver disease

Gut microbiota exerts a pivotal influence on the development of Metabolic Associated Fatty Liver Disease (MAFLD), although the specific contributions of individual bacterial strains and their metabolites remain poorly defined. We conducted stool shotgun metagenomic sequencing and plasma untargeted metabolomics in a large prospective cohort comprising 120 MAFLD patients and 120 matched healthy controls. The mechanisms and microbial-derived metabolites involved in MAFLD were further investigated through multi-omics analyses in vitro and in vivo. Distinct differences were identified in both the microbial community structure and metabolomic profiles between MAFLD patients and healthy controls. Bacteroides uniformis (B. uniformis) was the most significantly depleted species in MAFLD and negatively correlated with hepatic steatosis and BMI. MAFLD was characterized by marked disruptions in fatty acid and amino acid metabolism. Combined analysis of metabolomic and metagenomic data achieved high diagnostic accuracy for MAFLD and hepatic steatosis severity (AUC = 0.93). Transplantation of fecal microbiota from MAFLD subjects into ABX mice led to the onset of MAFLD-like symptoms, whereas B. uniformis administration alleviate disease progression by inhibiting intestinal fat absorption, FFA from eWAT influx into liver via the gut-liver axis, and IRE1α-XBP1s-mediated flipogenesis and ferroptosis, as confirmed by hepatic transcriptomic and proteomic analyses. Hexadecanedioic acid (HDA), potentially identified as a key metabolite produced by B. uniformis, ameliorated MAFLD symptoms. Mechanistically, B. uniformis-derived HDA also inhibited fat absorption and transported, and entered the liver via the portal vein to suppress IRE1α-XBP1s-mediated flipogenesis and ferroptosis. B. uniformis and its potential putative metabolite HDA may contribute to MAFLD progression modulation, through regulation of the IRE1α-XBP1s axis. This study provides new insights into the gut-liver axis in MAFLD and offers promising therapeutic targets based on specific microbes and their metabolites.

One-year metreleptin in Colombian sisters with congenital leptin deficiency

We discovered two adult sisters in Colombia, lineally consanguineous, with severe obesity and undetectable serum leptin levels despite markedly elevated body fat. Their clinical profile included childhood-onset extreme weight gain, intense hunger, hyperphagia, hypogonadotropic hypogonadism, and family history of obesity. Direct sequencing of the LEP gene revealed a novel homozygous missense mutation in exon 3 (c.350G>T [p.C117F]). The presence of this mutation, undetectable leptin, and severe obesity confirmed a diagnosis of monogenic leptin deficiency. Here we describe the clinical outcomes of a 12-month treatment with recombinant human leptin (metreleptin). Metabolic and endocrine assessments were conducted before and after therapy. Metreleptin therapy significantly reduced BMI: from 59 to 38 kg/m2 (OBX1, age 27) and 60 to 48 kg/m2 (OBX2, age 24). Total body fat mass decreased, serum lipids normalized, and insulin sensitivity improved. Hypogonadotropic hypogonadism reversed, and menstruation resumed. Thus, metreleptin reversed the major metabolic and endocrine abnormalities associated with leptin deficiency in these sisters. Limitations include the small sample size, absence of a control group, and lack of anti-metreleptin antibody measurements. Nevertheless, our findings support that leptin replacement with metreleptin is currently the only effective hormonal treatment for this monogenic form of human obesity.

Evolving perspectives on evaluating obesity: from traditional methods to cutting-edge techniques

Objective: This review examines the evolution of obesity evaluation methods, from traditional anthropometric indices to advanced imaging techniques, focusing on their clinical utility, limitations, and potential for personalized assessment of visceral adiposity and associated metabolic risks.

Methods: A comprehensive analysis of existing literature was conducted, encompassing anthropometric indices (BMI, WC, WHR, WHtR, NC), lipid-related metrics (LAP, VAI, CVAI, mBMI), and imaging technologies (3D scanning, BIA, ultrasound, DXA, CT, MRI). The study highlights the biological roles of white, brown, and beige adipocytes, emphasizing visceral adipose tissue (VAT) as a critical mediator of metabolic diseases.

Conclusion: Although BMI and other anthropometric measurements are still included in the guidelines, indicators that incorporate lipid metabolism information can more accurately reflect the relationship between metabolic diseases and visceral obesity. At the same time, the use of more modern medical equipment, such as ultrasound, X-rays, and CT scans, allows for a more intuitive assessment of the extent of visceral obesity.

Stevioside mitigates metabolic dysregulation in offspring induced by maternal high-fat diet: the role of gut microbiota-driven thermogenesis

Maternal obesity poses a significant threat to the metabolic profiles of offspring. Microorganisms acquired from the mother early in life critically affect the host's metabolic functions. Natural non-nutritive sweeteners, particularly stevioside (STV), play a crucial role in reducing obesity and affecting gut microbiota composition. Based on this, we hypothesized that maternal STV supplementation could improve the health of mothers and offspring by altering their gut microbiota. Our study found that maternal STV supplementation reduced obesity during pregnancy, decreased abnormal lipid accumulation in offspring mice caused by maternal obesity, and modified the gut microbiota of both dams and offspring, notably increasing the abundance of Lactobacillus apodemi (L. apodemi). Co-housing and fecal microbiota transplant experiments confirmed that gut microbiota mediated the effects of STV on metabolic disorders. Furthermore, treatment with L. apodemi alone replicated the beneficial effects of STV, which were associated with increased thermogenesis. In summary, maternal STV supplementation could alleviate lipid metabolic disorders in offspring by enhancing L. apodemi levels and promoting thermogenic activity, potentially involving changes in bile acid metabolism pathways.

Trends of cause-specific cardiovascular disease mortality in China, 2009-2019: a nationwide longitudinal study

BACKGROUND

Cardiovascular disease (CVD) is the top cause of death in China. We aimed to identify trends in cause-specific CVD mortality in a rapidly developing country, thereby providing evidence for CVD prophylaxis.

MATERIALS AND METHODS

Using raw data from the Chinese National Mortality Surveillance (CNMS) system, we assessed the mortalities of all CVD and cause-specific CVD during 2009-2019. Temporal trends of crude mortality rates (CMRs) and age-standardized mortality (ASMRs) of CVD were evaluated using joinpoint regression models. Age-sex-specific CVD mortality rates were predicted by using age-period-cohort Poisson regression model.

RESULTS

A total of 10,608,402 CVD death occurred during 2009-2019, accounting for 49.8% of all-cause of death in China. The three major CVD types [cerebrovascular disease, ischemic heart disease (IHD) and hypertensive disease (HD)] accounted for 94.6% of total CVD deaths. The CMR of all CVD increased [the annual average percentage change (AAPC) = 3.4%, 95% confidence interval (CI) 2.6% to 4.1%] while the ASMR decreased (AAPC = -2.0%, 95% CI -3.5% to -0.6%). Cerebrovascular disease is predicted to be the leading cause of CVD death in men and IHD will be the top cause of CVD death in women over the period 2025-2029.

CONCLUSIONS

Although the ASMR of total CVD decreased, CVD remained the leading cause of death in China. Cerebrovascular disease, IHD and HD were the major three leading causes of CVD-related death. Inflammatory heart disease-associated death increased in the young population. Attention should be paid to premature deaths associated with cerebrovascular disease and rheumatic heart disease among rural residents.

Multifunctional dietary approach reduces intestinal inflammation in relation with changes in gut microbiota composition in subjects at cardiometabolic risk: the SINFONI project

The development of cardiometabolic (CM) diseases is associated with chronic low-grade inflammation, partly linked to alterations of the gut microbiota (GM) and reduced intestinal integrity. The SINFONI project investigates a multifunctional (MF) nutritional strategy's impact combining different bioactive compounds on inflammation, GM modulation and CM profile. In this randomized crossover-controlled study, 30 subjects at CM-risk consumed MF cereal-products, enriched with polyphenols, fibers, slowly-digestible starch, omega-3 fatty acids or Control cereal-products (without bioactive compounds) for 2 months. Metabolic endotoxemia (lipopolysaccharide (LPS), lipopolysaccharide-binding protein over soluble cluster of differentiation-14 (LBP/sCD14), systemic inflammation and cardiovascular risk markers, intestinal inflammation, CM profile and response to a one-week fructose supplementation, were assessed at fasting and post mixed-meal. GM composition and metabolomic analysis were conducted. Mixed linear models were employed, integrating time (pre/post), treatment (MF/control), and sequence/period. Compared to control, MF intervention reduced intestinal inflammation (fecal calprotectin, p = 0.007) and endotoxemia (fasting LPS, p < 0.05), without alteration of systemic inflammation. MF decreased serum branched-chain amino acids compared to control (p < 0.05) and increased B.ovatus, B.uniformis, A.butyriciproducens and unclassified Christensenellaceae.CAG-74 (p < 0.05). CM markers were unchanged. A 2-month dietary intervention combining multiple bioactive compounds improved intestinal inflammation and induced GM modulation. Such strategy appears as an effective strategy to target low-grade inflammation through multi-target approach.