Interaction of homocysteine, glutathione and 8-hydroxy-2′-deoxyguanosine in metabolic syndrome progression

Nicotinamide N-methyltransferase (NNMT): a novel therapeutic target for metabolic syndrome

Metabolic syndrome (MetS) represents a constellation of metabolic abnormalities, typified by obesity, hypertension, hyperglycemia, and hyperlipidemia. It stems from intricate dysregulations in metabolic pathways governing energy and substrate metabolism. While comprehending the precise etiological mechanisms of MetS remains challenging, evidence underscores the pivotal roles of aberrations in lipid metabolism and insulin resistance (IR) in its pathogenesis. Notably, nicotinamide N-methyltransferase (NNMT) has recently surfaced as a promising therapeutic target for addressing MetS. Single nucleotide variants in the NNMT gene are significantly correlated with disturbances in energy metabolism, obesity, type 2 diabetes (T2D), hyperlipidemia, and hypertension. Elevated NNMT gene expression is notably observed in the liver and white adipose tissue (WAT) of individuals with diabetic mice, obesity, and rats afflicted with MetS. Knockdown of NNMT elicits heightened energy expenditure in adipose and hepatic tissues, mitigates lipid accumulation, and enhances insulin sensitivity. NNMT catalyzes the methylation of nicotinamide (NAM) using S-adenosyl-methionine (SAM) as the donor methyl group, resulting in the formation of S-adenosyl-l-homocysteine (SAH) and methylnicotinamide (MNAM). This enzymatic process results in the depletion of NAM, a precursor of nicotinamide adenine dinucleotide (NAD+), and the generation of SAH, a precursor of homocysteine (Hcy). Consequently, this cascade leads to reduced NAD+ levels and elevated Hcy levels, implicating NNMT in the pathogenesis of MetS. Moreover, experimental studies employing RNA interference (RNAi) strategies and small molecule inhibitors targeting NNMT have underscored its potential as a therapeutic target for preventing or treating MetS-related diseases. Nonetheless, the precise mechanistic underpinnings remain elusive, and as of yet, clinical trials focusing on NNMT have not been documented. Therefore, further investigations are warranted to elucidate the intricate roles of NNMT in MetS and to develop targeted therapeutic interventions.

A dense SERS substrate of the AgNPs@GO compound film for detecting homocysteine molecules

This study focuses on the development of a highly sensitive surface-enhanced Raman scattering (SERS) sensor for detecting homocysteine (Hcy) molecules. The Hcy sensor was created by depositing silver nanoparticles (AgNPs) onto the surface of graphene oxide (GO) film to form a dense AgNPs@GO composite film. The AgNPs on the composite film interacted with sulfur atoms (S) of Hcy molecules to form Ag-S bonds, which boosted the chemisorption of Hcy molecules and enabled them to be specifically recognized. The SERS sensor exhibited a maximum enhancement factor of up to 1.1 × 104, with a reliable linear response range from 1 to 60 ng mL-1. The limit of detection (LOD) for Hcy molecules was as low as 1.1 × 10-9 M. Moreover, Hcy molecules were successfully distinguished in a mixed solution of γ-aminobutyric acid and Hcy molecules. In this study, a simple preparation process of SERS substrate and a novel detection method for Hcy molecules provided a new pathway for the rapid and effective detection of Hcy molecules in the food and biomedicine fields.

A systematic review exploring the mechanisms by which citrus bioflavonoid supplementation benefits blood glucose levels and metabolic complications in type 2 diabetes mellitus

BACKGROUND

Citrus bioflavonoids are polyphenolic compounds that are derived from citrus fruits and vegetables. Although they are well known for their powerful antioxidant properties, their effects on glycemic control are not well understood. This review aims to highlight the potential benefits of using citrus bioflavonoids in patients with type 2 diabetes mellitus and its metabolic complications, as well as the medicinal effects of known subclasses of naturally occurring citrus bioflavonoids.

METHODS

In this systematic review, a survey of studies was conducted from January 2012 to February 2023 using various databases (PubMed, Medline, Google Scholar, and Scopus) to determine the effects of citrus bioflavonoid supplementation on reducing oxidative stress, improving lipid profiles, and glycemic index in patients with diabetes mellitus, as well as the proposed mechanisms of action.

RESULTS

The results of the survey indicate that citrus bioflavonoids may have a positive impact on reducing oxidative stress levels in patients with type 2 diabetes mellitus. In addition to reducing oxidative stress, citrus bioflavonoids may also have a positive impact on other markers of diabetes. For example, studies have shown that they can reduce non-enzymatic protein glycation, which is a process that occurs when glucose molecules bind to proteins in the body.

CONCLUSION

The reduction in oxidative stress that can be achieved using citrus bioflavonoids may help to maintain antioxidant levels in the body, thereby reducing the severity of diabetes and its complications. These findings suggest that citrus bioflavonoids may be a useful complementary therapy for patients with diabetes.

Vitamin B12, folate, and homocysteine in metabolic syndrome: a systematic review and meta-analysis

Background & aims

Metabolic syndrome (MetS) is associated with life-threatening conditions. Several studies have reported an association of vitamin B12, folic acid, or homocysteine (Hcy) levels with MetS. This systematic review and meta-analysis assessed the association of vitamin B12, folic acid, and Hcy levels with MetS.

Methods

PubMed, Scopus, Embase, Ovid/Medline, and Web of Science were searched up to February 13, 2023. Cross-sectional, case-control, or cohort studies were included. A random-effects model was performed using the DerSimonian and Laird method to estimate the between-study variance. Effect measures were expressed as odds ratios (OR) with their corresponding 95% confidence intervals (95% CI). Between-study heterogeneity was evaluated using Cochran's Q test and the I2 statistic.

Results

Sixty-six articles (n = 87,988 patients) were included. Higher vitamin B12 levels were inversely associated with MetS (OR = 0.87; 95% CI: 0.81-0.93; p < 0.01; I2 = 90%). Higher Hcy levels were associated with MetS (OR = 1.19; 95% CI: 1.14-1.24; p < 0.01; I2 = 90%). Folate levels were not associated with MetS (OR = 0.83; 95% CI: 0.66-1.03; p = 0.09; I2 = 90%).

Conclusion

Higher vitamin B12 levels were inversely associated with MetS, whereas higher Hcy levels were associated with MetS. Studies assessing the pathways underlying this association are required.

Subacute effects of hydroethanolic extracts of the pulp of Gambeya africana on glucose plasmatic levels and oxidative stress markers in diabetic rats

The management of hyperglycemia and oxidative stress is a key point in the control of diabetes and its complications. The work evaluated the hypoglycemiant and antioxidant properties of pulp extracts of Gambeya africana fruits. The acute toxicity was conducted for 14 days at the dose of 2000 mg/kg via oral gavage. Diabetes was induced in rats by intravenous administration of streptozotocin (50 mg/kg). The effect of the extract on blood glucose levels of diabetic rats was monitored at 2h after administration; and on the 7th and 14th days of treatment (single dose of 400 mg/kg/day). After 2 weeks of treatment, the rats were sacrificed. The oxidative stress markers (Hydroperoxides, Malonedialdehydes, Superoxide Dismutase, Catalase, and Total Antioxidant Capacity) and hepato/nephrotoxicity markers (Alanine Amino Transferase, urea, and creatinine) were determined. The hydroethanolic extract of G. africana fruits has a lethal dose upper than 2000 mg/kg. It significantly decreased glucose levels by 28.29% and 84.86% respectively after 2h and 14th days of treatment. The extract increased the antioxidant status and decrease oxidative stress, especially in the pancreas. This study suggests that the hydroethanolic pulp extract of G. africana fruits is a good hypoglycemiant and antioxidant agent and could be a potential source of compounds for diabetes management.

A simultaneous identification and quantification strategy for determination of sulfhydryl-containing metabolites in normal- and high-fat diet hamsters using stable isotope labeling combined with LC-MS

Sulfur-containing metabolites are related to several physiologic disorders and metabolic diseases. In this study, a simultaneous identification and quantification strategy in one batch for determination of sulfhydryl-containing metabolites was developed using stable isotope labeling combined with liquid chromatography-tandem mass spectrometry (SIL-LC-MS). In the proposed method, a pair of isotope labeling reagents, D₀/D₅-N-ethylmaleimide (D₀/D₅-NEM), was used to derivatize sulfhydryl-containing metabolites in blood and plasma of normal- and high-fat-diet (NFD and HFD) hamsters for reduced (-SH) and total (-SH, -S-S-, S-glutathionylated proteins) analysis. Quality control (QC) samples and test samples were prepared for LC-MS analysis. First, both QC samples and stable isotope labeled internal standards were used to monitor the status of the instrument and ensure the reliability of the analysis. Subsequently, an inhouse database containing 45 sulfhydryl-containing metabolites was established by MS¹ based on QC samples. Then, qualitatively differential sulfhydryl-containing metabolites were found by MS² between the NFD and HFD hamsters of the test samples, including 3 in reduced and 8 in total analysis of blood samples, and 2 in reduced and 2 in total analysis of plasma samples. Next, in quantitative analysis, satisfied linearities for 6 sulfhydryl-containing metabolites were obtained with the correlation coefficient (R²) > 0.99 and absolute quantification was carried out. The results showed that glutathione and cysteine have different concentrations in blood and plasma of hamsters. Finally, the correlation of sulfhydryl-containing metabolites with blood lipid and oxidative stress levels was determined, which provided insight into the hyperlipidemia-related oxidative stress. Taken together, the developed method of simultaneous identification with the inhouse database and MS² and quantification with standards in one batch provides a promising strategy for the analysis of sulfhydryl-containing metabolites in biological samples, which may promote the in-depth investigation on sulfhydryl-containing metabolites and related diseases.

Human SHC-transforming protein 1 and its isoforms p66shc: A novel marker for prediabetes

AIMS

Prediabetes is a multifactorial condition. Current guidelines for diabetes screening recommend either the use of glycated hemoglobin (HbA1c), or blood glucose level (BGL). This research aimed to identify if p66shc a component of the Human SHC-Transforming Protein 1 (Shc1), a mitochondrial associated oxidative stress biomarker, is significantly altered in patients with elevated BGL. Furthermore, we evaluated if inflammatory and oxidative stress markers, such as p66shc, are a useful addition to the regularly used biomarkers to increase sensitivity for identification of prediabetes.

METHODS

All participants attended the Diabetic Health Screening at Charles Sturt University (CSU), Australia. The cross-sectional clinical study collected demographic and clinical variables from 346 participants and classified into control or prediabetes based on fasting BGL. Blood and urine samples were analyzed for oxidative stress and inflammation markers. Logistic regression was used to compare multidimensional diagnostic models for prediabetes, including p66shc/Shc1, to the current HbA1c-only model in terms of sensitivity, specificity and predictive accuracy. Significance was set at P ≤ 0.05.

RESULTS

A significant decrease of p66shc/Shc1 was determined in prediabetes compared to controls (P ≤ 0.05). HbA1c testing resulted in an accuracy of 62%, while adding p66shc and triglycerides increased predictive accuracy to 88.05%. When HbA1c was omitted and Shc1 was combined with 8-hydroxy-2'-deoxyguanosine (8-OHdG) and monocyte chemo-attractant protein-1 (MCP-1), a predictive accuracy of 89.5% was achieved.

CONCLUSION

Our findings showed a major improvement of sensitivity to identify prediabetes by including oxidative stress and inflammatory biomarkers underlining beneficial diagnostic information, which most likely improves prevention and early treatment options in prediabetes.

Oxidative stress accelerates the carotid atherosclerosis process in patients with chronic kidney disease

INTRODUCTION

The atherosclerosis process is highly accelerated in patients with chronic kidney disease (CKD). Oxidative stress is considered as one of the pro-atherogenic factors involved in accelerating the atherosclerosis process of the carotid artery. The aim of the present study was to determine the relationship between oxidative stress markers and the progression of carotid atherosclerosis in CKD patients.

MATERIAL AND METHODS

The study was conducted on 162 patients with CKD and 40 controls, and the disease stage was scored between 2 and 5D. Blood samples were taken and advanced oxidative protein product, myeloperoxidases, malondialdehyde, nitric oxide, glutathione, and oxidised low-density lipoprotein were measured. Furthermore, we studied the correlations between these biomarkers and clinical and para-clinical cardiovascular complications.

RESULTS

The average age of patients was 56.5 years. The oxidative stress markers average ± SD levels in CKD groups compared to the control were as follows: advanced oxidation protein product (61.89 ±1.4 vs. 26.65 ±1.05 µmol/l), myeloperoxidase (59.89 ±1.98 vs. 38.45 ±1.98 UI/ml), malondialdehyde (6.1 ±0.12 vs. 3.26 ±0.03 µmol/l), nitric oxide (65.82 ±1.06 vs. 52.19 ±2.1 µmol/l), glutathione (52.21 ±1.3 vs. 89.4 ±2.6 IU/ml), and oxLDL (15.57 ±1.07 vs. 1.72 ±0.82 µmol/l). While the glutathione level decreased significantly in advanced CKD stage (p < 0.05), the concentrations of all the other biomarkers increased significantly in accordance with CKD score (p < 0.05).

CONCLUSIONS

Cardiovascular diseases, mainly atherosclerosis, can be diagnosed indirectly by measuring oxidative stress markers. Furthermore, theses markers can be used to predict the progression of CKD, for better management of the disease.

Plasma Homocysteine and Autonomic Nervous Dysfunction: Association and Clinical Relevance in OSAS

Objective

Elevated plasma homocysteine (Hcy) is an independent risk factor for cardiovascular diseases, but the precise mechanism of Hcy in cardiovascular disease remains elusive. This study is aimed at evaluating the association between Hcy levels and autonomic nervous system and at investigating their clinical relevance in obstructive sleep apnea syndrome (OSAS).

Methods

A total of 191 subjects with OSAS were enrolled for this cross-sectional study. Heart rate variability (HRV) represents the status of the autonomic nervous system and is a well-known index that allows studying the autonomic modulation. HRV and polysomnography parameters were collected based on Holter monitors and polysomnography system. The software computed all the basic HRV parameters including SDANN, SDNN and pNN50. Correlation analyses between Hcy and HRV parameters and echocardiographic parameters were performed.

Results

Compared with the mild-moderate OSAS group, the prevalence of male and smoking and Hcy levels were considerably higher in the severe OSAS group (P = 0.01, P = 0.02, and P = 0.01, respectively). Also, there were significant linear relationships between Hcy quartiles with the proportion of severe OSAS (P = 0.01 for the trend). Interesting, there is a negative linear correlation between SDANN and Hcy quartiles (P = 0.02 for the trend). Spearman's correlation analysis showed a significant negative correlation between SDANN and Hcy levels (r = -0.17, P = 0.02). Interestingly, the relationship of it remains significant after adjustment for clinical covariates (r = -0.15, P = 0.04). However, echocardiographic parameters were not significantly correlated with Hcy or HRV parameters (all P > 0.05).

Conclusions

Elevated plasma Hcy level is linearly correlated with cardiac autonomic nervous function disorders in patients with OSAS.

Relationships between Serum Uric Acid, Malondialdehyde Levels, and Carotid Intima-Media Thickness in the Patients with Metabolic Syndrome

Oxidative stress is the major cause of atherosclerosis and cardiovascular diseases. This cross-sectional study is aimed at determining if parallel serum markers of oxidative stress are related to carotid intima-media thickness (IMT). We enrolled 134 participants with varied metabolic syndrome (Met-S) scores (zero, n = 21; one, n = 19; two, n = 27; three, n = 26; four, n = 25; five, n = 16). Biochemical profiles and potential oxidative stress biomarkers malondialdehyde (MDA) and uric acid were measured in fasting plasma. We found that carotid IMT positively correlated with both MDA and uric acid levels. Multivariate analysis revealed that both MDA (p < 0.05) and uric acid (p < 0.01) levels were significantly associated with carotid IMT in participants whose Met-S scores were ≥1 or ≥2. However, only uric acid (p < 0.01) levels were positively associated with carotid IMT in patients with metabolic syndrome. Linear regression model analysis revealed that the prediction accuracies for carotid IMT from MDA combined with uric acid and from a combination of MDA, uric acid, and Met-S score were 0.176 and 0.237, respectively. These were better than the predication accuracies from MDA (r ² = 0.075) and uric acid (r ² = 0.148) individually. These results suggest that measuring uric acid levels along with MDA biomarkers and Met-S scores may be a promising step in the development of an effective model for monitoring the severity of carotid IMT and atherosclerosis in the patients with metabolic syndrome.

Hypoglycemic Agents and Changes in Oxidative Stress Indices, Electrolytes, and Cardiovascular Risk Factors in Type 2 Diabetes

<b><i>Background:</i></b> Metabolic complications of type 2 diabetes (T2DM), including dyslipidemia, electrolyte imbalance, and oxidative stress, have been shown to be modulated by hypoglycemic agents. <b><i>Objective:</i></b> The lipid profile, electrolytes, and oxidative stress indices were evaluated in T2DM. <b><i>Methods:</i></b> Fifty T2DM patients on metformin (<i>n</i> = 23), insulin (<i>n</i> = 17), and insulin/metformin (<i>n</i> = 10) and 40 controls were studied. Fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), total antioxidant capacity (TAC), total plasma peroxide (TPP), and total calcium (Ca) values were determined colorimetrically, sodium (Na⁺) and potassium (K⁺) levels were determined by flame photometry, chloride (Cl^–) and bicarbonate (HCO₃^–) levels were determined by titration, and low-density lipoprotein cholesterol (LDL-C) levels, the atherogenic index of plasma (AIP), and the oxidative stress index (OSI) were determined by calculation. Data were analyzed using <i>t</i> test, analysis of variance, and Pearson’s correlation at <i>p</i> &#x3c; 0.05. <b><i>Results:</i></b> T2DM patients had higher lipid peroxidation (TPP and OSI), atherogenic lipids (higher LDL-C and AIP and lower HDL-C), and lower antioxidants compared to controls (<i>p</i> &#x3c; 0.05). T2DM patients with poor glycemic control had higher lipid peroxidation (higher TPP) and atherogenic lipids (TG and AIP) compared to those with good control (<i>p</i> &#x3c; 0.05). Patients with T2DM for &#x3e;5 years had higher protein glycosylation (higher HBA1c) and TC compared to those with T2DM for &#x3c;5 years (<i>p</i> &#x3c; 0.05). The class of hypoglycemic agent has no effect on the levels of all of the biochemical indices studied (<i>p</i> &#x3e; 0.05). HDL-C correlated negatively with TG (<i>r</i> = –0.347, <i>p</i> = 0.013), LDL-C (<i>r</i> = –0.322, <i>p</i> = 0.018), and AIP (<i>r</i> = –0.714, <i>p</i> = 0.000) in T2DM. <b><i>Conclusion:</i></b> Chronic T2DM and poor glycemic control are associated with reduced antioxidants, lipid peroxidation, and atherogenic dyslipidemia. Different hypoglycemic agents exert no differential effects on the metabolic indices of T2DM studied.

Antioxidant properties of drugs used in Type 2 diabetes management: could they contribute to, confound or conceal effects of antioxidant therapy?

OBJECTIVES

This is a narrative review, investigating the antioxidant properties of drugs used in the management of diabetes, and discusses whether these antioxidant effects contribute to, confound, or conceal the effects of antioxidant therapy.

METHODS

A systematic search for articles reporting trials, or observational studies on the antioxidant effect of drugs used in the treatment of diabetes in humans or animals was performed using Web of Science, PubMed, and Ovid. Data were extracted, including data on a number of subjects, type of treatment (and duration) received, and primary and secondary outcomes. The primary outcomes were reporting on changes in biomarkers of antioxidants concentrations and secondary outcomes were reporting on changes in biomarkers of oxidative stress.

RESULTS

Diabetes Mellitus is a disease characterized by increased oxidative stress. It is often accompanied by a spectrum of other metabolic disturbances, including elevated plasma lipids, elevated uric acid, hypertension, endothelial dysfunction, and central obesity. This review shows evidence that some of the drugs in diabetes management have both in vivo and in vitro antioxidant properties through mechanisms such as scavenging free radicals and upregulating antioxidant gene expression.

CONCLUSION

Pharmaceutical agents used in the treatment of type 2 diabetes has been shown to exert an antioxidant effect..