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Liu S, Gu Y. INFLA score: a novel inflammatory marker for assessing cardiometabolic disease risk in obese individuals. Diabetol Metab Syndr 2024; 16:151. [PMID: 38982554 PMCID: PMC11232261 DOI: 10.1186/s13098-024-01396-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/29/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND The low-grade inflammation score (INFLA-score) is a composite index that assesses chronic inflammatory status using multiple inflammatory markers. However, its correlation with cardiometabolic diseases (CMDs) in obese populations remains unclear. METHODS We conducted a prospective cohort study involving 79,160 participants with obesity (BMI ≥ 30 kg/m2) from the UK Biobank. The INFLA-score was calculated based on high-sensitivity C-reactive protein, leukocyte count, platelet count and granulocyte/lymphocyte ratio. We employed Kaplan-Meier survival curves, multivariable Cox regression, restricted cubic splines and accelerated time-to-failure models to analyse the association between the INFLA-score and CMDs risk, including coronary heart disease (CAD), stroke and type 2 diabetes mellitus (T2DM). RESULTS Over a median follow-up of 161.41 months, we recorded 14,903 CMDs events, comprising 7184 CAD cases, 1914 strokes and 7924 T2DM cases. Cox regression analysis revealed that each unit increase in the INFLA-score corresponded to a 1.5%, 1.1%, 1.2% and 2.4% increase CMDs risk (HR: 1.015, 95% CI 1.013-1.018), CAD risk (HR: 1.011, 95% CI 1.007-1.015), stroke risk (HR: 1.012, 95% CI 1.004-1.020) and T2DM risk (HR: 1.024, 95% CI 1.020-1.028), respectively. Restricted cubic spline analysis indicated a non-linear relationship between cumulative INFLA-score and CMDs risk (P = 0.044). Subgroup analysis revealed interactions between sex, age, history of lipid-lowering drug use, and INFLA-score regarding CMDs risk. Sensitivity analysis corroborated the main findings. CONCLUSION Our findings strongly support the close association between INFLA-score and CMDs risk, particularly notable in women, those aged < 55, and individuals with a history of lipid-lowering drug use. These findings offer new insights into the role of inflammation in obesity-related CMDs, suggesting potential applications for prevention and identification of high-risk populations.
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Affiliation(s)
- Shuke Liu
- Department of Cardiovascular Medicine, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai Road, Xuzhou, 221000, Jiangsu, China
| | - Yan Gu
- Department of Cardiovascular Medicine, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai Road, Xuzhou, 221000, Jiangsu, China.
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Ji S, Gao R, Gao Q, Leng L, Gai N. Metformin ameliorates insulin resistance, thyroid nodules and thyroid function. Am J Transl Res 2023; 15:6180-6188. [PMID: 37969194 PMCID: PMC10641348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/25/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE To evaluate the ameliorative impact of metformin on insulin resistance (IR), as well as thyroid nodules (TNs) and function in TN patients with IR. METHODS The clinical data of 128 TN patients with IR admitted to Yantai Laiyang Central Hospital from July 2018 to March 2020 were retrospectively analyzed and categorized into a control group (CNG, n = 64) and a study group (SG, n = 64). Patients in the CNG received standard lifestyle intervention, while those in the SG received standard lifestyle intervention in conjunction with metformin therapy for 1 year of course. Weight-related indicators, IR, thyroid function, TN diameter, and oxidative stress levels were compared between the two groups before and after treatment. Additionally, the safety of metformin was evaluated. RESULTS Before treatment, no significant differences were observed between the two groups in fasting plasma glucose (FPG), 2-h postprandial glucose (2hPG), glycated hemoglobin (HbA1c), fasting insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), systolic blood pressure (SBP), diastolic blood pressure (DBP), thyroid-stimulating hormone (TSH), malondialdehyde (MDA), TN diameter, and thyroid volume (P > 0.05). After treatment, significant statistical differences were observed in the aforementioned indicators between the two groups (P < 0.05). After 1 year of treatment, the SG exhibited lower levels of FPG, 2hPG, HbA1c, FINS, HOMA-IR, SBP, DBP, TSH, MDA, TN diameter, and thyroid volume, and showed higher levels of HOMA-β, superoxide dismutase, and glutathione peroxidase levels compared to before treatment (P < 0.05). The incidence of adverse reactions in the SG was significantly higher than that in the CNG (P < 0.05). Taking metformin and free thyroxine (FT4) were protective factors for TSH (P < 0.05). CONCLUSION Metformin could significantly improve IR and oxidative stress levels, regulate TSH levels, and shrink TNs in TN patients with IR, with high safety. The administration of metformin and FT4 were identified as protective factors for positive prognosis.
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Affiliation(s)
- Shuhong Ji
- Department of Endocrinology, Dezhou Hospital of Traditional Chinese MedicineDezhou, Shandong, China
| | - Ruixin Gao
- Department of Endocrinology, Dongying Hospital of Traditional Chinese MedicineDongying, Shandong, China
| | - Qinghua Gao
- Department of Endocrinology, Central Hospital of LijinDongying, Shandong, China
| | - Lihong Leng
- Department of Anesthesiology, Yantai Penglai Traditional Chinese Medicine HospitalYantai, Shandong, China
| | - Ningning Gai
- Department of Endocrinology, Yantai Laiyang Central HospitalLaiyang, Shandong, China
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Li D, Guo J, Ni X, Sun G, Bao H. The progress and challenges of circRNA for diabetic foot ulcers: A mini-review. Front Endocrinol (Lausanne) 2022; 13:1019935. [PMID: 36531481 PMCID: PMC9747764 DOI: 10.3389/fendo.2022.1019935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Since the Human Genome Project was successfully completed, humanity has entered a post-genome era, and the second-generation sequencing technology has gradually progressed and become more accurate. Meanwhile, circRNAs plays a crucial role in the regulation of diseases and potential clinical applications has gradually attracted the attention of physicians. However, the mechanisms of circRNAs regulation at the cellular and molecular level of diabetic foot ulcer (DFU) is still not well-understood. With the deepening of research, there have been many recent studies conducted to explore the effect of circRNAs on DFU. In this mini-review, we discuss the potential role of circRNAs as therapeutic targets and diagnostic markers for DFU in order to gain a better understanding of the molecular mechanisms that underlie the development of DFU and to establish a theoretical basis for accurate treatment and effective prevention.
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Affiliation(s)
- Deer Li
- Graduate School, Inner Mongolia Medical University, Hohhot, China
- Department of Traumatology and Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
| | - Jiaxing Guo
- Department of Joint Surgery, The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Xiyu Ni
- Graduate School, Inner Mongolia Medical University, Hohhot, China
- Department of Traumatology and Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
| | - Guanwen Sun
- Department of Traumatology and Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
| | - Huhe Bao
- Department of Traumatology and Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
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Iwanaga S, Hashida R, Takano Y, Bekki M, Nakano D, Omoto M, Nago T, Kawaguchi T, Matsuse H, Torimura T, Shiba N. Hybrid Training System Improves Insulin Resistance in Patients with Nonalcoholic Fatty Liver Disease: A Randomized Controlled Pilot Study. TOHOKU J EXP MED 2021; 252:23-32. [PMID: 32863329 DOI: 10.1620/tjem.252.23] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Insulin resistance is associated with the progression of nonalcoholic fatty liver disease (NAFLD). Insulin resistance is regulated by various cytokines, including interleukin-6 (IL-6), a proinflammatory myokine, and selenoprotein P (SeP), a liver-derived secretory hepatokine. High levels of IL-6 and/or SeP have been shown to contribute to insulin resistance, and exercise is a first-line therapy for NAFLD. We have developed a hybrid training system (HTS): a neuromuscular electrical stimulation device to enhance exercise results. We aimed to investigate the effects of HTS on insulin resistance as well as serum IL-6 and SeP in patients with NAFLD. This is a randomized, single-blind (assessor), controlled trial. Subjects with NAFLD walked on a treadmill with or without HTS (9 subjects each) for 30 minutes three times a week for six weeks (HTS vs. control group; median age 45 vs. 45; male/female 5/4 vs. 6/3). We examined subjects before the first session and at the end of the final session. Serum SeP levels were measured by ELISA which measures the fragment of SeP. In the HTS group, HOMA-IR values were significantly reduced compared to the control group (Δ-0.71 vs. Δ0.05; P < 0.05). IL-6 and SeP levels in serum were also significantly reduced compared to that of the control group (IL-6; Δ-0.6 vs. Δ0.29 pg/mL; P < 0.05, SeP; Δ-1288.5 vs. Δ-435.4 ng/mL; P < 0.05, respectively). In conclusion, we propose that HTS improves insulin resistance by reducing serum IL-6 and SeP levels in patients with NAFLD.
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Affiliation(s)
- Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Yoshio Takano
- Department of Physical Therapy School of Health Sciences at Fukuoka, International University Health and Welfare
| | - Masafumi Bekki
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Masayuki Omoto
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Takeshi Nago
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital.,Department of Orthopedics, Kurume University School of Medicine
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Xia M, Liu K, Feng J, Zheng Z, Xie X. Prevalence and Risk Factors of Type 2 Diabetes and Prediabetes Among 53,288 Middle-Aged and Elderly Adults in China: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:1975-1985. [PMID: 33976558 PMCID: PMC8104985 DOI: 10.2147/dmso.s305919] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diabetes is a metabolic disorder that causes a heavy burden on healthcare systems worldwide. The aim of this study was to determine the prevalence of type 2 diabetes and prediabetes and its associated factors among eight communities in Nanchong, China. METHODS This was an observational cross-sectional study conducted throughout eight communities in Nanchong, China. The participants were 53,288 individuals aged 45 years or older. The participants' characteristics, comorbidities, health behaviors, family history, and dietary intake were assessed. Multinomial logistic regression models were fitted to identify factors associated with type 2 diabetes and prediabetes. RESULTS The prevalence of diabetes and prediabetes was 13.9% (95% confidence interval [CI], 13.6-14.2) and 3.1% (95% CI, 2.9-3.2) of the population, respectively. After adjusting for other risk factors, advanced age, overweight, obesity, abdominal obesity, comorbidities, smoking, a family history of diabetes, and Chinese cooking vegetable intake were associated with an increased risk of type 2 diabetes and prediabetes. CONCLUSION The prevalence of type 2 diabetes in the Chinese population is rising compared with data from the past. The risk factors of type 2 diabetes and prediabetes identified in this study will aid the identification of individuals at a high-risk of diabetes and the implementation of effective health promotion programs and campaigns. CLINICAL TRIAL REGISTRY NUMBER ChiCTR-HOC-17013200.
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Affiliation(s)
- Mengdi Xia
- Department of Nephrology, The Second Clinical Medical Institution of North Sichuan Medical College (Nanchong Central Hospital) and Nanchong Key Laboratory of Basic Science & Clinical Research on Chronic Kidney Disease, Nanchong, Sichuan, People’s Republic of China
| | - Kaixiang Liu
- Department of Nephrology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
| | - Jie Feng
- Department of Nephrology, The Second Clinical Medical Institution of North Sichuan Medical College (Nanchong Central Hospital) and Nanchong Key Laboratory of Basic Science & Clinical Research on Chronic Kidney Disease, Nanchong, Sichuan, People’s Republic of China
| | - Zaiqiong Zheng
- Department of Nephrology, The Second Clinical Medical Institution of North Sichuan Medical College (Nanchong Central Hospital) and Nanchong Key Laboratory of Basic Science & Clinical Research on Chronic Kidney Disease, Nanchong, Sichuan, People’s Republic of China
| | - Xisheng Xie
- Department of Nephrology, The Second Clinical Medical Institution of North Sichuan Medical College (Nanchong Central Hospital) and Nanchong Key Laboratory of Basic Science & Clinical Research on Chronic Kidney Disease, Nanchong, Sichuan, People’s Republic of China
- Correspondence: Xisheng Xie Department of Nephrology, The Second Clinical Medical Institution of North Sichuan Medical College (Nanchong Central Hospital), South Renmin Road 97, Shunqing District, Nanchong, Sichuan Province, 637000, People’s Republic of ChinaTel +86 158 8170 0265 Email
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Mashaqi S, Badr MS. The Impact of Obstructive Sleep Apnea and Positive Airway Pressure Therapy on Metabolic Peptides Regulating Appetite, Food Intake, Energy Homeostasis, and Systemic Inflammation: A Literature Review. J Clin Sleep Med 2019; 15:1037-1050. [PMID: 31383242 DOI: 10.5664/jcsm.7890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/04/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Sleep-related breathing disorders are very common and highly associated with many comorbid diseases. They have many metabolic consequences that impact appetite, energy expenditure, and systemic inflammation. These consequences are mediated through peptides (eg, ghrelin, leptin, adiponectin, resistin, apelin, obestatin, and neuropeptide Y). METHODS We searched the literature (PubMed) for sleep-disordered breathing (SDB) and metabolic peptides and included 15, 22, 14, 4 and 2 articles for ghrelin, leptin, adiponectin, resistin, and apelin respectively. RESULTS Our review of the published literature suggests that leptin levels seem to correlate with body mass index and adiposity rather than obstructive sleep apnea. Conversely, levels of adiponectin and ghrelin are influenced by obstructive sleep apnea alone. Finally, resistin and apelin seem to be not correlated with obstructive sleep apnea. Regarding positive airway pressure (PAP) impact, it seems that PAP therapy affected the levels of these peptides (mainly ghrelin). CONCLUSIONS There is significant controversy in the literature regarding the impact of SDB and PAP therapy on these metabolic peptides. This could be due to the lack of randomized clinical trials and the variability of the methodology used in these studies. Further research is needed to assess the impact of SDB and PAP therapy on the levels of these peptides and whether this impact is also related to body mass index and body fat composition.
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Affiliation(s)
- Saif Mashaqi
- Division of Sleep Medicine, University of North Dakota School of Medicine - Sanford Health, Fargo, North Dakota
| | - M Safwan Badr
- Department of Internal Medicine, Wayne State University, Detroit, Michigan
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