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Shi J, Yin G, Shi Z, Zhang S, Wei J, Xue T, Su X. Evaluation of the Effectiveness of In-Hospital Exercise Rehabilitation in Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus Combined with Sarcopenia Effect of Lifestyle Management on Disease Status in Patients with Type 2 Diabetes Mellitus. Endocr Res 2024; 49:154-164. [PMID: 38762774 DOI: 10.1080/07435800.2024.2353121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/04/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE The aim of this study was to explore the effects of in-hospital exercise rehabilitation on glucose and lipid metabolism and healthy physical fitness in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM) combined with sarcopenia, and to provide a reference for the effective implementation of exercise rehabilitation for middle-aged and elderly patients with T2DM combined with sarcopenia in healthcare institutions. METHODS This study retrospectively included 122 patients with T2DM combined with sarcopenia treated at the General Hospital of Ningxia Medical University from August 2017 to August 2020 and randomly divided into a control group and an experimental group. The control group was given conventional treatment and the experimental group was given exercise rehabilitation in the hospital for 12 weeks to compare the indexes related to glucose and lipid metabolism and healthy fitness in the two groups. RESULTS After the intervention, the experimental group showed significant decreases in fasting blood glucose (FBG), glycated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), triglycerides (TG), total cholesterol (TC), low-density cholesterol (LDL-C) and body fat percentage (p < 0.05), while high-density cholesterol (HDL-C), grip strength, lower limb extension, lower limb flexion, peak oxygen uptake were significantly higher (p < 0.05) and were more significant at 12 weeks compared to the 6-week intervention (p < 0.05). However, there were no significant changes in any of the glucose metabolism indicators in the control group before and after the intervention. A two-way repeated measures ANOVA showed that at control baseline levels, HbA1c decreased significantly in the experimental group after both 6 and 12 weeks of intervention compared to the control group (p < 0.05). After 6 weeks of intervention, the experimental group showed a significant decrease in body fat percentage and a significant increase in grip strength. After 12 weeks of intervention, the experimental group showed an increase in glycemic control from 33.3% to 73.3%, a significant decrease in body fat percentage and a significant increase in grip strength, lower limb extension and lower limb flexion strength and peak oxygen uptake. CONCLUSION In-hospital exercise rehabilitation can effectively improve the glycemic and lipid profiles of patients with T2DM combined with sarcopenia and enhance their health fitness, with good clinical rehabilitation effects.
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Affiliation(s)
- Jianhua Shi
- Health Management Center, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Gaojun Yin
- Health Management Center, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Zhiyun Shi
- Inspection Center, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Shengjun Zhang
- Department of Nutrition, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Jing Wei
- Health Management Center, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Tao Xue
- Department of Nutrition, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xiaoqian Su
- Health Management Center, General Hospital of Ningxia Medical University, Yinchuan, China
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El-Ashmawy NE, Khedr EG, Alfeky NH, Ibrahim AO. Upregulation of GLUT4 and PI3K, and downregulation of GSK3 mediate the anti-hyperglycemic effects of proanthocyanidins. MEDICINE INTERNATIONAL 2022; 2:14. [PMID: 36698506 PMCID: PMC9829200 DOI: 10.3892/mi.2022.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/08/2022] [Indexed: 01/28/2023]
Abstract
Diabetes mellitus is the most common chronic metabolic disorder worldwide. The present study was designed to investigate the potential role of cinnamon bark extract oligomeric proanthocyanidins (OPCs) in controlling streptozotocin (STZ)-induced hyperglycemia and to clarify the underlying molecular mechanisms underlying its effects. For this purpose, 60 male rats were equally divided into six groups as follows: The normal control group; OPC control group (non-diabetic rats treated with OPC at 300 mg/kg orally for 21 days); the untreated diabetic control group; the wortmannin control group [diabetic rats treated with wortmannin at 1 mg/kg, intraperitoneal (i.p.) on the final day of the experiment]; the OPC diabetic group (diabetic rats treated with OPC at 300 mg/kg orally for 21 days); and the OPC diabetic + wortmannin co-treated group (diabetic rats treated with OPC at 300 mg/kg/day for 21 consecutive days and then 24 h after the final OPC dose treated with a single wortmannin injection at 1 mg/kg, i.p.). The results indicated that OPC ameliorated the diabetic state, as evidenced by a significant decrease in serum glucose levels, and a significant increase in the levels of insulin, amylin, insulin receptor phosphorylation, glycogen and glucose transporter-4 translocation; it also improved the lipid profile in STZ-diabetic rats. On the whole, the findings of the present study provide biochemical evidence that OPC treatment is effective as an anti-diabetic and anti-hyperlipidemic agent by enhancing glucose uptake through the activation of insulin receptor kinase activity and the PI3K/Akt pathway.
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Affiliation(s)
- Nahla E. El-Ashmawy
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Gharbia 31111, Egypt
| | - Eman G. Khedr
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Gharbia 31111, Egypt
| | - Nehal H. Alfeky
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Gharbia 31111, Egypt
| | - Amera O. Ibrahim
- Department of Biochemistry, Faculty of Pharmacy, Tanta University, Tanta, Gharbia 31111, Egypt,Correspondence to: Dr Amera O. Ibrahim, Department of Biochemistry, Faculty of Pharmacy, Tanta University, El-Geish Street, Tanta, Gharbia 31111, Egypt
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Mabasa L, Kotze A, Shabalala S, Kimani C, Gabuza K, Johnson R, Sangweni NF, Maharaj V, Muller CJF. Sclerocarya birrea (Marula) Extract Inhibits Hepatic Steatosis in db/db Mice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3782. [PMID: 35409465 PMCID: PMC8998011 DOI: 10.3390/ijerph19073782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 12/18/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a spectrum of hepatic metabolic perturbations ranging from simple steatosis to steatohepatitis, cirrhosis and hepatocellular carcinoma. Currently, lifestyle modifications to reduce weight gain are considered the most effective means of preventing and treating the disease. The aim of the present study was to determine the therapeutic benefit of Sclerocarya birrea (Marula leaf extract, MLE) on hepatic steatosis. Obese db/db mice were randomly stratified into the obese control, metformin (MET) or MLE-treated groups. Mice were treated daily for 29 days, at which point all mice were euthanized and liver samples were collected. Hematoxylin and eosin staining was used for histological assessment of the liver sections, while qRT-PCR and Western blot were used to determine hepatic mRNA and protein expression, respectively. Thereafter, the association between methylenetetrahydrofolate reductase (Mthfr a key enzyme in one-carbon metabolism and DNA-methylation-induced regulation of gene transcription) and lipogenic genes was evaluated using Pearson's correlation coefficient. Mice treated with MLE presented with significantly lower body and liver weights as compared with the obese control and MET-treated mice (p ≤ 0.05). Further, MLE treatment significantly inhibited hepatic steatosis as compared with the obese control and MET-treated mice (p ≤ 0.05). The reduced lipid accumulation was associated with low expression of fatty acid synthase (Cpt1; p ≤ 0.05) and an upregulation of the fatty acid oxidation gene, carnitine palmitoyltransferase (Cpt1; p ≤ 0.01), as compared with the obese control mice. Interestingly, MLE treatment improved the correlation between Mthfr and Cpt1 mRNA expression (r = 0.72, p ≤ 0.01). Taken together, the results suggest that Marula leaf extracts may inhibit hepatic steatosis by influencing the association between Mthfr and genes involved in hepatic lipid metabolism. Further studies are warranted to assess DNA methylation changes in lipid metabolism genes.
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Affiliation(s)
- Lawrence Mabasa
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
| | - Anri Kotze
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
| | - Samukelisiwe Shabalala
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
- Division of Medical Microbiology, Department of Pathology and Laboratory-Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
| | - Clare Kimani
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
- Institute of Primate Research, P.O. Box 24481, Karen, Nairobi 00502, Kenya
| | - Kwazi Gabuza
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
| | - Rabia Johnson
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
| | - Nonhlakanipho F Sangweni
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
| | - Vinesh Maharaj
- Department of Chemistry, University of Pretoria, Pretoria 0001, South Africa
| | - Christo J F Muller
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3880, South Africa
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Ge X, He X, Lin Z, Zhu Y, Jiang X, Zhao L, Zeng F, Chen L, Xu W, Liu T, Chen Z, Zhao C, Huang Y, Liu B. 6,8-(1,3-Diaminoguanidine) luteolin and its Cr complex show hypoglycemic activities and alter intestinal microbiota composition in type 2 diabetes mice. Food Funct 2022; 13:3572-3589. [PMID: 35262159 DOI: 10.1039/d2fo00021k] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Flavonoid compounds such as luteolin exhibit hypolipidemic effects, and there are few reports on the hypoglycemic activity of luteolin derivatives. In this research, 6,8-(1,3-diaminoguanidine) luteolin (DAGL) and its Cr complex (DAGL·Cr) were obtained as a result of structural modifications to luteolin, and the hypoglycemic activities and the composition of intestinal microbiota in T2DM mice were investigated. This study found that DAGL and DAGL·Cr could significantly restore body weight, FBG, OGTT, AUC, and GSP in T2DM mice. Moreover, the pancreatic islet function index and the biochemical indicators of serum and the liver were also significantly improved. The histopathological results also showed that DAGL and DAGL·Cr had a stronger repair ability in the liver and the pancreas. It was also revealed that the potential hypoglycemic mechanism of DAGL and DAGL·Cr was involved in the simultaneous regulation of PI3K/AKT-1/GSK-3β/GLUT-4 and PI3K/AKT-1/mTOR/S6K1/IRS-1. Furthermore, DAGL and DAGL·Cr could also regulate the structure of the intestinal microbiota and increase the content of SCFA to relieve the symptoms of hyperglycemia in T2DM mice. This included a significant reduction in the ratio of Firmicutes and Bacteroidetes (F/B), and at the genus level, an increase in the relative abundance of Alistipe and Ruminiclostridium, and improvement in the content of SCFA in the feces of T2DM mice. In conclusion, in this study, DAGL and DAGL·Cr were found to improve hyperglycemia in T2DM mice by improving the pancreatic islet function index, regulating the biochemical indicators of serum and the liver, repairing damaged tissues, and regulating the PI3K/AKT-1 signaling pathway as well as reducing F/B, increasing the relative abundance of intestinal beneficial microbiota, and the content of SCFA in the feces. The hypoglycemic effect of DAGL·Cr on the body weight, serum IL-10, serum IL-6, and pancreatic islet function index was significantly better than that of DAGL.
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Affiliation(s)
- Xiaodong Ge
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Xiaoyu He
- National Engineering Research Center of JUNCAO Technology, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China
| | - Zhenshan Lin
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Yuxian Zhu
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Xiaoqin Jiang
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Liyuan Zhao
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Feng Zeng
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Ligen Chen
- College of Marine and Bioengineering, Yancheng Institute of Technology, Yancheng, Jiangsu 224051, China
| | - Wei Xu
- College of Marine and Bioengineering, Yancheng Institute of Technology, Yancheng, Jiangsu 224051, China
| | - Tingting Liu
- Clinical Pharmacy Department, Yancheng Second People's Hospital, Yancheng, Jiangsu 224051, China
| | - Zhigang Chen
- Clinical Pharmacy Department, Yancheng Second People's Hospital, Yancheng, Jiangsu 224051, China
| | - Chao Zhao
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Ying Huang
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Bin Liu
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
- National Engineering Research Center of JUNCAO Technology, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China
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Makhoba XH, Viegas C, Mosa RA, Viegas FPD, Pooe OJ. Potential Impact of the Multi-Target Drug Approach in the Treatment of Some Complex Diseases. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:3235-3249. [PMID: 32884235 PMCID: PMC7440888 DOI: 10.2147/dddt.s257494] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/08/2020] [Indexed: 12/16/2022]
Abstract
It is essential to acknowledge the efforts made thus far to manage or eliminate various disease burden faced by humankind. However, the rising global trends of the so-called incurable diseases continue to put pressure on Pharma industries and other drug discovery platforms. In the past, drugs with more than one target were deemed as undesirable options with interest being on the one-drug-single target. Despite the successes of the single-target drugs, it is currently beyond doubt that these drugs have limited efficacy against complex diseases in which the pathogenesis is dependent on a set of biochemical events and several bioreceptors operating concomitantly. Different approaches have thus been proposed to come up with effective drugs to combat even the complex diseases. In the past, the focus was on producing drugs from screening plant compounds; today, we talk about combination therapy and multi-targeting drugs. The multi-target drugs have recently attracted much attention as promising tools to fight against most challenging diseases, and thus a new research focus area. This review will discuss the potential impact of multi-target drug approach on various complex diseases with focus on malaria, tuberculosis (TB), diabetes and neurodegenerative diseases as the main representatives of multifactorial diseases. We will also discuss alternative ideas to solve the current problems bearing in mind the fourth industrial revolution on drug discovery.
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Affiliation(s)
- Xolani H Makhoba
- Department of Biochemistry, Genetics and Microbiology, Division of Biochemistry, University of Pretoria, Hatfield, South Africa
| | - Claudio Viegas
- Laboratory of Research in Medicinal Chemistry (PeQuiM), Institute of Chemistry, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Rebamang A Mosa
- Department of Biochemistry, Genetics and Microbiology, Division of Biochemistry, University of Pretoria, Hatfield, South Africa
| | - Flávia P D Viegas
- Laboratory of Research in Medicinal Chemistry (PeQuiM), Institute of Chemistry, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Ofentse J Pooe
- Discipline of Biochemistry, School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
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Gutiérrez G, Giraldo-Dávila D, Combariza MY, Holzgrabe U, Tabares-Guevara JH, Ramírez-Pineda JR, Acín S, Muñoz DL, Montoya G, Balcazar N. Serjanic Acid Improves Immunometabolic Markers in a Diet-Induced Obesity Mouse Model. Molecules 2020; 25:E1486. [PMID: 32218297 PMCID: PMC7181135 DOI: 10.3390/molecules25071486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 02/06/2023] Open
Abstract
Plant extracts from Cecropia genus have been used by Latin-American traditional medicine to treat metabolic disorders and diabetes. Previous reports have shown that roots of Cecropia telenitida that contains serjanic acid as one of the most prominent and representative pentacyclic triterpenes. The study aimed to isolate serjanic acid and evaluate its effect in a prediabetic murine model by oral administration. A semi-pilot scale extraction was established and serjanic acid purification was followed using direct MALDI-TOF analysis. A diet induced obesity mouse model was used to determine the impact of serjanic acid over selected immunometabolic markers. Mice treated with serjanic acid showed decreased levels of cholesterol and triacylglycerols, increased blood insulin levels, decreased fasting blood glucose and improved glucose tolerance, and insulin sensitivity. At transcriptional level, the reduction of inflammation markers related to adipocyte differentiation is reported.
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Affiliation(s)
- Gustavo Gutiérrez
- Natural Sciences School, Pharmaceutical Sciences Department, Universidad Icesi, 760031 Cali, Colombia;
| | - Deisy Giraldo-Dávila
- School of Chemistry, Industrial University of Santander, 680003 Bucaramanga, Santander, Colombia; (D.G.-D.); (M.Y.C.)
| | - Marianny Y. Combariza
- School of Chemistry, Industrial University of Santander, 680003 Bucaramanga, Santander, Colombia; (D.G.-D.); (M.Y.C.)
| | - Ulrike Holzgrabe
- University of Würzburg, Institute for Pharmacy and Food Chemistry, 97074 Würzburg, Germany;
| | - Jorge Humberto Tabares-Guevara
- Grupo Inmunomodulación, School of Medicine, Universidad de Antioquia, 050010 Medellín, Antioquia, Colombia; (J.H.T.-G.); (J.R.R.-P.)
| | - José Robinson Ramírez-Pineda
- Grupo Inmunomodulación, School of Medicine, Universidad de Antioquia, 050010 Medellín, Antioquia, Colombia; (J.H.T.-G.); (J.R.R.-P.)
- Department of Physiology and Biochemistry, School of Medicine, Universidad de Antioquia, Carrera 51D Nº 62–29, 050010 Medellin, Colombia;
| | - Sergio Acín
- Department of Physiology and Biochemistry, School of Medicine, Universidad de Antioquia, Carrera 51D Nº 62–29, 050010 Medellin, Colombia;
- GENMOL Group. Sede de Investigación Universitaria, Universidad de Antioquia, Calle 62 # 52–59, 050010 Medellín, Colombia;
| | - Diana Lorena Muñoz
- GENMOL Group. Sede de Investigación Universitaria, Universidad de Antioquia, Calle 62 # 52–59, 050010 Medellín, Colombia;
| | - Guillermo Montoya
- Natural Sciences School, Pharmaceutical Sciences Department, Universidad Icesi, 760031 Cali, Colombia;
| | - Norman Balcazar
- Department of Physiology and Biochemistry, School of Medicine, Universidad de Antioquia, Carrera 51D Nº 62–29, 050010 Medellin, Colombia;
- GENMOL Group. Sede de Investigación Universitaria, Universidad de Antioquia, Calle 62 # 52–59, 050010 Medellín, Colombia;
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