Adipokines and Obesity. Potential Link to Metabolic Disorders and Chronic Complications

Disrupted adipokine secretion and inflammatory responses in human adipocyte hypertrophy

Adipocyte hypertrophy is a critical contributor to obesity-induced inflammation and insulin resistance. This study employed a human adipocyte hypertrophy model to investigate the adipokine release, inflammatory responses, and the intracellular singling pathways. Hypertrophic adipocytes exhibited increased lipid content and lipolysis, a decline of anti-inflammatory adipokine adiponectin release and an increase of pro-inflammatory adipokine leptin release compared to mature adipocytes. Moreover, TNFα and LPS exacerbated the decrease in adiponectin secretion by hypertrophic adipocytes while promoting the secretion of leptin, MCP-1 and IL-6, which is associated with impaired activation of p38 and JNK MAPK and persistent activation of ERK and IκBα in hypertrophic adipocytes. These altered adipokine secretions and inflammatory responses within hypertrophic adipocytes may contribute to adipocyte dysfunction in human obesity.

Aqueous humor adipokine profile of primary open angle glaucoma patients and cataract patients with or without metabolic disorders

AIM

To investigate the role of adipokines in primary open angle glaucoma (POAG) by comparing the levels of these molecules in the aqueous humor among POAG patients and cataract patients with or without metabolic disorders.

METHODS

In this cross-sectional study, aqueous humor samples of 22 eyes of POAG patients (POAG group), 24 eyes of cataract patients without metabolic disorders (cataract group), and 24 eyes of cataract patients with metabolic disorders (cataract+metabolic disorders group) were assessed for 15 adipokines by Luminex bead-based multiplex array. The correlation between aqueous humor adipokines and clinical indicators of POAG was analyzed and compared across the groups.

RESULTS

The analysis revealed that the levels of adiponectin, leptin, adipsin, retinol-binding protein 4 (RBP4), angiopoietin-2, angiopoietin-like protein 4 (ANGPTL4), chemokine (C-C motif) ligand 2 (CCL2), interleukin-8 (IL-8), and interleukin-18 (IL-18) in the aqueous humor of the POAG group were significantly higher than those in the cataract group. Additionally, the level of angiopoietin-2 in the POAG group was higher than in the cataract+metabolic disorders group. However, no significant correlation was found between the levels of adipokines in the POAG group and intraocular pressure (IOP), severity of POAG, or the use of glaucoma medications.

CONCLUSION

This study demonstrates significant differences in aqueous humor adipokine levels between POAG and cataract patients. The findings suggest that the levels of aqueous humor adipokines may reflect the inflammatory states in POAG and systemic metabolic abnormalities.

Obesity, White Adipose Tissue, and Adipokines Signaling in Male Reproduction

Currently, obesity is a global pandemic characterized by systemic metabolic complications that negatively impact several organs, including white adipose tissue (WAT) and the tissues of the male reproductive system. Since the discovery of leptin in 1994, WAT has been recognized as a dynamic endocrine organ for secreting a series of molecules with hormonal functions, collectively called adipokines. The link between obesity, WAT, adipokines, and the male reproductive system is direct and little explored. With changes in nutritional status, WAT undergoes morphofunctional changes, and the secretion of adipokines is altered, negatively impacting reproductive mechanisms, including steroidogenesis and spermatogenesis. In this review, we address in an updated way the structural and functional characteristics of WAT as well as the link between obesity and changes in the signaling pathways of the adipokines leptin, adiponectin, resistin, visfatin, apelin, chemerin, omentin-1, vaspin, and asprosin in male reproduction. Understanding the relationship between obesity, these adipokines, and reproductive dysfunction can contribute to new strategies for the treatment of subfertility and male infertility.

The dual targeting effects of KD025 on casein kinase 2 and ROCK2 in a mouse model of diet-induced obesity

KD025(belumosudil), a selective ROCK2 inhibitor, exhibits unique anti-adipogenic activity through inhibition of casein kinase 2 (CK2). This study investigated the dual inhibitory effects of KD025 on metabolism in a diet-induced obese model. C57BL/6 mice on a high fat diet (HFD) were treated with KD025 for 4 weeks, while fasudil (a pan-ROCK inhibitor) and CX-4945 (a CK2-specific inhibitor) served as comparison treatments. KD025 significantly reduced body weight gain without affecting food intake, serum insulin, or fasting blood glucose levels. In contrast, while both CX-4945 and fasudil treatments showed a trend toward weight reduction, these results were not statistically significant. KD025 improved lipid metabolism by significantly lowering LDL cholesterol and triglyceride, although it slightly impaired glucose metabolism, as observed in insulin and glucose tolerance tests. Weight reduction in the KD025- and CX-4945-treated groups was attributed to decreased adipose tissue mass, particularly in inguinal (ingWAT) and epididymal (epiWAT) fat depots. Hematoxylin and eosin (H&E) staining confirmed smaller adipocyte size in these groups. KD025 had no significant effect on serum levels of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), or monocyte chemoattractant protein-1 (MCP-1) with varied inflammatory responses. Furthermore, KD025 and CX-4945 upregulated adipogenic and browning markers, such as Cebpa, Cidea, and Pparg in the epiWAT, though without significant UCP1 expression. Overall, KD025 effectively reduced weight gain in HFD-fed mice through dual inhibition of CK2 and ROCK2, highlighting its potential as a therapeutic agent for obesity-related conditions.

Chromium and formoterol therapy for obesity-induced asthma in rats

The development of asthma is impacted by fat. Asthma is more common in obese persons. The purpose of the experimental study is to determine how chromium, formoterol, and their combination can improve the quality of life for obese people with lung anomalies. Thirty-six male Wistar rats were divided into six groups: control (C), obesity (CO), obese-asthma (COA), and obese-asthma groups treated with formoterol (OAF), chromium (OACR), or both (OACRF). Except for group C, all groups received a high-fat diet for 4 weeks. Subsequently, ovalbumin (OVA) was administered subcutaneously (s.c.) to all groups except C and CO to induce sensitization. Asthma was triggered via 1% OVA aerosol challenges on days 26-28. Over 5 days, OAF and OACRF received daily formoterol inhalations (50 μg/kg), while OACR and OACRF were given chromium (400 μg/kg). Treatments were timed to align with asthma induction protocols. Lipid profile and inflammatory indicators were examined at the end of the trial-Immunohistochemical analysis of lung tissue, Histopathological and lung tissue stained with Hematoxylin and Eosin. The combination therapy (OACRF) significantly reduced body weight (p < 0.05), lowered LDL and triglycerides, increased HDL, and normalized lung tissue architecture compared to controls. Immunohistochemistry revealed reduced IL-1β and IL-17α expression. The (OACRF) group demonstrated superior asthma control by reducing body weight, improving inflammatory indicators, and restoring lung tissue to its normal state by administering chromium and formoterol therapy. The most effective strategy for treating both obesity and asthma is to address their two connected conditions. These findings demonstrate that combined chromium and formoterol therapy effectively addresses metabolic and inflammatory components of obesity-induced asthma, offering a promising dual-target therapeutic strategy.

The role of adipogenic niche resident cells in colorectal cancer progression in relation to obesity

Colorectal cancer (CRC) is the third most common cancer worldwide and has one of the highest mortality rates. Considering its nonlinear etiology, many risk factors are associated with CRC formation and development, with obesity at the forefront. Obesity is regarded as one of the key environmental risk determinants for the pathogenesis of CRC. Excessive food intake and a sedentary lifestyle, together with genetic predispositions, lead to the overgrowth of adipose tissue along with a disruption in the number and function of its building cells. Adipose tissue-resident cells may constitute part of the CRC microenvironment. Alterations in their physiology and secretory profiles observed in obesity may further contribute to CRC progression, and despite similar localization, their contributions are not equivalent. They can interact with CRC cells, either directly or indirectly, influencing various processes that contribute to tumorigenesis. The main aim of this review is to provide insights into the diversity of adipose tissue resident cells, namely, adipocytes, adipose stromal cells, and immunological cells, regarding the role of particular cell types in co-forming the CRC microenvironment. The scope of this study was also devoted to the abnormalities in adipose tissue physiology observed in obesity states and their impact on CRC development.

A multiplex assay of leptin, resistin, and adiponectin by immunoaffinity enrichment and targeted mass spectrometry

Background

Leptin, resistin, and adiponectin are critical adipokines involved in the pathophysiology of obesity and its related disorders, including type 2 diabetes. Although these biomarkers have historically been quantified using immunoassays, the specificity of antibody-based methods has frequently been questioned. As a result, there is an increasing interest in developing reliable, multiplexed clinical assays that utilize mass spectrometry for improved accuracy. In this study, we present a multiplexed immunoaffinity liquid chromatography-tandem mass spectrometry (multi-IA-LC-MS/MS) assay designed for the sensitive and selective measurement of leptin, resistin, and adiponectin in human plasma.

Methods

Leptin, resistin, and adiponectin were selectively enriched from plasma samples using an antibody cocktail composed of monoclonal antibodies targeting each respective adipokine. The enriched adipokines underwent enzymatic digestion, and the resulting tryptic peptides were quantified using LC-MS/MS. The validated assay was subsequently applied to plasma samples collected from a cohort of subjects representing various weight categories, including normal weight, overweight, and obesity.

Results

The lower limits of quantification for the assay were determined to be 0.5 ng/mL for both leptin and resistin, and 50 ng/mL for adiponectin. Intra- day, inter- day, and total imprecision measurements were all < 15 %, while spike recovery consistently exceeded 83 %. Comparative analysis with individual immunoassays demonstrated strong correlation, with all correlation coefficients (r) being equal to or greater than 0.869. Notably, when comparing subjects with obesity to those with normal weight, there was an approximately nine-fold increase in circulating leptin levels and a ∼1.6-fold decrease in circulating adiponectin levels.

Conclusions

A multi-IA-LC-MS/MS assay was developed for the simultaneous and sensitive measurement of leptin, resistin, and adiponectin in clinical samples. This quantitative method shows significant potential for applications related to obesity and could facilitate improved clinical management and understanding of obesity-related conditions.

Early diagnosis of type 2 diabetes mellitus in patients with psoriasis: Construction of a multifactorial diagnostic model

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a significant comorbidity of psoriasis that exerts a long-term detrimental effect on patients. Early T2DM detection in psoriasis patients is essential for timely medical intervention and the prevention of further complications.

OBJECTIVE

To develop a diagnostic model and introduce a web-based calculator for assessing the risk of T2DM in patients with psoriasis.

METHODS

A diagnostic model was constructed using the least absolute shrinkage and selection operator and logistic regression on data from 17,124 patients with psoriasis from 49 hospitals. The model's performance was evaluated using receiver operating characteristic curve, decision curve analysis, and clinical impact curve.

RESULTS

Eleven significant independent predictors were identified in our model. The area under the receiver operating characteristic curve of this model was 0.875 (95% confidence interval: 0.862-0.889), and the result of Hosmer-Lemeshow goodness of fit test showed a P-value of 0.06. Within the threshold probability of 0-0.2, the diagnostic model showed a significant net benefit.

LIMITATIONS

The limitations of retrospective studies, including a potential data bias to arise during pandemics, must be considered.

CONCLUSION

A multifactorial diagnostic model for diagnosing T2DM in patients with psoriasis was constructed to help clinicians make better decisions.

The Role of Perirenal Adipose Tissue in Carcinogenesis-From Molecular Mechanism to Therapeutic Perspectives

Perirenal adipose tissue (PRAT) exhibits particular morphological features, with its activity being mainly related to thermogenesis. However, an expanded PRAT area seems to play a significant role in cardiovascular diseases, diabetes mellitus, and chronic kidney disease pathogenesis. Numerous studies have demonstrated that PRAT may support cancer progression and invasion, mainly in obese patients. The mechanism underlying these processes is of dysregulation of PRAT's secretion of adipokines and pro-inflammatory cytokines, such as leptin, adiponectin, chemerin, apelin, omentin-1, vistatin, nesfatin-1, and other pro-inflammatory cytokines, modulated by tumor cells. Cancer cells may also induce a metabolic reprogramming of perirenal adipocytes, leading to increased lipids and lactate transfer to the tumor microenvironment, contributing to cancer growth in a hypoxic milieu. In addition, the PRAT browning process has been specifically detected in renal cell carcinoma (RCC), being characterized by upregulated expression of brown/beige adipocytes markers (UCP1, PPAR-ɣ, c/EBPα, and PGC1α) and downregulated white fat cells markers, such as LEPTIN, SHOX2, HOXC8, and HOXC9. Considering its multifaceted role in cancer, modulation of PRAT's role in tumor progression may open new directions for oncologic therapy improvement. Considering the increasing evidence of the relationship between PRAT and tumor cells, our review aims to provide a comprehensive analysis of the perirenal adipocytes' impact on tumor progression and metastasis.

Cardiometabolic Markers in Algerian Obese Subjects with and Without Type 2 Diabetes: Adipocytokine Imbalance as a Risk Factor

Background/Objectives: An increase in body fat is linked to abnormalities in energy metabolism. We aimed at determining cardiometabolic risk in Algerian participants with obesity alone and with or without type 2 diabetes. The study measured the concentrations of circulating adipocytokines (leptin, adiponectin, resistin), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) to identify and examine how imbalances in adipocytokines may affect the parameters of cardiometabolic health. Methods: Algerian participants (n = 300) were recruited and divided into three groups: control, obese, and type 2 diabetics (with two sub-groups: with and without obesity). Insulin resistance was evaluated using HOMA-IR, while ELISA was used to measure adipocytokines. Atherogenic index in plasma (AIP), adiponectin-leptin ratio (ALR), and visceral adiposity index (VAI) were also assessed. One-way ANOVA was used to compare obesity and diabetes groups to the control one (p < 0.05). Logistic regression analysis was conducted to strengthen the robustness of statistical correlations. Results: Participants with reduced adiponectin-leptin ratio (ALR) and elevated levels of resistin, TNF-α, and IL-6 are found to be at higher risk of cardiovascular diseases. An imbalance in adipocytokine levels is caused by a decrease in adiponectin concentrations, and an increase in pro-inflammatory adipocytokines that maintain and exacerbate energy imbalance and induces hyperinsulinemia, exposing individuals to a high risk of cardiovascular diseases. Conclusions: Given that ALR is a functional biomarker of inflammation, insulin resistance, and adipose tissue dysfunction, targeting ALR could potentially be a therapeutic approach to coping with obesity-related cardiometabolic risks. Mediterranean diet, weight loss, and increased physical activity can be key components to promote healthy adipose tissue through the increase in ALR.

Pathophysiology of Maternal Obesity and Hypertension in Pregnancy

Obesity is one of the biggest health problems in the 21st century and the leading health disorder amongst women of fertile age. Maternal obesity is associated with several adverse maternal and fetal outcomes. In this group of women, the risk for the development of hypertensive disorders of pregnancy (HDPs), such as gestational hypertension (GH) and pre-eclampsia (PE), is increased. In fact, there is a linear association between an increase in pre-pregnancy body mass index (BMI) and PE. Excessive weight gain during pregnancy is also related to the development of PE and GH. The role of obesity in the pathophysiology of HDP is complex and is most likely due to an interaction between several factors that cause a state of poor maternal cardiometabolic health. Adipokines seem to have a central role in HDP development, especially for PE. Hypoadiponectinemia, hyperleptinemia, insulin resistance (IR), and a proinflammatory state are metabolic disturbances related to PE pathogenesis, contributing to its development by inducing a state of maternal endothelial dysfunction. Hypertriglyceridemia is suggested to also be a part of the disease mechanisms of HDP. Therefore, this review seeks to explore the scientific literature to assess the complications of maternal obesity and its association with the development of HDP.

Emerging mechanisms of organ crosstalk: The role of oxylipins

There is growing interest in the role of oxylipins in the pathophysiology of several diseases. This is accompanied by a limited but evolving evidence base describing augmented oxylipin concentrations in a range of complications including cardiovascular disease, obesity, liver disease and neurological disorders. Despite this, literature describing oxylipin profiles in blood and multiple organs is inconsistent and the mechanisms by which these profiles are altered, and the relationships between localised tissue and circulating oxylipins are poorly understood. Inflammation and immune response associated with disease requires communication across organs and physiological systems. For example, inflammation and comorbidities associated with obesity extend beyond the adipose tissue and affect the vascular, hepatobiliary and digestive systems amongst others. Communication between organs and physiological systems is implicated in the progression of disease as well as the maintenance of homeostasis. There is emerging evidence for the role of oxylipins as a mechanism of communication in organ crosstalk but the role of these in orchestrating multiple organ and system responses is poorly understood. Herein, we review evidence to support and describe the role of oxylipins in organ crosstalk via the cardiosplenic and gut-link axis. In addition, we review emerging mechanisms of oxylipin regulation, the gut microbiome and modification using nutritional intervention. Finally, we describe future perspectives for addressing challenges in measurement and interpretation of oxylipin research with focus on the host genome as a modifier of oxylipin profiles and response to dietary lipid intervention.

Association between systemic immune inflammation index and adolescent obesity in a cross-sectional analysis

Obesity is a prevalent health issue among adolescents, characterized by chronic low-grade inflammation, which increases the risk of developing various chronic diseases in the future. The systemic immune-inflammation index (SII) serves as an indicator of inflammation and immune response. This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016, including 5,676 participants. A multivariate logistic regression model, Generalized Additive Models (GAM), and subgroup analysis were used to examine the relationship between obesity and SII. The multivariate logistic regression results revealed a significant positive correlation between log SII and adolescent obesity (1.254 [1.024-1.537]). Furthermore, the risk of obesity increased with higher quartiles of SII. Subgroup analysis and interaction tests showed that this positive association persisted across various factors, including female gender, race (Non-Hispanic White and Mexican American), non-hyperlipidemia, normal white blood cell count, and PIR < 1. Additionally, a U-shaped relationship between log SII and obesity was observed, with a turning point at 6.410. The findings suggest that an increase in the systemic immune-inflammation index is significantly associated with obesity in adolescents. However, further validation through large-scale prospective studies is needed.

The food environment in favelas is associated with the presence of arterial hypertension and diabetes in socially vulnerable women

OBJECTIVE

To evaluate the relationship between the food environment in favelas and the presence of arterial hypertension and diabetes among women in the context of social vulnerability.

DESIGN

A cross-sectional and partially ecological population-based study was conducted in a Brazilian capital city. The healthiness and availability of ultra-processed foods in the food environment were assessed through retailer audits using the AUDITNOVA instrument. The presence of diabetes and arterial hypertension was evaluated based on self-reported prior medical diagnosis. Logistic regression models were applied using generalised estimating equations, adjusted for age, education, race/skin colour and poverty status.

PARTICIPANTS

1882 adult women of reproductive age (20-44 years).

RESULTS

It was found that 10·9 % of women were hypertensive and 3·2 % had diabetes. The likelihood of having diabetes and arterial hypertension decreases with higher levels of healthiness in the food environment (diabetes (OR: 0·25; 95 % CI: 0·07, 0·97)/arterial hypertension (OR: 0·45; 95 % CI: 0·24, 0·81)) and increases with greater availability of ultra-processed foods in their living area (diabetes (OR: 2·18; 95 % CI: 1·13, 4·21)/arterial hypertension (OR: 1·64; 95 % CI: 1·09, 2·47)).

CONCLUSIONS

These results suggest that characteristics of the consumer food environment have a significant effect on the occurrence of chronic diseases among socially vulnerable women, adding to the existing evidence in the literature and highlighting the need for integrated health care.

Association between the body roundness index and female infertility: a cross-sectional study from NHANES

Background

Infertility is strongly associated with obesity. The body roundness index (BRI) is a more accurate assessment of visceral fat content than the body mass index (BMI). However, current evidence on the association between visceral fat accumulation and infertility remains insufficient and controversial. Therefore, we utilized the 2017-2020 National Health and Nutrition Examination Survey (NHANES) database to explore the correlation between BRI and infertility.

Methods

We used multiple logistic regression, smoothed curve fitting, subgroup analyses, and interaction tests to investigate the potential association between BRI and infertility. Additionally, we assessed the ability of BRI and BMI to predict infertility risk using receiver operating curve (ROC) analysis and calculate the area under the curve (AUC),sensitivity, and specificity.

Results

In the study, 1463 women aged 20 to 45 participated, and 172 of them were found to be infertile. After adjusting for all factors except body measurements, the findings indicated that for each one-unit increase in BRI, there was a 19% increase in the risk of infertility (OR = 1.19, 95% CI 1.05, 1.34). The analysis also revealed a positive nonlinear relationship between BRI and infertility. Furthermore, based on the ROC curves, it was observed that BRI was a more reliable predictor of infertility risk compared to BMI (BRI AUC = 0.5773, BMI AUC = 0.5681).

Conclusion

This study demonstrated a positive association between higher BRI values and infertility among adult women in the United States and showed a stronger association than BMI.

Impact of Obesity on Pubertal Timing and Male Fertility

Childhood obesity has profound effects on puberty in boys and girls, altering its timing, progression, and associated hormonal changes. Also, later male fertility could be impaired by childhood and pubertal obesity in light of the impact of inflammatory markers on semen quality. The aim of this narrative review is to explore the intricate relationship between childhood obesity and its impact on pubertal development and fertility, with a specific focus on boys. Such a relationship between obesity and pubertal timing in males is highly influenced by metabolic, hormonal, genetic, epigenetic, and environmental factors. While many studies suggest that obesity accelerates pubertal onset in boys, some studies do not confirm these findings, especially in cases of severe obesity. In fact, delayed puberty has also been reported in certain instances. Obesity influences fertility through different central and peripheral processes, including an altered endocrine milieu, inflammatory environment, and epigenetic modifications that alter semen quality and vitality, leading to subfertility or infertility. The early identification and management of potential issues associated with obesity are crucial for ensuring optimal reproductive health in adulthood. Further research is essential to clarify these associations and to develop targeted interventions aimed at preventing the negative health outcomes associated with obesity-related disruptions in puberty and fertility.

Assessing the relation between systemic lupus erythematosus and metabolic syndrome in Syria: a cross-sectional study

BACKGROUND

Systemic Lupus Erythematosus (SLE) affects all organ systems. As a result, fat intake and sedentary life are evident in the modern world. The prevalence of metabolic syndrome, with its components, increased, leading to increased mortality. We aimed to investigate the prevalence of metabolic syndrome in SLE and its relationship with disease activity.

METHODS

A cross-sectional study was conducted on 70 SLE patients at Al Mouwasat University Hospitals in Damascus, Syria, between November 2021 and November 2022. The patients were divided into two groups based on the presence or absence of metabolic syndrome. The SLE Disease Activity Index (SLEDAI) was assessed in each group and compared with different disease parameters.

RESULTS

Out of the 70 patients, 65 were females. The mean age was 32.19 ± 7.15 years, and the mean disease duration was 4.4 ± 2.96 years. Metabolic syndrome was found in 32 patients (45.7%). Metabolic syndrome in SLE patients was associated with a higher disease activity index, older age, delayed age at first diagnosis, longer disease duration, higher frequency of renal involvement, and use of cyclophosphamide.

CONCLUSION

Our study highlights the importance of evaluating and treating metabolic syndrome and its components in patients with SLE, as it may play a role in controlling disease activity. We recommend conducting larger studies in the future to overcome the limitations of this research, such as including a larger number of patients, conducting multicenter studies to generalize the results, and including a healthy control group.

Adipokines Pathogenesis in Heart Failure

Many studies have reported that obesity causes heart failure (HF) pathogenesis. The elevated circulating levels of angiopoietin-like protein 2 (ANGPTL2) observed in patients with HF suggest potential links among elevated ANGPTL2 levels, metabolic disturbances, and inflammation. C1q/TNF-related protein 3 and C1q/TNF-related protein 9 are diminished in patients with HF with reduced ejection fraction, in proportion to disease severity, and are associated with elevated morbidity and mortality. In addition, fibroblast growth factor 21 (FGF21) has been suggested to be involved in the pathophysiology of diastolic HF. Further studies are necessary to determine whether FGF21 plays a causal role in HF, and whether measuring circulating FGF21 might effectively improve HF prediction, diagnosis, and prognosis. Osteopontin has also been reported to be upregulated in patients with HF and therefore might potentially serve as a novel prognostic biomarker in patients with chronic HF. A considerable number of patients with community-acquired HF have elevated tumor necrosis factor-alpha, which is associated with significantly diminished survival and significantly elevated risk of HF.

Effects of Sodium Bicarbonate Ringer's Solution Combined with Positive End-Expiratory Pressure on the Internal Environment of Patients Undergoing Bariatric Surgery: A Randomized 2 × 2 Factorial Design Pilot

BACKGROUND

To evaluate the influence of sodium bicarbonate Ringer's solution (BRS) combined with positive end-expiratory pressure (PEEP) on the internal environment in patients who have undergone laparoscopic bariatric surgery.

METHODS

A total of 128 patients undergoing laparoscopic bariatric surgery were randomly divided into the control group (group C), the PEEP group (group P), the BRS group (group B), and the BRS combined with the PEEP group (group BP). The results of arterial blood gas analysis, including pH value, base excess (BE), concentrations of electrolyte, and lactate (Lac) were documented before intravenous infusion (T0) and 5 min after the surgery (T1). Additional metrics included tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and were quantified before intravenous infusion and at 30 min post-surgery. The quality of recovery-15 questionnaire (QoR-15) scores were documented preoperatively (D0) and on the first (D1) and third (D3) days, postoperatively.

RESULTS

There was no significant interaction effect between the two factors of BRS and PEEP (p = 0.659). After the infusion of BRS, the pH level increased significantly at T2 (p < 0.05). Using PEEP during operation can increase PaO2 in patients with obesity (p < 0.05). The level of pH value is increased, and the concentrations of inflammatory factors are reduced due to the combination of BRS and PEEP (p < 0.05). Compared with group C, group BP exhibited an augmentation in QoR-15 (p < 0.05), and the recovery time of group BP was significantly shortened (p < 0.05).

CONCLUSIONS

BRS combined with PEEP has been demonstrated to improve acid-base balance, reduce the inflammatory response, shorten the recovery time, and substantially enhance the quality of early postoperative recovery.

Investigation of adipocyte differentiation based on proteomics and intact N-glycopeptide modificationomics

OBJECTIVE

To investigate the role of N-glycosylation modification of proteins in adipocyte differentiation during the adipogenic process.

METHODS

SVF cells and adipocytes were analyzed for proteomics and intact N-glycopeptide modificationomics.Differential expression of proteins, glycoforms, and sites between the two groups was screened and subjected to Gene Ontology (GO) functional enrichment analysis, KEGG pathway enrichment analysis, and protein-protein interaction (PPI) network analysis. The top 20 most significantly differentially expressed adipogenic differentiation-related proteins were identified, and the most pronouncedly altered proteins were analyzed for glycoforms, glycan chains, and sites.

RESULTS

Proteomics analysis identified 39,392 peptides and 5208 proteins, while intact N-glycopeptide modification profiling identified 3293 intact glycopeptides, 426 proteins, and 161 glycan chains. Proteomics identified 2510 differentially expressed proteins, with CD36 (Cluster of Differentiation 36, CD36) significantly upregulated. In adipocytes, CD36 had 4 N-glycosylation sites: N79, N220, N320, N417, with N320 being a newly identified site. GO enrichment results indicated that CD36 is associated with fatty acid oxidation, lipid oxidation, and fatty acid uptake into cells.

CONCLUSION

Multiple proteins undergo N-glycosylation modification during adipocyte differentiation, with CD36, a fatty acid translocase, being significantly expressed in adipocytes. This suggests that N-glycosylation modification of CD36 may play a crucial role in adipocyte differentiation, providing a foundation for further investigation into the function of CD36 N-glycosylation in adipocyte differentiation.

Systematic review and meta-analyses of adipokine levels in hypothyroidism: a role for retinol-binding protein 4

BACKGROUND

Hypothyroidism (HT) is associated with numerous well-characterized comorbidities and established biomarkers for subclinical atherosclerosis which may lead to an elevated risk of cardiovascular disease; however, the precise molecular mechanism underlying these pathological features remains elusive. Increased levels of adipokines may have adverse effects on multiple atherosclerotic risk factors in HT. Different studies have evaluated the association between HT and adipokines with conflicting results.

METHODS

A systematic review and meta-analyses were conducted to provide an overview of adipokine levels in HT. The last literature search was done in February 2024 for studies analyzing traditional and novel circulating adipokines levels (excluding resistin and irisin) in patients with HT. The standard mean differences and 95% confidence intervals (CI) were calculated using random-effect models except if no heterogeneity was found.

RESULTS

HT was not associated with leptin, adiponectin, omentin-1, visfatin, or apelin levels; however, increased retinol-binding protein 4 (RPB4) levels were found in both overall and subclinical HT (p-values = 0.0002 and 0.004 respectively).

CONCLUSION

While pooled analysis suggested a role for RBP4 in hypothyroid patients, associations do not imply cause-effect relationships, and therefore the potential clinical implications of these findings should await further mechanistic studies.

REGISTRATION

The protocol has been registered in the Prospective Register of Systematic Reviews (PROSPERO) under the identification number CRD42024537717.

The association of BMI and subclinical myocardial dysfunction in breast cancer patients after single or dual anti-HER2 targeted therapy

BACKGROUND

Anti-HER2 targeted therapy has significantly reduced the recurrence and death of HER2-overexpressing breast cancer patients, but might lead to cardiotoxicity. Some patients with normal myocardial function may suffer from subclinical myocardial dysfunction after anti-HER2 targeted therapy. We sought to evaluate earlier the subclinical myocardial dysfunction in breast cancer patients after single or dual anti-HER2 targeted therapy, and identify the risk factors related to subclinical myocardiotoxicity.

METHODS

In our study, 40 breast cancer patients after single anti-HER2 targeted therapy, and 40 breast cancer patients after dual anti-HER2 targeted therapy were enrolled. Global longitudinal strain (GLS) was measured through echocardiography.

RESULTS

Seven patients in single anti-HER2 therapy group and eight patients in dual anti-HER2 therapy group had GLS lower than - 18%, suggesting subclinical myocardial dysfunction, but no difference between these two groups. Furthermore, we found that increased BMI was associated with reduction of GLS in breast cancer patients after anti-HER2 targeted therapy. Increased BMI (OR 2.683; 95% CI 1.225-5.879) was a risk factor of subclinical cardiotoxicity in dual anti-HER2 targeted therapy group. In addition, the patients with BMI ≥ 25 were more prone to have subclinical myocardial dysfunction in dual anti-HER2 therapy group compared with those with BMI ≥ 25 in single anti-HER2 therapy group.

CONCLUSION

Our results indicate dual anti-HER2 therapy does not increase the risk of subclinical myocardial dysfunction for breast cancer patients, compared with single anti-HER2 therapy. Patients with BMI ≥ 25 are more prone to have subclinical cardiotoxicity after dual anti-HER2 therapy than after single anti-HER2 therapy. Weight reduction should be the major measure to prevent subclinical myocardial dysfunction for these patients.

Effect of Long-Term Taurine Supplementation on the Lipid and Glycaemic Profile in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis

BACKGROUND

Taurine has been demonstrated to regulate and improve metabolic health. However, physiological and pathological differences among individuals with overweight or obesity may result in varied responses to taurine supplementation. This study aims to estimate the effects of long-term taurine supplementation on blood lipids, glycemia, and insulin sensitivity in adults with overweight or obesity through a systematic review and meta-analysis.

METHODS

The literature search was based on six databases (Web of Science, PubMed, Scopus, EMBASE, Cochrane, and SPORTDiscus) up to October 2024. Subgroup analyses were performed based on daily taurine intake dosage (<3 g or 3 g), overweight (BMI 25-29.9 kg/m2), and obesity (BMI ≥30 kg/m2).

RESULTS

The final number of studies that met the inclusion criteria was 9 RCTs. The overall analysis showed that taurine supplementation significantly decreased TG (WMD = -0.56 mg/dL, 95% CI: -0.92 to -0.2, p = 0.002, I2 = 63%), TC (WMD = -0.71 mg/dL, 95% CI: -1.17 to -0.25, p = 0.002, I2 = 73%), and fasting insulin (WMD = -2.15 µU/mL, 95% CI: -3.24 to -1.06, p = 0.0001, I2 = 9%). In the subgroup analysis, long-term taurine intake led to BMI improvement in overweight adults (WMD = -1.14 kg/m2, 95% CI: -1.81 to -0.47, p = 0.0008, I2 = 0%). Meanwhile, improvements in HbA1c (WMD = -0.33%, 95% CI: -0.53 to -0.12, p = 0.002, I2 = 16%) and HOMA-IR (WMD = -0.91, 95% CI: -1.74 to -0.08, p = 0.003, I2 = 54%) were observed only in obese participants following taurine supplementation. Additionally, the long-term intake of 3 g of taurine significantly improved HbA1c (WMD = -0.37%, 95% CI: -0.61 to -0.13, p = 0.003, I2 = 0%) and FPG levels (WMD = -7.14 mg/dL, 95% CI: -12.53 to -1.74, p = 0.003, I2 = 70%) in overweight/obesity.

CONCLUSIONS

Long-term taurine supplementation is particularly effective in improving glycemic control and insulin sensitivity in obesity. Furthermore, higher doses of taurine (3 g per day) demonstrate even greater improvements in glycemic control.

Exploring the Link Between Psoriasis and Adipose Tissue: One Amplifies the Other

Psoriasis and obesity, while distinct, are inter-related inflammatory conditions. Adipose tissue (AT)-derived mediators could be pathogenically active in triggering and/or amplifying psoriatic skin inflammation and, vice versa, skin inflammation could drive increased adiposity that triggers the development of several chronic conditions. Gaining insight into their intricate relationship could be essential for effective management and treatment. The aim of this study was to determine (i) the pathogenic role of psoriasis-signature cytokines in contributing to AT metabolism and (ii) the role of AT-derived mediators in triggering and/or amplifying skin inflammation. For this reason, firstly, whole AT was treated with IL-17 and TNF-α, alone or in combination, to investigate their effects on the expression and production of adipokines and inflammatory factors. IL-17 and TNF-α were able to induce an additive or synergistic effect on AT-derived mediators. In order to assess the effects on the skin of inflamed AT by psoriasis-signature cytokines, ex vivo skin organ culture was performed and an increase in several inflammatory mediators was observed. These findings confirm that psoriasis and obesity amplify each other's inflammatory processes and understanding this mutual exacerbation could lead to more effective therapeutic strategies that address both skin inflammation and AT metabolism.

Effect of Low- and Moderate-Intensity Aerobic Training on Body Composition Cardiorespiratory Functions, Biochemical Risk Factors and Adipokines in Morbid Obesity

BACKGROUND

Obesity poses an enormous public health and economic burden worldwide. Visceral fat accumulation is associated with various metabolic and cardiovascular consequences, resulting in an increased prevalence of atherosclerotic conditions. We aimed to examine the impact of low-and moderate-intensity aerobic training on several anthropometric and cardiorespiratory parameters and markers of atherosclerosis, including inflammation, serum levels of lipoproteins and adipokines of extremely obese patients in poor condition.

METHODS

Forty severely obese patients were recruited and randomized into two groups, Group 1 and Group 2, for a six-week inpatient study. Group 1 received moderate-intensity (40-60% heart rate reserve) and Group 2 received low-intensity (30-39% of heart rate reserve) aerobic training combined with resistance training. The patients' cardiorespiratory functions were assessed by ergospirometry. Anthropometric data were recorded, body composition was analyzed and functional tests were performed. We also investigated serum lipids and high-sensitive C-reactive protein levels and calculated the homeostatic model assessment-insulin resistance indices and adipokine levels as predictive biomarkers.

RESULTS

Functional abilities and some biochemical parameters, such as homeostatic model assessment-insulin resistance, serum lipids, apolipoprotein A and apolipoprotein-B improved in both groups in a positive direction. However, cardiorespiratory capacity and the serum levels of high-sensitive C-reactive protein and Lipocalin-2 decreased, while irisin and paraoxonase 1 increased significantly, but only in Group 1.

CONCLUSIONS

Six weeks of aerobic training, regardless of its intensity, could induce favorable changes in functional tests, body composition and serum lipids, even in severely obese, extremely unconditioned patients in both groups. However, moderate-intensity aerobic training should at least increase cardiorespiratory capacity and yield a better lipid profile oxidative status and inflammation profile.

Adipocyte-derived fatty acid uptake induces obesity-related breast cancer progression: a review

Obesity is a metabolic disorder that occurs when excess energy taken into the body is stored as fat. It is known that this metabolic imbalance affects the development of other diseases such as cancer, cardiovascular diseases, insulin resistance, and diabetes. The main cellular component of adipose tissue is adipocytes, and the environmental interactions of adipocytes are important to study the mechanism of disorder formation. Breast tissue is rich in adipose tissue and obesity is known to be an important risk factor in the development of breast cancer. Altered adipogenesis and lipogenesis processes in adipocytes in breast tissue support tumor development through the transfer of fatty acids released from adipocytes. We believe that blending adipocyte biology with breast cancer development is important for investigating the mechanisms that regulate breast tumor malignant behavior and providing new targets for treatment. Fatty acids, which are an energy source for breast cancer cells, are discussed from molecular perspectives in this review.

Subcutaneous adipose tissue: Implications in dermatological diseases and beyond

Subcutaneous adipose tissue (SAT) is the deepest component of the three-layered cutaneous integument. While mesenteric adipose tissue-based immune processes have gained recognition in the context of the metabolic syndrome, SAT has been traditionally considered primarily for energy storage, with less attention to its immune functions. SAT harbors a reservoir of immune and stromal cells that significantly impact metabolic and immunologic processes not only in the skin, but even on a systemic level. These processes include wound healing, cutaneous and systemic infections, immunometabolic, and autoimmune diseases, inflammatory skin diseases, as well as neoplastic conditions. A better understanding of SAT immune functions in different processes, could open avenues for novel therapeutic interventions. Targeting SAT may not only address SAT-specific diseases but also offer potential treatments for cutaneous or even systemic conditions. This review aims to provide a comprehensive overview on SAT's structure and functions, highlight recent advancements in understanding its role in both homeostatic and pathological conditions within and beyond the skin, and discuss the main questions for future research in the field.

The effect of ketogenic diet on adipokines levels: a systematic review and meta-analysis of randomized-controlled trials

BACKGROUND

Considering the impact of adipokines on metabolic syndrome-related disorders and even chronic illnesses, it would appear vital to look for efficient treatments for these variables. The goal of this study was to thoroughly examine how the ketogenic diet (KD) affects adipokines.

METHODS

Using standard keywords, the databases Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase were searched to find all controlled trials looking into how KD affected adipokines (leptin, adiponectin, and ghrelin). By using a random-effects model analysis, pooled weighted mean difference and 95% confidence intervals were obtained.

RESULTS

This article featured twenty-two studies. The combined results demonstrated that, as compared to the control group, leptin levels in all populations are significantly lower when KD is adhered to (WMD: - 0.14 ng/ml, 95% CI: - 8.66, - 3.61, P < 0.001). On the other hand, no discernible impact of this diet on ghrelin and adiponectin concentrations was noted. The subgroup analysis results demonstrated that the drop in leptin levels was considerably higher in persons with BMI > 30 kg/m2 and in trials that followed the KD for ≤ 8 weeks than in the other groups.

CONCLUSIONS

Generally speaking, this diet can be utilized as a potentially helpful supplementary therapy to improve this adipokine, given the significance that leptin plays on numerous metabolic illnesses.

Omentin roles in physiology and pathophysiology: an up-to-date comprehensive review

Omentin (intelectin) was first detected in the visceral omental adipose tissue. It has mainly two isoforms, omentin-1 and -2, with isoform-1 being the main form in human blood. It possesses insulin-sensitizing, anti-inflammatory, anti-atherogenic, cardio-protective, and oxidative stress-decreasing effects. Omentin's cardiovascular protective actions are caused by the improved endothelial cell survival and function, increased endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) bioavailability, enhanced vascular smooth muscle cells (VSMCs) relaxation with reduced proliferation, decreased inflammation, and suppressed oxidative stress. Omentin may also have a potential role in different cancer types and rheumatic diseases. Thus, omentin is an excellent therapeutic target in many diseases, including diabetes mellitus (DM), metabolic syndrome (MetS), cardiovascular diseases (CVDs), inflammatory diseases, and cancer. This review demonstrates the physiological functions of omentin in ameliorating insulin resistance (IR), vascular function, and inflammation and its possible share in managing obesity-linked diseases, such as metabolic disorders, DM, and cardiovascular conditions.

Low circulating levels of neuregulin 4 as a potential biomarker associated with the severity and prognosis of obesity-related metabolic diseases: a systematic review

BACKGROUND

Neuregulin 4 (Nrg4) is a brown adipose tissue-derived adipokine that greatly affects systemic metabolism and improves metabolic derangements. Although abnormal circulating levels of Nrg4 are common in obesity, it remains elusive whether low or elevated levels of this batokine are associated with the onset of metabolic diseases.

AIM

To assess Nrg4 levels and its role as a feasible biomarker to predict the severity of obesity, gestational diabetes mellitus (GDM), type 2 diabetes mellitus (T2DM), non-alcoholic fatty liver disease (NAFLD), and cardiovascular diseases (CVD).

METHODS

A search for relevant studies was performed systematically using prominent search engines, including PubMed, Google Scholar, and Embase, by following PRISMA guidelines.

RESULTS

Ample clinical evidence reported low serum/plasma levels of Nrg4 in obesity and these were inversely proportional to the indices of metabolic syndrome, including body mass index, waist circumference, triglycerides, fasting plasma glucose, and homoeostatic model assessment for insulin resistance as well as high-sensitivity C-reactive protein. Low circulating Nrg4 levels may aid in the prediction of morbid obesity, and subsequent GDM, T2DM, NAFLD, and CVD.

CONCLUSION

Current clinical evidence emphasizes that the circulating levels of Nrg4 are decreased in morbid obesity, and it also highlights that Nrg4 May serve as a potential prognostic biomarker for obesity-related metabolic diseases.

Effect of White Tea on Leptin and Asprosin Levels in Rats Feeding a High-Fat Diet

BACKGROUND

Currently, obesity affects over 600 million individuals and is responsible for numerous severe health conditions, particularly diabetes and metabolic syndrome. The objective of our study was to examine the impact of white tea, known for its potent antioxidant properties, on the reduction in body weight as well as the levels of leptin and asprosin.

METHODS

A total of 72 male Sprague-Dawley rats were randomly assigned to 9 groups, with each group consisting of 8 rats. The groups were partitioned into two in order to examine the preventative and therapeutic effects of white tea on obesity. During this study, the case groups were administered white tea together with a high-fat diet, whereas the positive control group was administered orlistat along with a high-fat diet through oral gavage. After the experiment concluded, the levels of leptin, asprosin, and insulin hormones were evaluated in serum samples collected from rats using the ELISA method.

RESULTS

The findings demonstrated that the administration of white tea led to a significant decrease in body weight, serum leptin, and asprosin levels, as well as oxidative stress indicators, in rats that were fed a high-fat diet.

CONCLUSIONS

Utilizing natural chemicals, such as white tea, which possess minimal side effects and have powerful antioxidant activity, can mitigate the detrimental consequences associated with obesity.

Gut microbiota and skin pathologies: Mechanism of the gut-skin axis in atopic dermatitis and psoriasis

Atopic dermatitis (AD) and psoriasis are chronic skin diseases with a global impact, posing significant challenges to public health systems and severely affecting patients' quality of life. This review delves into the key role of the gut microbiota in these diseases, emphasizing the importance of the gut-skin axis in inflammatory mediators and immune regulation and revealing a complex bidirectional communication system. We comprehensively assessed the pathogenesis, clinical manifestations, and treatment strategies for AD and psoriasis, with a particular focus on how the gut microbiota and their metabolites influence disease progression via the gut-skin axis. In addition, personalized treatment plans based on individual patient microbiome characteristics have been proposed, offering new perspectives for future treatment approaches. We call for enhanced interdisciplinary cooperation to further explore the interactions between gut microbiota and skin diseases and to assess the potential of drugs and natural products in modulating the gut-skin axis, aiming to advance the treatment of skin diseases.

Visseral Lipectomy Improves Metabolic Syndrome Parameters and Adipokines in a Rat Model of Metabolic Syndrome Induced by Monosodium Glutamate

OBJECTIVE

Metabolic syndrome (MetS) includes abdominal obesity, hypertension, insulin resistance, and dyslipidemia. Research has indicated that reducing excess visceral fat has positive effects on inflammation and insulin resistance. We examined whether visceral lipectomy modifies the effects of MetS parameters and adipocytokine levels.

METHODS

Each group included 15 newborn male rats: control+sham (C+S), metabolic syndrome+sham (MetS+S), and metabolic syndrome+visceral lipectomy (MetS+VL). On postnatal days 0, 2, 4, 6, 8, and 10, subcutaneous injections of monosodium glutamate (MSG) (4 g/mg) were administered to induce MetS. The control group received saline injection. The rats underwent sham surgery or lipectomy on the 120th day of life. Two months post-surgery, tests were performed to check lipid and insulin levels as well as the Lee index, HOMA-IR, serum adiponectin (ADP), resistin, interleukin-6 (IL6), leptin, tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) levels.

RESULTS

These findings showed that the Lee index (p = 0.001), insulin resistance (p = 0.002), and hyperinsulinemia (p = 0.009) were significantly improved in the MetS+VL group compared to those in the MetS+S group. The lipid profile was unaffected by visceral lipectomy. Furthermore, visceral lipectomy normalized MetS-induced adipokine imbalance.

CONCLUSION

The decrease in the Lee index and improvement in hyperinsulinemia suggest that visceral lipectomy may benefit impaired glucose metabolism. Although visceral lipectomy has no apparent effect on the lipid profile, positive effects on adipokine levels by reducing various inflammatory markers including resistin, IL6, leptin, TNF-α, and CRP. These findings indicate that visceral lipectomy may have therapeutic potential for MetS.

NO LEVEL ASSIGNED

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cafeteria diet and caloric restriction affect metabolic but not behavioral characteristics in male Wistar rats

This study aimed to evaluate the effects of a cafeteria diet and caloric restriction on behavioral and metabolic profiles of adult male Wistar rats. The rats were randomly divided into three groups (n = 12/group) and from 10 weeks of age fed either ad libitum standard rat chow (control group), ad libitum cafeteria diet in addition to standard chow (diet-induced obesity (DIO) group) or kept on caloric restriction (at 85% weight of controls; restricted group) for a period of 12 weeks. Body weight was assessed twice per week and glucose levels were measured at three times during the 12-week period. At week 11 the animals were behaviorally profiled using the multivariate concentric square field™ (MCSF) test. After 12 weeks of diet the animals were euthanized, blood collected, relative organ weights were assessed and plasma or serum levels of insulin, glucose, and lipid profile were measured. The DIO group gained 23% more weight than the control group (p < 0.001) and increased adipose tissue weight in comparison to the control (p < 0.001) and restricted (p < 0.001) groups. Glucose was significantly increased (p < 0.001) only during the second measurement at week 7 and insulin levels were elevated in the DIO group compared to controls and restricted groups (p < 0.01; p < 0.001, respectively). Plasma cholesterol levels were reduced for both DIO (p < 0.01) and restricted (p < 0.001) groups relative to controls. Adiponectin and leptin levels were higher for the DIO group in comparison to both the control (p < 0.001; p < 0.05) and restricted (p < 0.001; p < 0.001) groups. Thus, the two diets led to significant changes in body weight gain, adiposity, and metabolism. However, they did not alter the behavioral profiles in the MCSF test, suggesting that activity, exploration, risk assessment, risk taking or shelter seeking remained unaffected by the dietary interventions. The current findings suggest that an increase or reduction in energy intake resulted in no behavioral effects, despite the accompanying glycemic alterations potentially related to diabetes development.

Obesity-induced neuronal senescence: Unraveling the pathophysiological links

Obesity is one of the most prevalent and increasing metabolic disorders and is considered one of the twelve risk factors for dementia. Numerous studies have demonstrated that obesity induces pathophysiological changes leading to cognitive decline; however, the underlying molecular mechanisms are yet to be fully elucidated. Various biochemical processes, including chronic inflammation, oxidative stress, insulin resistance, dysregulation of lipid metabolism, disruption of the blood-brain barrier, and the release of adipokines have been reported to contribute to the accumulation of senescent neurons during obesity. These senescent cells dysregulate neuronal health and function by exhibiting a senescence-associated secretory phenotype, inducing neuronal inflammation, deregulating cellular homeostasis, causing mitochondrial dysfunction, and promoting microglial infiltration. These factors act as major risks for the occurrence of neurodegenerative diseases and cognitive decline. This review aims to focus on how obesity upregulates neuronal senescence and explores both pharmacological and non-pharmacological interventions for preventing cognitive impairments, thus offering new insights into potential therapeutic strategies.

Leptin is a potential biomarker of childhood obesity and an indicator of the effectiveness of weight-loss interventions

Childhood obesity represents a significant public health concern, imposing a substantial burden on the healthcare system. Furthermore, weight-loss programs often exhibit reduced effectiveness in adults who have a history of childhood obesity. Therefore, early intervention against childhood obesity is imperative. Presently, the primary method for diagnosing childhood obesity relies on body mass index (BMI), yet this approach has inherent limitations. Leptin, a satiety hormone produced by adipocytes, holds promise as a superior tool for predicting both childhood and subsequent adulthood obesity. In this review, we elucidate the tools employed for assessing obesity in children, delve into the biological functions of leptin, and examine the factors governing its expression. Additionally, we discuss maternal and infantile leptin levels as predictors of childhood obesity. By exploring the relationship between leptin levels and weight loss, we present leptin as a potential indicator of the effectiveness of obesity interventions.

Composition of gut microbiota in obese and normal-weight Uygur adults and its association with adipocyte-related factors

Obesity is a serious global health issue. Emerging evidence indicates that the gut microbiota may contribute to the development of obesity, possibly by instigating inflammatory processes. The objective of this research is to conduct a comparative analysis of the gut microbiota composition in obese and normal-weight Uygur adults, while examining the associations with adipocyte-related factors and dietary variables. According to the inclusion and exclusion criteria, twenty-seven Uygur adults with obesity and twenty Uygur adults with normal-weight were recruited from a local community. Anthropometric measurements and blood samples were collected. Gut microbiota composition was analyzed using 16 S rRNA gene sequencing. Adipocyte-related factors were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses were performed to compare the gut microbiota composition between the two groups and to identify correlations between gut microbiota and adipocyte-related factors. Compared with the normal-weight group, the obese group exhibited a marked reduction in both diversity and richness of the gut microbiota, alongside a decrease in Ruminococcaceae_UCG_014, Coprococcus_2, and Parabacteroides, and an increase in Megamonas and Lachnoclostridium, implying a potential link to the development of obesity. Individuals with obesity were found to have higher Leptin (LEP), Interleukin-6 (IL-6), and C-reactive protein (CRP) than normal-weight individuals. Obese Uygur adults exhibited a gut microbiota characterized by diminished diversity and richness relative to normal-weight individuals. Parabacteroides, Megamonas, and Lachnoclostridium may play an important role in the development of obesity in Uygur population. Underlying mechanisms need further investigation.

Overview of anti-inflammatory diets and their promising effects on non-communicable diseases

An anti-inflammatory diet is characterised by incorporating foods with potential anti-inflammatory properties, including fruits, vegetables, whole grains, nuts, legumes, spices, herbs and plant-based protein. Concurrently, pro-inflammatory red and processed meat, refined carbohydrates and saturated fats are limited. This article explores the effects of an anti-inflammatory diet on non-communicable diseases (NCD), concentrating on the underlying mechanisms that connect systemic chronic inflammation, dietary choices and disease outcomes. Chronic inflammation is a pivotal contributor to the initiation and progression of NCD. This review provides an overview of the intricate pathways through which chronic inflammation influences the pathogenesis of conditions including obesity, type II diabetes mellitus, CVD, autoinflammatory diseases, cancer and cognitive disorders. Through a comprehensive synthesis of existing research, we aim to identify some bioactive compounds present in foods deemed anti-inflammatory, explore their capacity to modulate inflammatory pathways and, consequently, to prevent or manage NCD. The findings demonstrated herein contribute to an understanding of the interplay between nutrition, inflammation and chronic diseases, paving a way for future dietary recommendations and research regarding preventive or therapeutic strategies.

White Tea Consumption Alleviates Anthropometric and Metabolic Parameters in Obese Patients

Background and Objectives: Obesity and related disorders are an increasing global health problem. Achieving and maintaining long-term weight loss through lifestyle changes and/or pharmacological interventions have not met expectations. Dietary supplements and alternative treatments have also shown limited effectiveness in this regard. The consumption of green tea in general has been shown to benefit obese patients, with effects attributed to caffeine, catechins, polyphenols and other components. However, the potential of white tea to prevent and treat the negative effects of obesity has not been addressed so far. In this study, the effect of white tea (WT) consumption in obese individuals was anthropometrically and biochemically investigated. Materials and Methods: Based on anthropometric and biochemical assessments, the patients were assigned to the control, orlistat, metformin and WT groups. Patients were given a diet and exercise program and one of either orlistat, metformin or WT for 12 weeks. At the end of the 12th week, the anthropometric and biochemical measurements were reassessed. Results: Body weight, waist circumference and BMI parameters decreased significantly in all groups. TNF-α, IL-6, IL-1β and MMP-9 levels decreased significantly in the WT group. In addition, contrary to a significant elevation in HDL-C, the serum cholesterol, LDL-C and TG levels decreased significantly. Furthermore, leptin, ghrelin and asprosin levels decreased significantly. Serum glucose levels decreased significantly in all groups except for the control. In the WT group, while there was a significant decrease in the levels of serum PL MDA and 8-OHdG, the opposite was true for GSH. Conclusions: The oral consumption of WT, its availability and its potency in obesity treatment and prevention pave the way for further delineation of the mechanisms of actions of its bioactive compounds at the cellular and endocrinological levels.

Omentin-1 and diabetic foot

Introduction: Diabetic foot disease is an advanced complication of diabetes mellitus, which is associated with severe invalidization and high mortality rate among affected people. Many factors are involved in its pathogenesis but not all of them are fully elucidated. Objectives: Adipose tissue and its hormones - adipokines, are related to diabetic complications and metabolic disorders. Until now, there are limited data on their role in diabetic foot. The aim of this cross-sectional study is to determine the levels of the adipokine omentin-1 in people with and without diabetic foot disease and to look for its potential involvement in this complication. Methods: Eighty patients with type 2 diabetes and mean age of 60.8±10.5 years were included in this study. They were divided into two groups: with (n=36) and without (n=44) diabetic foot disease. Standard antrometric, clinical and laboratory tests were made. Body composition was analyzed by bioelectrical impedance based device. Serum omentin-1 was measured using ELISA method. Results: Levels of omentin-1 were significantly higher among people with diabetic foot disease (700.2±345.1 ng/ml), compared to the other group (560.2±176.7 ng/ml). This difference remained significant even after adjusting for potential confounders. In a regression model omentin-1 proved its predictive value for development of diabetic foot. Conclusion: Adipokines, and particularly omentin-1, might be included in the pathogenesis of diabetic foot disease.

Effects of atypical antipsychotics on serum asprosin level and other metabolic parameters in patients with schizophrenia

BACKGROUND

In this cross-sectional study, we compared fasting serum asprosin levels and metabolic parameters between patients receiving one of three atypical antipsychotics (olanzapine, risperidone, or aripiprazole) and healthy subjects.

METHODS

The study population included 62 adult outpatients with schizophrenia and 22 healthy controls, matched for age and gender. Patients were in remission and had been on stable monotherapy with one of these atypical antipsychotics for over 6 months. Body Mass Index (BMI) and fasting serum levels of asprosin, glucose, HA1c, insulin, and lipid profile were compared across the investigated groups. Additionally, the number of participants meeting the insulin resistance criterion, defined as homeostasis model assessment for insulin resistance (HOMA-IR) >2.5, as well as the number of participants with elevated BMI levels (men >27 kg/m2, women >25 kg/m2) were compared among the groups.

RESULTS

We observed statistically significant differences in BMI and fasting serum levels of glucose, HA1c, insulin, triglyceride (TG), high-density lipoprotein cholesterol, and asprosin among patients receiving olanzapine or risperidone, as compared to those receiving aripiprazole and healthy subjects. Patients on aripiprazole exhibited values comparable to healthy subjects, whereas those on risperidone or olanzapine showed significantly higher values, with the highest observed in the olanzapine group. Additionally, the prevalence of participants meeting the insulin resistance criterion and those with elevated BMI was also greater in individuals receiving olanzapine or risperidone compared to those on aripiprazole and healthy subjects. Serum asprosin levels showed a significant positive correlation with BMI and several metabolic parameters, including HbA1c, fasting insulin, HOMA-IR, and TG. No significant differences were observed among the investigated groups in terms of serum levels of total cholesterol and low-density lipoprotein cholesterol.

CONCLUSIONS

Our cross-sectional study highlights the association between elevated asprosin levels, weight gain, and metabolic disorders in patients treated with olanzapine and risperidone. Given the bidirectional nature of the relationship between serum asprosin levels and these metabolic disturbances, further research is warranted to elucidate potential causative pathways.

2024 Guidelines of the Taiwan Society of Cardiology on the Primary Prevention of Atherosclerotic Cardiovascular Disease --- Part I

Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of death worldwide and in Taiwan. It is highly prevalent and has a tremendous impact on global health. Therefore, the Taiwan Society of Cardiology developed these best-evidence preventive guidelines for decision-making in clinical practice involving aspects of primordial prevention including national policies, promotion of health education, primary prevention of clinical risk factors, and management and control of clinical risk factors. These guidelines cover the full spectrum of ASCVD, including chronic coronary syndrome, acute coronary syndrome, cerebrovascular disease, peripheral artery disease, and aortic aneurysm. In order to enhance medical education and health promotion not only for physicians but also for the general public, we propose a slogan (2H2L) for the primary prevention of ASCVD on the basis of the essential role of healthy dietary pattern and lifestyles: "Healthy Diet and Healthy Lifestyles to Help Your Life and Save Your Lives". We also propose an acronym of the modifiable risk factors/enhancers and relevant strategies to facilitate memory: " ABC2D2EFG-I'M2 ACE": Adiposity, Blood pressure, Cholesterol and Cigarette smoking, Diabetes mellitus and Dietary pattern, Exercise, Frailty, Gout/hyperuricemia, Inflammation/infection, Metabolic syndrome and Metabolic dysfunction-associated fatty liver disease, Atmosphere (environment), Chronic kidney disease, and Easy life (sleep well and no stress). Some imaging studies can be risk enhancers. Some risk factors/clinical conditions are deemed to be preventable, and healthy dietary pattern, physical activity, and body weight control remain the cornerstone of the preventive strategy.

Markers of chronic disease risk in term low birthweight Indian children aged 8-14 years

Background

Low birth weight (LBW) is a public health problem in India with consequences in the short and long term. It increases the risk of obesity and its related comorbidities including type 2 diabetes and cardiovascular disease (CVD) in later life. This study aimed to assess the risk markers of chronic disease in term born low birthweight Indian children aged 8-14 years.

Methods

This was a cross-sectional follow-up of LBW children from DIViDS (Delhi Infant Vitamin D Supplementation) cohort and involved assessment of their anthropometric measurements, body composition, levels of adipokines and biomarkers of chronic diseases. Neighbourhood children born normal birth weight (NBW) (>2.5 kg) were enrolled for comparison.

Results

The study included 667 LBW and 87 NBW children. Height-for-age, body mass index for-age (BMIZ), fat-free mass index, and waist circumference of LBW children were lower than those of NBW children. LBW children could jump farther. LBW children who were now overweight had higher leptin, triglyceride and VLDL and lower HDL, compared to NBW children in the same BMIZ category. Currently underweight LBW children had higher adiponectin and lower leptin levels than the reference group. There were no differences between LBW and NBW children in visfatin, fasting glucose and insulin, hemoglobin A1c, triglyceride, low density lipoprotein or C-reactive protein.

Conclusion

At 8-14 years few children were overweight and there were few differences in some risk markers of chronic disease between LBW and NBW children. Overweight, which was associated with some increased risk markers, may increase with age, thus timely counselling and monitoring of these LBW children will be important to mitigate these risks.

The Impact of the Endocrine and Immunological Function of Adipose Tissue on Reproduction in Women with Obesity

Obesity, which leads to metabolic dysregulation and body function impairment, emerges as one of the pressing health challenges worldwide. Excessive body fat deposits comprise a dynamic and biologically active organ possessing its own endocrine function. One of the mechanisms underlying the pathophysiology of obesity is low-grade systemic inflammation mediated by pro-inflammatory factors such as free fatty acids, lipopolysaccharides, adipokines (including leptin, resistin and visfatin) and cytokines (TNF-α, IL-1β, Il-6), which are secreted by adipose tissue. Together with obesity-induced insulin resistance and hyperandrogenism, the exacerbated immune response has a negative impact on the hypothalamic-pituitary-gonadal axis at all levels and directly affects reproduction. In women, it results in disrupted ovarian function, irregular menstrual cycles and anovulation, contributing to infertility. This review focuses on the abnormal intracellular communication, altered gene expression and signaling pathways activated in obesity, underscoring its multifactorial character and consequences at a molecular level. Extensive presentation of the complex interplay between adipokines, cytokines, immune cells and neurons may serve as a foundation for future studies in search of potential sites for more targeted treatment of reproductive disorders related to obesity.

Different Short-Chain Fatty Acids Unequally Modulate Intestinal Homeostasis and Reverse Obesity-Related Symptoms in Lead-Exposed High-Fat Diet Mice

Our previous study showed that heavy metal lead (Pb) exposure exacerbates high-fat-diet (HFD)-induced metabolic damage and significantly depletes the gut microbiota-derived metabolite short-chain fatty acid (SCFA) levels. However, it remains unclear whether SCFA is a key metabolite involved in accelerating adverse consequences after Pb exposure. In this study, we explored the effects of exogenous supplementation of acetate, propionate, and butyrate on a metabolic disorder model in Pb-exposed HFD mice. We found that three SCFA interventions attenuated glycolipid metabolism disorders and liver damage, with butyrate performing the best effects in improving obesity-related symptoms. All three SCFA promoted the abundance of Muribaculaceae and Muribaculum, acetate specifically enriched Christensenellaceae, Blautia, and Ruminococcus, and butyrate specifically enriched Parasutterella, Rikenella, Prevotellaceae_UCG-001, and Bacteroides, which contributed to the positive promotion of SCFA production forming a virtuous cycle. Besides, butyrate inhibited Gram-negative bacteria Escherichia-Shigella. All of these events alleviated the intestinal Th17/Treg imbalance and inflammatory response through crosstalk between the G protein-coupled receptor (GPR)/histone deacetylase 3 (HDAC3) and lipopolysaccharide (LPS)/toll-like receptors 4 (TLR4)/nuclear factor κ-B (NF-κB) pathways and ultimately improved the intestinal barrier function. SCFA further upregulated the monocarboxylate transporter 1 (MCT1) and GPR43/adenosine 5'-monophosphate-activated protein kinase (AMPK) pathways to inhibit hepatic lipid accumulation. Overall, SCFA, especially butyrate, is an effective modulator to improve metabolic disorders in obese individuals exposed to heavy metals by targeting gut microecology.

Effects of Febuxostat Therapy on Circulating Adipokine Profiles in Patients with Overweight or Obesity and Asymptomatic Hyperuricemia: A Randomized Controlled Study

INTRODUCTION

Elevated levels of serum uric acid (SUA) are strongly associated with several components of the metabolic syndrome, particularly obesity. Previous studies have reported the correlation between SUA levels, xanthine oxidoreductase (XOR) activity, and the imbalanced adipokine levels that are characteristic of obesity. In this study, we explored the effect of febuxostat on circulating adipokine profiles in patients with overweight or obesity and asymptomatic hyperuricemia.

METHODS

This study was a single-center, randomized, and controlled clinical trial that enrolled 130 participants with asymptomatic hyperuricemia and obesity. One hundred seventeen participants were included in the final analysis, with 60 participants in the febuxostat group and 57 in the control group. We compared the circulating adipokine levels at 3 and 6 months, including high molecular weight (HMW) adiponectin, chemerin, omentin, monocyte chemotactic protein-1, asprosin, fibroblast growth factor 21, neuregulin-4, leptin, resistin, vaspin, visfatin, adipsin, and assessed the correlation between changes in adipokine levels (Δadipokines) and changes in XOR activity (ΔXOR) after febuxostat treatment.

RESULTS

The results showed that an increase in HMW adiponectin and omentin levels and a decrease in chemerin and asprosin levels at 3 or 6 months compared to the control group. Additionally, a positive correlation was observed between ΔXOR activity and Δasprosin. Furthermore, after adjusting for triglyceride (ΔTG) and serum uric acid (ΔSUA) in multiple linear regression analyses, we found that ΔXOR activity was independently correlated with Δasprosin.

CONCLUSION

This study may provide important evidence that febuxostat could alleviate the imbalance in circulating adipokine levels in patients with overweight or obesity and asymptomatic hyperuricemia. Furthermore, we observed a positive correlation between changes in asprosin levels and changes in XOR activity after febuxostat treatment.

Prevention Is Better than Cure-Body Composition and Glycolipid Metabolism after a 24-Week Physical Activity Program without Nutritional Intervention in Healthy Sedentary Women

Women are generally less active than men; therefore, the search for an attractive form of physical activity that benefits women's health is underway. This study aimed to investigate the influence of a 24-week physical activity program on body composition and indices of carbohydrates and lipid metabolism in sedentary, healthy women. The study comprised 18 female volunteers (mean age 35.0 ± 5.3 years). Dietary intake was assessed using a standardized seven-day food record. Before entering the program and after completing it, each participant's body composition and indices of glycolipid metabolism were measured. Insulin resistance indexes were calculated based on the obtained data. After the physical activity program, significant decreases in body mass and composition, BMI, waist circumference, percentage of fat content, and fat mass were found. Moreover, there was a significant decrease in glucose, insulin, triglycerides (TG), and resistin concentrations, as well as in the mean values of HOMA-IR and HOMA-AD. A substantial increase in adiponectin levels was also found. To conclude, the combined endurance-resistance physical activity program had a beneficial effect on body mass and composition and improved carbohydrate and lipid metabolism in normal-weight, healthy women. Therefore, we recommend this activity to sedentary young women to prevent obesity and metabolic disorders.

Serum Levels of Adipolin and Adiponectin and Their Correlation with Perinatal Outcomes in Gestational Diabetes Mellitus

Objectives: This study aimed to investigate the serum level of adipolin and adiponectin in healthy pregnant women and pregnant women with gestational diabetes mellitus (GDM) during the second trimester, the prepartum period, and in the newborns of these patients. Methods: A total of 55 women diagnosed with GDM and 110 healthy pregnant women were included in this study. Pearson's and Spearman's correlation coefficients were calculated to determine the association of adipolin and adiponectin with anthropometric markers of obesity (body mass index (BMI), mid-upper arm circumference (MUAC), tricipital skinfold thickness (TST)), inflammation markers (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP)), and maternal glucose homeostasis parameters (fasting glucose, insulin, C peptide, glycosylated hemoglobin A1c (HbA1c), Insulin Resistance-Homeostatic Model Assessment (IR HOMA)). Results: There were no statistical differences between the adipolin value in patients with GDM compared to healthy patients (p = 0.65 at diagnosis and p = 0.50 prepartum) and in newborns from mothers with GDM compared to healthy mothers (p = 0.24). Adipolin levels are significantly higher in patients with GDM who gave birth via cesarean section (p = 0.01). In patients with GDM, the adipolin level correlates positively with HgA1c in the prepartum period. We found a positive correlation between the maternal adipolin values at diagnosis and prepartum and neonatal adipolin (respectively: r = 0.556, p = 0.001; r = 0.332, p = 0.013). Adiponectin levels were significantly lower in patients with GDM at diagnosis and prepartum (p = 0.0009 and p = 0.02), but their levels increased prepartum (5267 ± 2114 ng/mL vs. 6312 ± 3150 ng/mL p = 0.0006). Newborns of mothers with GDM had lower adiponectin levels than newborns of healthy mothers (p < 0.0001). The maternal adiponectin value correlates negatively with maternal BMI, MUAC, and IR HOMA in both groups at diagnosis and prepartum. There were no differences between the groups in terms of cesarean rate (p > 0.99). The relative risk of occurrence of adverse events in patients with GDM compared to healthy ones was 2.15 (95% CI 1.416 to 3.182), and the odds ratio for macrosomia was 4.66 (95% CI 1.591 to 12.69). Conclusions: There was no difference in adipolin levels between mothers with GDM and healthy mothers during the second trimester and the prepartum period. Adipolin is known to enhance insulin sensitivity and reduce inflammation, but unlike adiponectin, it does not appear to contribute to the development of GDM.

The Interplay between Obesity and Inflammation

Obesity is an important condition affecting the quality of life of numerous patients and increasing their associated risk for multiple diseases, including tumors and immune-mediated disorders. Inflammation appears to play a major role in the development of obesity and represents a central point for the activity of cellular and humoral components in the adipose tissue. Macrophages play a key role as the main cellular component of the adipose tissue regulating the chronic inflammation and modulating the secretion and differentiation of various pro- and anti-inflammatory cytokines. Inflammation also involves a series of signaling pathways that might represent the focus for new therapies and interventions. Weight loss is essential in decreasing cardiometabolic risks and the degree of associated inflammation; however, the latter can persist for long after the excess weight is lost, and can involve changes in macrophage phenotypes that can ensure the metabolic adjustment. A clear understanding of the pathophysiological processes in the adipose tissue and the interplay between obesity and chronic inflammation can lead to a better understanding of the development of comorbidities and may ensure future targets for the treatment of obesity.