Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus

Protective Effect of Artemisinin Against Luperox Induced Oxidative Stress and Insulin Resistance via Pi3k/Akt Pathway in Zebrafish Larvae

Oxidative stress plays a critical role in the development of insulin resistance (IR), a key factor in metabolic disorders such as diabetes. Plant active ingredients play a crucial role in protecting organisms from environmental stressors and have shown promising therapeutic potential against various metabolic disorders. Artemisinin (ART), a sesquiterpenoid with a lactone ring obtained from the herb Artemisia annua, exhibits promising therapeutic properties. This study investigates the potential of ART on Luperox (LUP)-induced oxidative stress and the resulting IR in zebrafish larvae, specifically investigating the involvement of the PI3K/AKT signaling pathway. Zebrafish larvae were chosen due to their high sensitivity to oxidative stress, well-characterized glucose metabolism, and genetic similarity to human metabolic pathways. They were exposed to LUP to induce oxidative stress, followed by treatment with ART. The effects were evaluated through biochemical assays, fluorescence staining and gene expression analysis. ART effectively restored key antioxidant enzymes (SOD, CAT, GSH) and mitigated oxidative stress evidenced by reduction in intercellular ROS and lipid peroxidation, as confirmed through DCFDA and DPPP staining assays. Additionally, ART improved glucose uptake and lowered blood glucose levels. Gene expression analysis further indicated increased levels of PI3K/Akt signalling components and antioxidant-related genes (NRF2, HO-1, GPx, and GSR). Our results indicate that artemisinin significantly alleviates oxidative stress by reducing ROS levels and enhancing antioxidant enzyme activity. Furthermore, artemisinin mitigates IR by restoring glucose metabolism and upregulating PI3K/AKT pathway components. These findings highlight the translational potential of plant active ingredients, particularly artemisinin, for the development of therapies targeting IR and oxidative stress-related metabolic disorders.

The Role of Neuroinflammation in the Comorbidity of Psychiatric Disorders and Internal Diseases

Psychiatric disorders and internal diseases frequently co-occur, posing significant challenges due to overlapping symptoms, shared pathophysiological mechanisms, and increased healthcare burdens. Neuroinflammation has emerged as a central mechanism linking these conditions, driven by systemic inflammation, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and autonomic nervous system (ANS) imbalance. This review synthesizes current evidence on the role of neuroinflammation in comorbid conditions such as depression, anxiety, cardiovascular disease, and diabetes mellitus, emphasizing bidirectional relationships and shared inflammatory pathways. This analysis identifies gaps in longitudinal studies, biomarker validation, and the integration of multidisciplinary care models. Emerging therapeutic approaches, including IL-6 inhibitors, vagus nerve stimulation, and behavioral interventions, show promise but remain underexplored in combined applications. Furthermore, disparities in research representation limit the generalizability of findings and highlight the need for inclusive clinical trials. Addressing these gaps through precision medicine, advanced biomarker monitoring technologies, and equitable healthcare strategies could transform the management of these complex comorbidities. By advancing our understanding of neuroinflammatory mechanisms and promoting integrated interventions, this review underscores the need for a collaborative, patient-centered approach to improve outcomes and reduce the global burden of psychiatric and internal disease comorbidities.

The gut microbiota: A key player in cadmium toxicity - implications for disease, interventions, and combined toxicant exposures

Cadmium (Cd) is a highly toxic heavy metal contaminant found in soil and water due to human activities such as mining and industrial discharge. Cd can accumulate in the body, leading to various health risks such as organ injuries, osteoporosis, renal dysfunction, Type 2 diabetes (T2DM), reproductive diseases, hypertension, cardiovascular diseases, and cancers. The gut is particularly sensitive to Cd toxicity as it acts as the primary barrier against orally ingested Cd. Even at low concentrations, Cd can cause oxidative stress, inflammation, and intestinal bleeding. Cd also disrupts the gut microbiota, affecting its structure, taxonomic composition, and metabolic functions. Cd exposure alters the structure of the gut microbial community, reducing diversity and upregulating certain phyla and genera. This disturbance can lead to physiological and metabolic imbalances, including disruptions in energy homeostasis, amino acid, lipid, nucleotide, and short-chain fatty acid (SCFAs) metabolism. The effects of Cd on the gut microbiota depend on the duration of exposure, the dose of Cd, and can vary based on sex and age. Cd-induced gut dysbiosis has been linked to various diseases, including diabetes, adiposity, atherosclerosis, liver damage, infections, cancer, and neurodegenerative diseases. Interventions targeting the gut microbiota, such as probiotics, specific diets, melatonin, selenium, vitamin D3, and certain compounds, have shown potential in reducing the health risks associated with Cd exposure. However, combined exposure to Cd and other toxicants, such as microplastics (MPs), heavy metals, and antibiotics, can amplify the toxicity and dysbiosis in the gut microbiota.

Pathophysiological hallmarks in type 2 diabetes heterogeneity (review)

The mechanistic complexity in type 2 diabetes (T2DM) is primarily responsible for the degrees of heterogeneity and development of complications. A complex mode of interactions between different pathophysiological events and diabetogenic environmental factors support for the genesis of diabetes heterogeneity both in phenotypic and clinical contexts. The currently used diabetes classification strategies suffer from several inconsistencies that cannot fully capture the inherent heterogeneity among the diabetes patients. To effectively address this pathobiological and heterogeneity-related issue in diabetes research, the current review proposes nine pathophysiological hallmarks of T2DM that aims to mechanistically explain complexities of diabetes associated pathophysiological events and their underlying features. These pathophysiological hallmarks are pancreatic beta cell dysfunction, insulin sensitivity, insulin resistance, obesity, aging, subclinical inflammation, metabolic dysregulation, prothrombotic state induction and hypertension. Detail knowledge of these pathophysiological hallmarks with their key molecular mediators, influencing factors, clinical biomarkers and clinical assessment methodologies will greatly support precision medicine approaches in diabetes including patient stratification, subtype diagnosis and treatment.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13340-024-00783-w.

Benefits of inulin and fructo-oligosaccharides on high fat diet-induced type 2 diabetes mellitus by regulating the gut microbiota in mice

Type 2 diabetes mellitus (T2DM) is pathologically associated with gut microbiota imbalance, which is implicated in disease progression through metabolic and inflammatory pathways. The therapeutic potential of inulin, a well-characterized prebiotic, has been explored to mitigate T2DM via microbiota modulation. However, the efficacy of this intervention, with its performance dependent on the degree of polymerization (DP), requires further investigation. This study assessed the therapeutic roles of inulin (DP3-60) and fructo-oligosaccharides (FOS, DP3-10) in T2DM management. Dietary administration of these prebiotic compounds demonstrated a significant capacity to alleviate multiple metabolic pathologies, including obesity, insulin resistance, systemic inflammation, oxidative stress, dyslipidemia and hepatic steatosis in high-fat diet (HFD)-fed induced T2DM mice. Significant superior efficacy was observed in FOS for ameliorating glucose metabolic dysregulation, adipocyte hypertrophy, liver weight, and histopathological alterations in colonic tissue, while inulin exhibited greater potency in alleviating oxidative stress. Both inulin and FOS enhanced gut microbiota diversity and richness in T2DM mice, accompanied by a significant reduction in Firmicutes/Bacteroidetes ratio. Notably, the S24-7 family emerged as a crucial microbial taxon modulated by both inulin and FOS. Furthermore, FOS demonstrated superior capacity to restore HFD-induced gut microbiota. Taxonomically significant amplicon sequence variants (ASVs), which were altered by HFD and modulated by inulin and FOS, exhibited distinct taxonomic profiles between the two compounds. This study provides preliminary evidence that the biological effects and beneficial properties of inulin-type fructans exhibit DP-dependent variations, which may enhance their efficient utilization in metabolic disorders.

Targeting Diabetic Atherosclerosis: The Role of GLP-1 Receptor Agonists, SGLT2 Inhibitors, and Nonsteroidal Mineralocorticoid Receptor Antagonists in Vascular Protection and Disease Modulation

Atherosclerosis is a closely related complication of diabetes mellitus (DM), driven by endothelial dysfunction, inflammation, and oxidative stress. The progression of atherosclerosis is accelerated by hyperglycemia, insulin resistance, and hyperlipidemia. Novel antidiabetic agents, SGLT2 inhibitors, and GLP-1 agonists improve glycemic control and offer cardiovascular protection, reducing the risk of major adverse cardiovascular events (MACEs) and heart failure hospitalization. These agents, along with nonsteroidal mineralocorticoid receptor antagonists (nsMRAs), promise to mitigate metabolic disorders and their impact on endothelial function, oxidative stress, and inflammation. This review explores the potential molecular mechanisms through which these drugs may prevent the development of atherosclerosis and cardiovascular disease (CVD), supported by a summary of preclinical and clinical evidence.

Low Plasma Carnosinase-1 Activity in Patients with Left Ventricular Systolic Dysfunction: Implications for Carnosine Therapy in Heart Failure

Therapeutic efficacy of histidyl dipeptides such as carnosine is hampered by circulating carnosinase-1 (CN1), which catalyzes carnosine's hydrolysis and degradation. Prior reports suggest that oral carnosine may improve cardiometabolic parameters in patients with heart failure (HF), but whether CN1 activity is affected by HF is unknown. Here, we measured CN1 content and carnosine degradation rate (CDR) in preoperative plasma samples from a cohort of patients (n = 138) undergoing elective cardiac surgery to determine whether plasma CN1 and/or CDR varied with left ventricular (LV) systolic dysfunction. CN1 content was normally distributed in the cohort, but plasma CDR displayed a quasi-bimodal distribution into high- (>2 nmol/(h*μL)) and low-activity (≤2 nmol/(h*μL)) clusters. Multivariable analysis confirmed female sex, diabetes and LV systolic dysfunction was associated with the low-activity CDR cluster. Although CN1 content did not differ, logistic regression analysis revealed that CDR and CN1-specific activity (CDR/CN1 content) was significantly lower in patients with both moderate (ejection fraction, EF ≥ 35 to <50%) and severe LV systolic dysfunction (EF < 35%) compared with patients in the normal range (EF ≥ 50%). These findings suggest that plasma CN1 activity is regulated by factors independent of expression, and that a decline in LV systolic function is associated with low CN1 activity. Further studies are needed to delineate specific mechanisms controlling CN1 expression and activity, which will facilitate the development of carnosine and other histidyl dipeptide therapies for cardiometabolic disorders such as HF.

Association between Blood Trihalomethane Concentrations and the Risk of Dyslipidemia: Nationally Representative Cross-Sectional Study

Experimental studies have indicated that exposure to disinfection byproducts (DBPs) may affect the lipid synthesis. However, epidemiological evidence is sparse. This study aimed to investigate the relationship between blood trihalomethane (THM) exposure and the risk of dyslipidemia from the National Health and Nutrition Examination Survey 2005-2018. We included adults (n = 16,159) whose blood concentrations of chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM) were quantified. Multivariable logistic regression revealed significantly elevated dyslipidemia risks in the highest group of TCM [adjusted odds ratios (ORs) = 1.30, 95% confidence intervals (CIs): 1.15-1.47], BDCM (1.23,1.07-1.42), TBM (1.35, 1.08-1.68), and total THMs (TTHMs; sum of all four THMs) (1.30, 1.14-1.48). In subgroup analysis, these associations were stronger among young/middle-aged individuals. In Weighted Quantile Sum regression and Quantile G-Computation analysis, combined THM exposure was positively associated with dyslipidemia risk. Our study provides new evidence of a positive association between blood THM concentrations and the risk of dyslipidemia, underscoring the need for further research to confirm these findings and explore the underlying mechanisms.

Flavonoid Derivatives Isolated from Hypericum monogynum Ameliorate Insulin Resistance via Modulation of IRS-1/PI3K/Akt/FOXO1 Pathway in HepG2 Cells

In this study, two high-content flavonoid derivatives [3-8 biapigenin (HM 104) and quercetin-3-O-β-d-galactopyranoside (HM 111)] were obtained through the bioactivity-guided isolation of antidiabetic compounds from Hypericum monogynum flowers. HM 104 and HM 111 exhibited good glucose consumption in fatty acid-induced insulin-resistant HepG2 cells. Moreover, both active compounds enhanced glucose uptake by restoring the expression of key regulators of glucose metabolism, including insulin receptor substrate 1, phosphoinositide 3-kinase, protein kinase B, and glucose transporter type 4, and by mitigating the expression of forkhead box O1 and the factors involved in gluconeogenesis. They upregulate the phosphorylation of glycogen synthase kinase-3β, which may affect glycogen synthesis. Furthermore, the production of reactive oxygen species was decreased by the two compounds. This study provides novel mechanistic insights into the protective effects of flavonoid derivatives isolated from H. monogynum flowers in preventing and managing insulin resistance and associated metabolic disorders.

Association of ethylene oxide exposure with sex hormones in the general US population: a cross-sectional study

Background

Ethylene oxide (EO) is an environmental chemical widely used in industry and has been related to various conditions such as dyslipidemia and metabolic syndrome. However, it is not clear what effect EO has on sex hormones. This paper aims to investigate the connection between EO exposure and sex hormones.

Methods

EO exposure was assessed by measuring blood levels of hemoglobin adducts of EO (HbEO). Based on the National Health and Nutrition Examination Survey (NHANES) 2013-2016 dataset, we assessed linear and nonlinear associations between HbEO and sex hormone levels using weighted multivariate linear regression analyses and weighted generalized additive modeling approaches. We further calculated the threshold effect using a two-piecewise linear regression model. In addition, we performed subgroup analyses.

Results

In men, HbEO levels showed a U-shaped relationship with total testosterone (TT) and sex hormone binding globulin (SHBG), with inflection points ln(HbEO) (natural logarithmic transformed value of HbEO) of 4.12 and 3.78 pmol/g Hb, respectively. HbEO levels in women showed an inverted U-shaped relationship with TT, with an inflection point ln(HbEO) of 4.54 pmol/g Hb. However, to the right of the inflection point, the relationship between HbEO and TT was not statistically significant (β = -0.09, 95%CI -0.21, 0.03). Female HbEO levels were negatively correlated with estradiol (β = -0.11, 95%CI -0.19, -0.03). In addition, we found a positive correlation between HbEO and SHBG in women with a body mass index (BMI) <25 (β = 0.12, 95%CI 0.04, 0.20, P for interaction = 0.007).

Conclusions

EO exposure leads to altered sex hormone levels in the general US population, and further research is required in the future to validate our findings.

Methacrylated silk fibroin based composite hydrogel with ROS-scavenging and osteogenic ability to orchestrate diabetic bone regeneration

The repair of diabetic bone defects is still filled with enormous challenges. Excessive reactive oxygen species (ROS) are regenerated in diabetic bone defect sites which is harmful to bone regeneration. Therefore, it's to a good strategy to scavenge the excess ROS to provide a friendly environment for diabetic bone defects repair. Herein, a novel composite hydrogel with ROS-scavenging and osteogenic ability is constructed. This methacrylated silk fibroin based composite hydrogel is capable of releasing tannin acid and inorganic ion, which can reduce oxidative stress, restore homeostasis and enhance osteogenesis. In vitro results indicated that the composite hydrogel could promote osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) under oxidative stress condition. Furthermore, in vivo results suggested that it can significantly promote bone regeneration in diabetic bone defects. In conclusion, this study provides critical insight into the biological mechanism and potential therapy for diabetic bone regeneration.

Electrolyte Imbalances and Metabolic Emergencies in Obesity: Mechanisms and Clinical Implications

Electrolyte imbalances are a frequently overlooked yet critical component of obesity-related metabolic dysfunction, contributing to an increased risk of cardiovascular disease, kidney impairment, and metabolic emergencies such as diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and acute kidney injury (AKI). These disturbances arise from insulin resistance, chronic inflammation, hormonal dysregulation, and renal dysfunction, leading to sodium retention, potassium depletion, and deficiencies in calcium and magnesium homeostasis. Managing electrolyte imbalances is essential in obesity management, as imbalances exacerbate hypertension, metabolic acidosis, neuromuscular complications, and insulin resistance. This review explores the pathophysiology of electrolyte disturbances in obesity and their impact on fluid balance, acid-base status, and metabolic health. Effective management strategies include individualized electrolyte monitoring, dietary sodium restriction, potassium supplementation, vitamin D and magnesium correction, and pharmacologic interventions targeting renin-angiotensin-aldosterone system (RAAS) activity and insulin resistance. Additionally, lifestyle interventions, including dietary modification, weight loss strategies, and hydration optimization, play a key role in preventing metabolic complications. Future research should investigate the long-term impact of electrolyte imbalances in obesity, the role of emerging therapies, and how lifestyle interventions can optimize electrolyte homeostasis and metabolic outcomes. A personalized, multidisciplinary approach integrating endocrinology, nephrology, and clinical nutrition is essential to improving the prevention and management of electrolyte imbalances in obese individuals.

Integrated in vitro, in silico, and in vivo approaches to elucidate the antidiabetic mechanisms of Cicer arietinum and Hordeum vulgare extract and secondary metabolites

Diabetes mellitus is a group of metabolic disorders that can lead to severe health problems, and the current treatments often have harmful side effects. Therefore, there is a growing interest in discovering new antidiabetic drugs with fewer adverse effects, and natural products are a promising source for this purpose. Cicer arietinum and Hordeum vulgare are plants with high levels of phytochemicals that have been shown to have therapeutic properties. This study investigates the anti-diabetic potential of C. arietinum and H. vulgare seeds and their secondary metabolites. We employed a comprehensive approach combining in vitro, in silico, and in vivo methods to evaluate the efficacy of the compounds. Our findings reveal that the extracts of C. arietinum (IC50 55.08 μg/mL) and H. vulgare (IC50 115.8 ± 5 μg/mL) demonstrated a stronger inhibitory effect on α-amylase compared to acarbose (standard drug) (IC50 196.3 ± 10 μg/mL). Similarly, both C. arietinum and H. vulgare exhibited significant inhibitory activity against α-glucosidase (IC50 100.2 ± 5 μg/mL and IC50 216.2 ± 5 μg/mL, respectively) compared to acarbose (IC50 246.5 ± 10 μg/mL). To further investigate their mechanism of action, a computational screening of 194 phytochemicals from these plants was conducted, followed by molecular docking with α-amylase (PDB ID#1B2Y) and α-Glucosidase (PDB ID# 5NN8) receptors. According to the binding affinities and molecular dynamics (MD) simulations, Medicagol, Euphol, Stigmasterol, and Beta-Sitosterol emerged as promising candidates for diabetes treatment. Molecular dynamics showed that Medicagol was a strong inhibitor against selected receptor proteins because the ligand-protein complexes remained stabilized during the entire simulation time of 100 ns. In vitro analysis also confirmed that Medicagol, stigmasterol, and Euphol have significant potential for type 2 diabetes prevention via inhibition of carbohydrates hydrolyzing enzymes. In vivo study demonstrated significant therapeutic effects in STZ-induced diabetes mice. Including reductions in hyperlipidemia, hyperglycemia, and insulin resistance. Histopathological analysis revealed that plant extracts mitigated STZ-induced pancreatic and liver damage. Additionally, extracts enhanced antioxidant defenses by increasing SOD, CAT, and GSH levels, while decreasing MDA levels in the liver, kidneys, and pancreas, highlighting their protective role against oxidative stress. These results support the potential of Cicer arietinum and Hordeum vulgare as natural sources for developing antidiabetic agents.

Homozygous AA Genotype of IL-17A and 14-bp Insertion Polymorphism in HLA-G 3'UTR Are Associated with Increased Risk of Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is a common pregnancy complication characterized by hyperglycemia and insulin resistance, with unclear genetic mechanisms. The specific involvement of proinflammatory cytokines, including IL-17A, and the immuno-tolerogenic HLA-G remains poorly understood in GDM. We aimed to explore the associations of three polymorphisms, IL-17A -197G>A (rs2275913), IL-17RA -947A>G (rs4819554), and HLA-G 14-bp insertion/deletion (indel), with GDM risk in a Brazilian population. We conducted a case-control study (79 GDM cases and 79 controls). Genetic polymorphisms were analyzed using PCR-RFLP, with DNA extracted using the Salting-out procedure. Significant associations were identified between -197G>A rs2275913 and HLA-G 14-bp indel polymorphisms in both codominant and recessive models. The IL-17A rs2275913 AA genotype was associated with a nearly ten-fold increased risk of GDM in both the codominant (p = 0.021, OR 9.89, 95% CI: 1.63-59.92) and recessive models (p = 0.006, OR 9.33, 95% CI: 1.57-55.38). Similarly, the HLA-G 14-bp Ins/Ins genotype was associated with an increased risk in both the codominant (p = 0.026, OR 3.34, 95% CI: 0.98-11.41) and recessive models (p = 0.010, OR 4.20, 95% CI: 1.36-12.96). IL-17RA polymorphism showed no significant associations. The study findings highlight the potential genetic and immune factors associated with GDM, particularly the -197G>A rs2275913 and HLA-G 14-bp indel polymorphisms. Further functional characterization is warranted to uncover the mechanism of genotype-phenotype association.

Fruit Carbohydrates and Their Impact on the Glycemic Index: A Study of Key Determinants

Background: Fruits are a convenient and natural source of carbohydrates that can rapidly affect blood sugar levels and the glycemic index (GI). The GI plays a crucial role in the management of chronic diseases, including diabetes, obesity, hyperglycemia, and diet-related illnesses. Despite there being several health benefits linked with consuming fruits, it remains unclear which specific components of fruits are the key determinants that significantly influence the GI. Methods: This study retrospectively examined the relationship between different types of carbohydrates and the GI of various fruits to determine their correlation. The fruits' sugar and fiber contents were identified from available public databases, the U.S. Department of Agriculture (USDA), FooDB, PubMed, and published sources. Results: Previously, the GI was determined by the available carbohydrates, which include different types of sugar. In this study, individual hexose sugars, along with the total carbohydrates and dietary fiber, were examined. The results indicated a strong correlation between fructose and the GI, whereas glucose and total glucose did not exhibit such a correlation. The total carbohydrate-to-fiber ratio displayed a stronger correlation (R = 0.57 and p > 0.0001) with the GI compared to glucose alone (R = 0.37; p = 0.01) or the total glucose (R = 0.45; p = 0.0009) with the consideration of fiber, while the scattering of data points around the regression line suggested that factors beyond the total carbohydrate and fiber also contribute to determining the GI. Conclusions: This study demonstrated that individual hexose sugars, especially fructose, significantly influence the GI. These findings suggest that the carbohydrate-to-fiber ratio may offer a more accurate and reliable metric for determining the GI than traditional methods. Further research is warranted to investigate the specific contribution of dietary fiber components, fruit texture, micronutrients, vitamins, genetic predispositions, gut microbiota, and the body's physiological status to gain a deeper understanding of GI regulation.

Crosstalk Between Antioxidants and Adipogenesis: Mechanistic Pathways and Their Roles in Metabolic Health

The interplay between oxidative stress and adipogenesis is a critical factor in the development of obesity and its associated metabolic disorders. Excessive reactive oxygen species (ROS) disrupt key transcription factors such as peroxisome proliferator-activated receptor gamma (PPARγ) and CCAAT/enhancer-binding protein alpha (C/EBPα), impairing lipid metabolism, promoting adipocyte dysfunction, and exacerbating inflammation and insulin resistance. Antioxidants, classified as endogenous (e.g., glutathione, superoxide dismutase, and catalase) and exogenous (e.g., polyphenols, flavonoids, and vitamins C and E), are pivotal in mitigating these effects by restoring redox balance and preserving adipocyte functionality. Endogenous antioxidants neutralize ROS and safeguard cellular structures; however, under heightened oxidative stress, these defenses are often insufficient, necessitating dietary supplementation. Exogenous antioxidants derived from plant-based sources, such as polyphenols and vitamins, act through direct ROS scavenging, upregulation of endogenous antioxidant enzymes, and modulation of key signaling pathways like nuclear factor kappa B (NF-κB) and PPARγ, reducing lipid peroxidation, inflammation, and adipocyte dysfunction. Furthermore, they influence epigenetic regulation and transcriptional networks to restore adipocyte differentiation and limit lipid accumulation. Antioxidant-rich diets, including the Mediterranean diet, are strongly associated with improved metabolic health, reduced obesity rates, and enhanced insulin sensitivity. Advances in personalized antioxidant therapies, guided by biomarkers of oxidative stress and supported by novel delivery systems, present promising avenues for optimizing therapeutic interventions. This review, "Crosstalk Between Antioxidants and Adipogenesis: Mechanistic Pathways and Their Role in Metabolic Health", highlights the mechanistic pathways by which antioxidants regulate oxidative stress and adipogenesis to enhance metabolic health.

Hepatic and Pancreatic Cellular Response to Early Life Nutritional Mismatch

To determine the basis for perinatal nutritional mismatch causing metabolic dysfunction-associated steatotic liver disease and diabetes mellitus, we examined adult phenotype, hepatic transcriptome, and pancreatic β-islet function. In prenatal caloric-restricted rats with intrauterine growth restriction (IUGR) and postnatal exposure to high fat with fructose (HFhf) or high carbohydrate, we investigated male and female IUGR-HFhf and IUGR-high carbohydrate, vs HFhf and control offspring. Males more than females displayed adiposity, glucose intolerance, insulin resistance, hyperlipidemia, and hepatomegaly with hepatic steatosis. Male hepatic triglyceride synthesis, de novo lipogenesis genes increased, while female lipolysis, β-oxidation, fatty acid efflux, and FGF21 genes increased. IUGR-HFhf males demonstrated reduced β-islet insulin and humanin, and type 1 diabetes mellitus human amniotic fluid increased humanin. Humanin suppression disabled glucose stimulated insulin, ATP production, with apoptotic diminished β-islet viability. Humanin and FGF21 may reverse perinatal nutritional mismatched phenotype by restoring functional β islets and preventing metabolic dysfunction-associated steatotic liver disease and diabetes mellitus.

Heart failure and microvascular dysfunction: an in-depth review of mechanisms, diagnostic strategies, and innovative therapies

Microvascular dysfunction (MVD) is increasingly recognized as a critical contributor to the pathogenesis of heart failure (HF), particularly in heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Coronary microvascular dysfunction (CMD) significantly impacts HFpEF by reducing coronary flow reserve and myocardial perfusion reserve, leading to adverse outcomes such as myocardial ischemia, diastolic dysfunction, and increased risk of major cardiovascular events, including atrial fibrillation. In HFrEF, microvascular impairment is linked to heightened oxidative stress, reduced nitric oxide production, and activation of the renin-angiotensin-aldosterone system, further driving disease progression and contributing to poor prognosis. Advancements in diagnostic techniques, such as positron emission tomography, cardiac magnetic resonance imaging, and biomarker analysis, improve our ability to assess CMD in heart failure patients, enabling earlier diagnosis and risk stratification. Emerging therapies, including sodium-glucose cotransporter-2 inhibitors, angiotensin receptor-neprilysin inhibitors, and endothelial-targeted interventions, enhance microvascular function and improve patient outcomes. The role of personalized medicine is becoming increasingly important, as individualized therapeutic approaches tailored to patient-specific microvascular abnormalities are essential for optimizing treatment effectiveness. This review underscores the pivotal role of MVD in HF. It highlights the urgent need for innovative therapeutic strategies and diagnostic tools to address this complex condition and improve clinical outcomes for HF patients.

Moringa oleifera in a modern time: A comprehensive review of its nutritional and bioactive composition as a natural solution for managing diabetes mellitus by reducing oxidative stress and inflammation

Globally, diabetes mellitus (DM) and its complications are considered among the most significant public health problems. According to numerous scientific studies, Plants and their bioactive compounds may reduce inflammation and oxidative stress (OS), leading to a reduction in the progression of DM. Moringa oleifera (MO), widely used in Ayurvedic and Unani medicine for centuries because of its health-promoting characteristics, particularly its ability to control DM and its related complications. MO is a multi-purpose plant that has an impressive range of nutritional components including proteins, amino acids (Essential and non-essential amino acids), carbs, fats, fiber, vitamins, and phenolic compounds. In the modern era, scientists have paid close attention to the anti-diabetic, anti-oxidative and anti-inflammatory attributes and other medicinal properties, of MO leaves and seeds. MO leaves and seeds have modulatory effects on DM that are likely influenced by multiple mechanisms. Some of these mechanisms include direct effects, but other mechanisms involve inhibition the production of inflammatory markers, modulation of the gut microbiome, reduction of OS, enhancement of glucose metabolism through hexokinase and glucose 6-phosphate dehydrogenase, improve insulin sensitivity and glucose uptake in the liver and muscles. Overall, these findings suggest that MO may play a role in lowering the risk of DM and its related outcomes. The purpose of this review is to provide a comprehensive overview of the nutritional and bioactive profiles of MO leaves and seeds, as well as to investigate their possible anti-diabetic effects by modulating oxidative stress and inflammation. Our results indicate that MO may be a beneficial natural resource for management of DM and related issues by lowering oxidative stress and inflammation. Furthermore, studies on MO has yielded promising findings in diabetic animal models, indicating antioxidant and anti-inflammatory properties. However, human trials have shown less solid results, most likely due to a lack of studies, different techniques, and dosages. More clinical research is needed to fully understand MO's anti-diabetic potential, notably in lowering oxidative stress and inflammation, both of which are critical in controlling diabetes complications.

Copper biomarkers and their relationship with parameters of insulin resistance in obese women

Some studies have demonstrated the involvement of high concentrations of copper in the manifestation of insulin resistance in individuals with obesity. The objective of this study was to evaluate the copper nutritional status and its relationship with parameters of glycemic control in women with obesity. An observational case-control clinical study involving 203 women aged between 20 and 50 years, divided into two groups: obese (n = 84) and eutrophic (n = 119). Body weight, height and waist, hip and neck circumferences, dietary copper intake, copper biomarkers, determine ceruloplasmin activity and glycemic control parameters were measured. It was observed that women with obesity had higher copper concentrations in plasma and lower concentrations in erythrocytes when compared to the control group. Analysis of glycemic control parameters revealed a statistically significant difference in fasting blood glucose (p < 0.05) between groups. The study identified a significant positive correlation between plasma copper and fasting insulin values and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index (p < 0.05). The results of this study demonstrate that obese women have high copper concentrations in plasma and lower concentrations in erythrocytes. Furthermore, the significant positive correlation between plasma copper and fasting insulin and HOMA-IR index suggests the influence of this mineral on glycemic control parameters in obese women.

Heme oxygenase, biliverdin reductase, and bilirubin pathways regulate oxidative stress and insulin resistance: a focus on diabetes and therapeutics

Metabolic and insulin-resistant diseases, such as type 2 diabetes mellitus (T2DM), have become major health issues worldwide. The prevalence of insulin resistance in the general population ranges from 15.5% to 44.6%. Shockingly, the global T2DM population is anticipated to double by 2050 compared with 2021. Prior studies indicate that oxidative stress and inflammation are instrumental in causing insulin resistance and instigating metabolic diseases. Numerous methods and drugs have been designed to combat insulin resistance, including metformin, thiazolidinediones (TZDs), sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide 1 receptor agonists (GLP1RA), and dipeptidyl peptidase 4 inhibitors (DPP4i). Bilirubin is an antioxidant with fat-burning actions by binding to the PPARα nuclear receptor transcription factor, improving insulin sensitivity, reducing inflammation, and reversing metabolic dysfunction. Potential treatment with antioxidants like bilirubin and increasing the enzyme that produces it, heme oxygenase (HMOX), has also gained attention. This review discusses the relationships between bilirubin, HMOX, and insulin sensitivity, how T2DM medications affect HMOX levels and activity, and potentially using bilirubin nanoparticles to treat insulin resistance. We explore the sex differences between these treatments in the HMOX system and how bilirubin levels are affected. We discuss the emerging concept that bilirubin bioconversion to urobilin may have a role in metabolic diseases. This comprehensive review summarizes our understanding of bilirubin functioning as a hormone, discusses the HMOX isoforms and their beneficial mechanisms, analyzes the sex differences that might cause a dichotomy in responses, and examines the potential use of HMOX and bilirubin nanoparticle therapies in treating metabolic diseases.

Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that significantly increases the risk of cardiovascular disease, which is the leading cause of morbidity and mortality among diabetic patients. A central pathophysiological mechanism linking T2DM to cardiovascular complications is oxidative stress, defined as an imbalance between reactive oxygen species (ROS) production and the body's antioxidant defenses. Hyperglycemia in T2DM promotes oxidative stress through various pathways, including the formation of advanced glycation end products, the activation of protein kinase C, mitochondrial dysfunction, and the polyol pathway. These processes enhance ROS generation, leading to endothelial dysfunction, vascular inflammation, and the exacerbation of cardiovascular damage. Additionally, oxidative stress disrupts nitric oxide signaling, impairing vasodilation and promoting vasoconstriction, which contributes to vascular complications. This review explores the molecular mechanisms by which oxidative stress contributes to the pathogenesis of cardiovascular disease in T2DM. It also examines the potential of lifestyle modifications, such as dietary changes and physical activity, in reducing oxidative stress and mitigating cardiovascular risks in this high-risk population. Understanding these mechanisms is critical for developing targeted therapeutic strategies to improve cardiovascular outcomes in diabetic patients.

The protective effects of liraglutide in reducing lipid droplets accumulation and myocardial fibrosis in diabetic cardiomyopathy

BACKGROUND

Diabetes is a primary contributor to diabetic cardiomyopathy (DbCM), which is marked by metabolic imbalances such as elevated blood glucose and lipid levels, leading to significant structural and functional alterations in the myocardium. Elevated free fatty acids (FFAs) and hyperglycemia play critical roles in DbCM development, with FFAs inducing insulin resistance in cardiomyocytes and promoting lipid accumulation, resulting in oxidative stress and fibrosis. Current research suggests that glucagon-like peptide-1 (GLP-1) receptor agonists may effectively mitigate DbCM, although an effective treatment for this condition remains elusive, and the precise mechanisms of this protective effect are not fully understood.

METHODS

In this study, we aimed to replicate diabetic glucolipotoxic conditions by treating differentiated H9c2 cells with high glucose and free fatty acids. Additionally, a diabetic cardiomyopathy model was induced in mice through high-fat diets. Both in vitro and in vivo models were used to investigate the protective effects of liraglutide on cardiomyocytes and elucidate its underlying molecular mechanisms.

RESULTS

Our findings indicate that liraglutide significantly reduces lipid droplet (LD) formation and myocardial fibrosis, as evidenced by decreased expression of fibrosis markers, including TGF-β1 and collagen types I and III. Liraglutide also enhanced AMP-activated protein kinase (AMPK) activation, which improved mitochondrial function, increased antioxidant gene expression, enhanced insulin signaling, and reduced oxidative stress.

CONCLUSIONS

These results demonstrate the potential therapeutic role of liraglutide in managing diabetes-related cardiac complications, offering a comprehensive approach to improving cardiac outcomes in patients with diabetes.

MAFLD: Exploring the Systemic Effects Beyond Liver

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a growing global health concern which is driven by the increasing prevalence of diabetes and obesity. MAFLD is characterized by excessive fat accumulation in the liver, which encompasses a range of conditions, from simple hepatic steatosis to more severe forms. This condition is associated with various complications, including chronic kidney disease (CKD), Cardiovascular Disease (CVD), liver cirrhosis, and even malignancy. Recent research has highlighted a potential connection between gut dysbiosis and MAFLD, particularly in relation to CKD. This has underscored the significance of the gut-liver-kidney axis in understanding MAFLD's pathogenesis. Inflammation triggered by MAFLD increases the risk of CVD through multiple mechanisms linked to metabolic dysfunction. These mechanisms include heightened oxidative stress, systemic and hepatic insulin resistance, low-grade inflammation, and endothelial dysfunction. Hepatic steatosis and metabolic dysfunction are major diagnostic criteria for MAFLD, often coexisting with other liver ailments. This prospective review emphasizes the intricate associations between MAFLD, cardiovascular complications, renal issues, and hepatic diseases. Understanding the underlying pathophysiological pathways is crucial in comprehending the increased risk of CKD, CVD, and other hepatic complications in individuals with MAFLD.

Synergistic Effects of Hypoxia-Preconditioned Mesenchymal Stem Cells Secretome and Alkaline Water in Alleviating Oxidative Stress and Inflammation in Type 2 Diabetic Rats

Background

Chronic inflammation and oxidative stress are central to the pathophysiology of Type 2 Diabetes Mellitus (T2DM), contributing to the progression of metabolic dysfunction and related complications.

Objective

The aim of this study was to explore the therapeutic potential of combining hypoxia-preconditioned mesenchymal stem cell SH-MSC with alkaline water in a T2DM rat model.

Methods

T2DM was induced in Wistar rats through a high-fat diet (HFD) followed by streptozotocin (STZ) administration. A total of 30 healthy male Wistar rats were randomly assigned to five groups: healthy control, T2DM, T2DM + Metformin, T2DM + SH-MSC, and T2DM + SH-MSC + alkaline water.

Results

The combination of SH-MSC and alkaline water significantly reduced malondialdehyde (MDA) levels, a key indicator of lipid peroxidation, and suppressed the expression of p65 mRNA, a crucial component of the NF-κB signaling pathway. Notably, the most pronounced reduction in p65 mRNA expression was observed in the group receiving both SH-MSC and alkaline water, suggesting a synergistic effect in mitigating oxidative stress and inflammation.

Conclusion

These findings highlight the potential of SH-MSC and alkaline water as a novel therapeutic strategy for alleviating T2DM.

Influence of rosiridin on streptozotocin-induced diabetes in rodents through endogenous antioxidants-inflammatory cytokines pathway and molecular docking study

The research was undertaken to assess the antidiabetic activity of rosiridin in the streptozotocin (STZ)-induced diabetic model. Type 2 diabetes mellitus was elicited chemically in experimental animals using STZ (60 mg/kg, i.p.). Experimental rats were arbitrarily allocated to normal control, rosiridin perse, diabetic control, and STZ + rosiridin groups. After the confirmation of diabetes, rosiridin (10 mg/kg) was given orally to the experimental animals for 30 days. Various anti-diabetic (blood glucose, insulin), hypolipidemic, anti-inflammatory (Nuclear factor kappa B, tumour necrosis factor-α, interleukin beta (IL-1β), and IL-6), antioxidant (and malondialdehyde level, hepatic function and others markers (ALT, AST, adiponectin, and FNDC5) and histopathological indices of injury were evaluated. In addition, the rosinidin was docked into the active site of NF-Kβ (1SVC), FNDC5 (4LSD) and adiponectin (5LXG) proteins with AutoDock tools. MD simulations were carried out for the complexes of rosiridin with NF-Kβ, myokine and human adiponectin receptor 1. Rosiridin treatment restored the biochemical parameters and preserved the histopathological building of the pancreas as compared to the diabetic rats. Histopathological analysis of the pancreas confirmed that rosiridin antidiabetic efficacy in the STZ-induced diabetes mellitus model. The 5LXG_rosinidin showed favourable affinity with the best binding energies at -7.534 kcal/mol. MD simulations were carried out for the complexes of rosiridin with NF-Kβ, myokine and human adiponectin receptor 1, the complex of myokine and rosiridin exhibited the most stable complex. Rosiridin may exhibit considerable anti-diabetic activity in the STZ-induced diabetes mellitus model.Communicated by Ramaswamy H. Sarma.

The Role of Dietary Anthocyanins for Managing Diabetes Mellitus-Associated Complications

Diabetes mellitus (DM) is an intricate metabolic disorder marked by persistent hyperglycemia, arising from disruptions in glucose metabolism, with two main forms, type 1 and type 2, involving distinct etiologies affecting β-cell destruction or insulin levels and sensitivity. The islets of Langerhans, particularly β-cells and α-cells, play a pivotal role in glucose regulation, and both DM types lead to severe complications, including retinopathy, nephropathy, and neuropathy. Plant-derived anthocyanins, rich in anti-inflammatory and antioxidant properties, show promise in mitigating DM-related complications, providing a potential avenue for prevention and treatment. Medicinal herbs, fruits, and vegetables, abundant in bioactive compounds like phenolics, offer diverse benefits, including glucose regulation and anti-inflammatory, antioxidant, anticancer, anti-mutagenic, and neuroprotective properties. Anthocyanins, a subgroup of polyphenols, exhibit diverse isoforms and biosynthesis involving glycosylation, making them potential natural replacements for synthetic food colorants. Clinical trials demonstrate the efficacy and safety of anthocyanins in controlling glucose, reducing oxidative stress, and enhancing insulin sensitivity in diabetic patients, emphasizing their therapeutic potential. Preclinical studies revealed their multifaceted mechanisms, positioning anthocyanins as promising bioactive compounds for managing diabetes and its associated complications, including retinopathy, nephropathy, and neuropathy.

Systematic Review and Meta-Analysis of Risk Factors Associated with Postoperative Stress Hyperglycemia in Patients without Diabetes Following Cardiac Surgery

Background

To systematically evaluate risk factors for stress-induced hyperglycemia in patients without diabetes after cardiac surgery.

Methods

Databases including CNKI, WanFang data, VIP, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library were searched using computer retrieval. The data were subjected to an in-depth meta-analysis using RevMan 5.4 and Stata 15.0 software.

Results

This study involved 11,645 postoperative cardiac surgery patients, including 8 case-control studies and 3 cohort studies, over which 18 risk factors were identified. The results of the meta-analysis indicated that statistically significant risk factors included age >65 years [odds ratios (OR) (95% CI ) = 3.47 (2.61-4.32)], female gender [OR (95%) = 1.54 (1.34-1.76)], combined heart valve and coronary artery bypass surgery [OR (95%) = 1.82 (1.23-2.70)], ejection fraction <40% [OR (95%) = 1.38 (1.17-1.63)], history of heart surgery [OR (95%) = 1.30 (1.06-1.59)], myocardial infarction [OR (95%) = 1.17 (1.05-1.31)], hyperlipidemia [OR (95%) = 0.76 (0.67-0.86)], hypertension [OR (95%) = 1.12 (1.03-1.22)], anticoagulant medication [OR (95%) = 0.77 (0.65-0.90)], cardiopulmonary bypass time >2 hours [OR (95%) = 20.26 (17.03-23.48)] and history of cardiopulmonary bypass [OR (95%) = 1.24 (1.09-1.41)].

Conclusions

Current evidence suggests that there are key risk factors for postoperative stress hyperglycemia in patients without diabetes who have undergone cardiac surgery. These factors can help identify patients at a high risk of perioperative stress hyperglycemia during cardiac surgery. This evidence provides a basis for healthcare professionals to develop predictive management strategies for perioperative stress hyperglycemia in patients without diabetes. However, more high-quality studies are required to address the limitations of the current research.

The PROSPERO registration

CRD42024479215, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=479215.

Viscosol Treatment Ameliorates Insulin-Mediated Regulation of Dyslipidemia, Hepatic Steatosis, and Lipid Metabolism by Targeting PTP1B in Type-2 Diabetic Mice Model

Type 2 diabetes mellitus (T2DM), a metabolic disorder, has the hallmarks of persistent hyperglycemia, insulin resistance, and dyslipidemia. Protein-tyrosine phosphatase 1B (PTP1B) was found to be overexpressed in many tissues in the case of T2DM and involved in the negative regulation of insulin signaling. So, PTP1B inhibition can act as a therapeutic target for T2DM. Numerous studies claimed the anti-inflammatory, hypoglycemic, hepatoprotective, and hypolipidemic activities of Dodonaea viscosa. Previously, we generated the high-fat diet (HFD)-low dose streptozotocin (STZ)-induced diabetic male mice model and treated it with a PTP1B inhibitor (5, 7-dihydroxy-3, 6-dimethoxy-2- (4-methoxy-3- (3-methyl-2-enyl) phenyl)-4H-chromen-4-one), isolated from Dodonaea viscosa. In the current study, we aimed to investigate the De novo lipogenesis, adipocyte differentiation, augmentation of lipoproteins clearance, fatty acid uptake, antilipolysis activity, and hepatic steatosis of PTP1B inhibition in adipose and liver tissues of the HFD-STZ-induced diabetic mice model. We found the retrieval of normal morphology of adipocytes and hepatocytes in the compound-treated group. The biochemical parameters showed the gradual reduction of LDL, VLDL, TC, and TG in the serum of the compound-treated group. To further test our hypothesis, real-time PCR was performed, and data revealed the reduction of PTP1B and other inflammatory markers in both tissues, showing enhanced expression of insulin signaling markers (INSR, IRS1, IRS2, and PI3K). Our compound upregulated the adipogenic (PPARγ), lipogenic (SREBP1c, FAS, ACC, and DGAT2), lipoprotein clearance (LPL, LDLR, and VLDLR), fatty acid uptake (CD36 and FATP1), and lipid droplet forming (FSP27 and perilipin-1) markers expressions in adipocytes and downregulated in hepatocytes. Furthermore, we found elevated cholesterol efflux (in adipose and liver) and decreased lipolysis in adipocytes and elevated in hepatocytes. Hence, we can conclude that our compound protects the adipocytes from abrupt lipolysis and stimulates adipocyte differentiation. In addition, it plays a hepatic protective role by shifting clearance and uptake of lipoproteins and fatty acids to the peripheral tissues and retrieving the fatty liver condition.

Alterations in Striatal Architecture and Biochemical Markers' Levels During Postnatal Development in the Rat Model of an Attention Deficit/Hyperactivity Disorder (ADHD)

Attention deficit/hyperactivity disorder (ADHD) is defined as a neurodevelopmental condition. The precise underlying mechanisms remain incompletely elucidated. A body of research suggests disruptions in both the cellular architecture and neuronal function within the brain regions of individuals with ADHD, coupled with disturbances in the biochemical parameters. This study seeks to evaluate the morphological characteristics with a volume measurement of the striatal regions and a neuron density assessment within the studied areas across different developmental stages in Spontaneously Hypertensive Rats (SHRs) and Wistar Kyoto Rats (WKYs). Furthermore, the investigation aims to scrutinize the levels and activities of specific markers related to immune function, oxidative stress, and metabolism within the striatum of juvenile and maturing SHRs compared to WKYs. The findings reveal that the most pronounced reductions in striatal volume occur during the juvenile stage in SHRs, alongside alterations in neuronal density within these brain regions compared to WKYs. Additionally, SHRs exhibit heightened levels and activities of various markers, including RAC-alpha serine/threonine-protein kinase (AKT-1), glucocorticoid receptor (GCsRβ), malondialdehyde (MDA), sulfhydryl groups (-SH), glucose (G), iron (Fe), lactate dehydrogenase (LDH). alanine transaminase (ALT), and aspartate transaminase (AST). In summary, notable changes in striatal morphology and elevated levels of inflammatory, oxidative, and metabolic markers within the striatum may be linked to the disrupted brain development and maturation observed in ADHD.

1H NMR-Based Metabolomic Signatures in Rodent Models of Sporadic Alzheimer's Disease and Metabolic Disorders

Alzheimer's disease (AD) is a chronic neurological disorder that impacts the elderly population all over the globe. Evidence suggests association between AD and metabolic disorders such as diabetes mellitus (DM) and obesity (OB). The present study is an attempt to evaluate metabolic alterations in the serum and brain through NMR spectroscopy with the aim to identify shared metabolic signatures. AD was induced in rats by stereotactic intracerebroventricular injection of oligomerized Aβ-42 peptide into the brain. DM and OB were induced by intraperitoneal injection of streptozotocin and feeding rats on a high-fat diet, respectively. The metabolic alterations obtained through 1H NMR spectroscopy were further subjected to multivariate analysis by principal component analysis and partial least-squares discrimination for identification of metabolic signatures. In the serum, the levels of lactate and betaine were increased in AD, DM, and OB rats. On the other hand, the metabolite profile of brain indicated increase in the levels of lactate, N-acetylaspartate, and creatinine in AD, DM, and OB rats. Additionally, the concentration of neurochemicals such as glutamate, GABA, N-acetylglutamate, and myo-inositol were also elevated. The alterations in neurotransmitters and cerebral energy metabolism were accompanied by deficits in cognition assessed by Morris water maze in AD, DM, and OB rats. The perturbed metabolic profiles were accompanied by the presence of pathogenic amyloid deposits visualized by Congo red stain in the brains of AD, DM, and OB rats. Overall, the study identifies common metabolic signatures in AD, DM, and OB that may be involved in etiopathogenesis and also suggests linkages between these three conditions.

Exploring Awareness Levels of Diabetic Ketoacidosis Risk Among Patients with Diabetes: A Cross-Sectional Study

Background/Objectives: Diabetic ketoacidosis (DKA) is a critical complication of diabetes mellitus, posing significant health. While global studies have indicated a concerning lack of awareness regarding DKA among patients with diabetes, research specific to the northern area of Saudi Arabia remains limited. This study aims to explore the level of knowledge and awareness of DKA among patients with diabetes residing in the local region. Methods: A cross-sectional analysis was conducted utilizing a non-probability convenient sampling technique, with 339 participants recruited from March to August 2024. Data were gathered through a self-administered pre-validated questionnaire distributed via different social media platforms to assess demographic characteristics and awareness levels relating to DKA, including knowledge of its symptoms, causes, and treatment options. Results: Although there was moderate awareness of DKA, with 68.4% having heard of the condition, two-thirds of the participants exhibited significant gaps in overall knowledge. Among those aware, 76.3% recognized DKA as an emergency requiring immediate medical intervention. At the same time, 64.6% understood the causes of DKA, and only 25.6% identified insulin deficiency as a major contributing factor. Although 62.5% felt knowledgeable about treatment, 66.0% incorrectly identified oral sugar as a DKA treatment. Notably, 30.1% cited social media as their main information source. Age emerged as an essential factor impacting knowledge, with younger participants (ages 18-30) demonstrating higher awareness than older individuals. Additionally, single participants displayed a higher percentage of good knowledge than married participants (p = 0.000). Non-working individuals showed better overall knowledge about DKA (p = 0.002). The duration of diabetes did not show a significant association with knowledge levels about DKA across the various duration categories. Conclusions: The present findings underscore a substantial knowledge gap concerning DKA among the local community, highlighting a critical need for targeted public health educational interventions.

Metformin protects against small intestine damage induced by diabetes and dunning's prostate cancer: A biochemical and histological study

The oral biguanide metformin is used to treat type 2 diabetic mellitus (T2DM). Anti-cancer effects have been proven by metformin in different hormone-sensitive tumors, including breast, pancreatic, colon, and prostate cancer. Therefore, we investigated whether metformin could defend against small intestine damage in Dunning's prostate cancer. The study divided the six groups of male Copenhagen rats into the following categories: control, diabetic (D), cancer (C), diabetic + cancer (DC), cancer + metformin (CM), and diabetic + cancer + metformin (DCM). After sacrifice, the small intestines were removed to assess biochemical markers and histopathological evaluation. Biochemical evaluations showed that glutathione (reduced) levels and other enzyme activities related antioxidant systems, paraoxonase, sodium potassium ATPase, acetylcholinesterase activities were decreased. In contrast, lipid peroxidation, total oxidant status, reactive oxygen species, interleukin-1β, interleukin-6, tumor necrosis factor-α, sucrase, maltase, trypsin, myeloperoxidase, xanthine oxidase activities, protein carbonyl contents and sialic acid levels were raised in the damaged groups. Treatment with metformin restored all of this. The histological assessment revealed moderate to severe damage in the small intestine following processes D and C. According to the study's findings, metformin treatment led to a notable decline in histopathological damage in the C and DC. A slight lowering in inflammatory cells and an improvement in the damaged gland integrity in the small intestine were noted with metformin treatment.​ Metformin use protected the small intestinal tissue damage and decreased oxidative stress.

Ziziphus jujuba (Jujube) in Metabolic Syndrome: From Traditional Medicine to Scientific Validation

PURPOSE OF REVIEW

This review evaluates the therapeutic potential of Ziziphus jujuba and its main components in managing complications of metabolic syndrome, including diabetes, dyslipidemia, obesity, and hypertension.

RECENT FINDINGS

The reviewed studies provide evidence supporting the use of Z. jujuba and its main components (lupeol and betulinic acid) as natural treatments for complications of metabolic syndrome. These substances enhance glucose uptake through the activation of signaling pathways such as phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt), reduce hepatic glucose synthesis, and increase glucose uptake by adipocytes and skeletal muscle cells. They also improve insulin sensitivity by modulating AMP-activated protein kinase (AMPK) activity and regulating insulin signaling proteins and glucose transporters. In the field of dyslipidemia, they inhibit triglyceride synthesis, lipid accumulation, and adipogenic enzymes, while influencing key signaling pathways involved in adipogenesis. Z. jujuba and its constituents demonstrate anti-adipogenic effects, inhibiting lipid accumulation and modulating adipogenic enzymes and transcription factors. They also exhibit positive effects on endothelial function and vascular health by enhancing endothelial nitric oxide synthase (eNOS) expression, NO production, and antioxidant enzyme activity. Z. jujuba, lupeol, and betulinic acid hold promise as natural treatments for complications of metabolic syndrome. They improve glucose metabolism, insulin sensitivity, and lipid profiles while exerting anti-adipogenic effects and enhancing endothelial function. However, further research is needed to elucidate the mechanisms and confirm their efficacy in clinical trials. These natural compounds offer potential as alternative therapies for metabolic disorders and contribute to the growing body of evidence supporting the use of natural medicines in their management.

Co-exposure to parabens, bisphenol A, and triclosan and the associations with dyslipidemia in Chinese older adults: The mediation effect of oxidative stress

Dyslipidemia is a prevalent metabolic disorder in older adults and has negative effects on cardiovascular health. However, the combined effect of paraben, bisphenol A (BPA), and triclosan (TCS) exposure on dyslipidemia and the underlying mechanisms remain unclear. This cross-sectional study recruited 486 individuals ≥60 years in Shenzhen, China. Morning spot urine samples were collected and analyzed for four parabens, BPA, TCS, and 8-hydroxy-2'-deoxyguanosine (8-OHdG), a typical biomarker for oxidative stress, using mass spectrometry. Blood samples were tested for lipid levels using an automated biochemical analyzer. Quantile-based g-computation (QGC) was used to assess the combined effects of exposures on dyslipidemia. Mediation analysis was applied to investigate the mediating role of 8-OHdG between exposure and dyslipidemia. QGC showed that co-exposure to parabens, BPA, and TCS was positively linked with hypercholesterolemia (OR: 1.17, 95%CI: 1.10-1.24, P < 0.001) and hyper-LDL-cholesterolemia (OR: 1.35, 95%CI: 1.05-1.75, P = 0.019). Methylparaben (MeP), n-propyl paraben (PrP), and butylparaben (BtP) were the major contributors. 8-OHdG mediated 6.5% and 13.0% of the overall effect of the examined chemicals on hypercholesterolemia and hyper-LDL-cholesterolemia, respectively (all P < 0.05). Our study indicated that co-exposure to parabens, BPA, and TCS is associated with dyslipidemia and oxidative stress partially mediate the association. Future research is needed to explore additional mechanisms underlying these relationships.

Betaine regulates steroidogenesis, endoplasmic reticulum stress response and Nrf2/HO-1 antioxidant pathways in mouse Leydig cells under hyperglycaemia condition

We studied the effects of betaine on steroidogenesis, endoplasmic reticulum stress and Nrf2 antioxidant pathways of mice Leydig cells under hyperglycaemia conditions. Leydig cells were grown in low and high glucose concentrations (5 mM and 30 mM) in the presence of 5 mM of betaine for 24 h. Gene expression was determined using a real-time PCR method. The protein levels were determined by Western blot analysis. The testosterone production was evaluated by the ELISA method. Cellular contents of reduced and oxidised glutathione were measured by colorimetric method. Hyperglycaemia caused impaired steroidogenesis and ERS in Leydig cells associated with the down-regulation of 3β-HSD, StAR, P450scc, LH receptor and increased expression of GRP78, CHOP, ATF6 and IRE1. Betaine could improve cell viability, attenuate the ERS, and restore testosterone production in Leydig cells under hyperglycaemia conditions. Betaine can protect Leydig cells against the adverse effects of hyperglycaemia by regulating steroidogenesis, antioxidants, and ERS.

Identification of hub genes affecting gestational diabetes mellitus based on GEO database

This research aimed to obtain gestational diabetes mellitus (GDM) related hub genes, providing new targets for clinical diagnosis and treatment of GDM. The microarray data of GSE9984 and GSE103552 were obtained from the Gene Expression Omnibus (GEO). The dataset GSE9984 contained placental gene expression profiles of 8 GDM patients and four healthy specimens. The dataset GSE103552 contained 20 specimens from GDM patients and 17 normal specimens. The differentially expressed genes (DEGs) were identified by GEO2R online analysis. DAVID database was applied to conduct functional enrichment analysis of the DEGs. The Search Tool for the Retrieval of Interacting Genes (STRING) database was adopted to acquire protein-protein interaction (PPI) networks. A total of 195 up-regulated and 371 down-regulated DEGs were selected in the GSE9984, and total of 191 up-regulated and 229 down-regulated DEGs were selected in the GSE103552. In the two datasets, 24 common differential genes were obtained and named co-DEGs. The Gene Ontology (GO) annotation analysis indicated the DEGs participated in multi-multicellular organism process, endocrine hormone secretion, long-chain fatty acid biosynthetic process, cell division, unsaturated fatty acid biosynthetic process, cell adhesion and cell recognition. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that GSE9984 and GSE103552 were related to vitamin digestion and absorption, tryptophan metabolism, steroid hormone biosynthesis, Ras signaling pathway, protein digestion and absorption, PPAR signaling pathway, PI3K-Akt signaling pathway, p53 signaling pathway. PPI was constructed in string database, and six hub genes were selected, including CCNB1, APOA2, AHSG and IGFBP1. Four critical genes were identified to be considered as therapeutic potential biomarkers of GDM, including CCNB1, APOA2, AHSG and IGFBP1.

The therapeutic effect of NRF2 activator, ezetimibe, in cardiac cachexia

INTRODUCTION

Heart failure (HF) is caused by functional and structural irregularity leading to impaired ejection or filling capacity of the heart. HF leads to chronic inflammatory conditions in the heart leads to weight loss, anorexia, and muscle atrophy known as cachexia. The present study was carried out to investigate the role of Ezetimibe, an NRF2 activator, in cardiac cachexia and to develop a treatment strategy for cardiac cachexia.

METHOD

Balb/c mice of either sex at 6-8 weeks of age were given 2 mg/kg of doxorubicin in 0.9% sodium chloride solution intraperitoneally (i.p.) for the alternate days for the first week and then once a week for the next 4 weeks. After induction of cardiac atrophy, treatment with Ezetimibe (1.5 mg/kg, p.o) was given for the next 4 weeks.

RESULT

In the cardiac cachectic animals, a significant decrease in body weight, food, and water intake was observed. Cardiac cachectic animals showed a significant increase in serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK-MB, LDH, and CRP levels. Cardiac atrophic index, heart weight to body weight ratios (HW/BW), right ventricular weight to heart weight ratios (RV/HW), and left ventricular weight to heart weight ratios (LV/HW), were significantly decreased in cardiac cachectic animals. The weights of the skeletal muscles such as EDL, gastrocnemius, soleus, tibialis anterior, and quadriceps muscles, and the weight of adipose tissue such as subcutaneous, visceral, perirenal, and brown adipose tissue were significantly decreased in the cardiac cachectic group relative to the normal group. Treatment with ezetimibe improves body weight, food intake, and water intake. Ezetimibe decreases serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK-MB, LDH and CRP levels. Cardiac atrophic markers such as HW/BW, RV/HW, and LV/HW were improved. The weight of skeletal muscles and adipose tissue was increased after treatment with ezetimibe.

CONCLUSION

Our data showed that the NRF2 activator, Ezetimibe produces a beneficial effect on cardiac cachexia in the doxorubicin-induced cardiac cachexia model. Ezetimibe was successful to reduce the levels of inflammatory cytokines, ameliorate the effects on cardiac muscle wasting, lipid levels, fat tissues, and skeletal muscles.

Aerobic interval training preconditioning protocols inhibit isoproterenol-induced pathological cardiac remodeling in rats: Implications on oxidative balance, autophagy, and apoptosis

This study aimed to investigate the potential cardioprotective effects of moderate and high-intensity aerobic interval training (MIIT and HIIT) preconditioning. The focus was on histological changes, pro-oxidant-antioxidant balance, autophagy initiation, and apoptosis in myocardial tissue incited by isoproterenol-induced pathological cardiac remodeling (ISO-induced PCR). Male Wistar rats were randomly divided into control (n ​= ​6), ISO (n ​= ​8), MIIT (n ​= ​4), HIIT (n ​= ​4), MIIT ​+ ​ISO (n ​= ​8), and HIIT ​+ ​ISO (n ​= ​8) groups. The MIIT and HIIT protocols were administered for 10 weeks, followed by the induction of cardiac remodeling using subcutaneous injection of ISO (100 ​mg/kg for two consecutive days). Alterations in heart rate (HR), mean arterial pressure (MAP), rate pressure product (RPP), myocardial oxygen consumption (MV ˙ O2), cardiac hypertrophy, histopathological changes, pro-oxidant-antioxidant balance, autophagy biomarkers (Beclin-1, Atg7, p62, LC3 I/II), and apoptotic cell distribution were measured. The findings revealed that the MIIT ​+ ​ISO and HIIT ​+ ​ISO groups demonstrated diminished myocardial damage, hemorrhage, immune cell infiltration, edema, necrosis, and apoptosis compared to ISO-induced rats. MIIT and HIIT preconditioning mitigated HR, enhanced MAP, and preserved MV ˙ O2 and RPP. The pro-oxidant-antioxidant balance was sustained in both MIIT ​+ ​ISO and HIIT ​+ ​ISO groups, with MIIT primarily inhibiting pro-apoptotic autophagy progression through maintaining pro-oxidant-antioxidant balance, and HIIT promoting pro-survival autophagy. The results demonstrated the beneficial effects of both MIIT and HIIT as AITs preconditioning in ameliorating ISO-induced PCR by improving exercise capacity, hemodynamic parameters, and histopathological changes. Some of these protective effects can be attributed to the modulation of cardiac apoptosis, autophagy, and oxidative stress.

Neem seed oil ameliorates diabetic phenotype by suppressing redox imbalance, dyslipidaemia and pro-inflammatory mediators in a rodent model of type 2 diabetes

The neem plant (Azadirachta indica) has popular ethnomedicinal applications. The anti-diabetic potential and mechanism of neem seed oil (NSO) in a rodent model of type 2 diabetes mellitus was evaluated in the present study. Experimentally-induced diabetic animals were administered NSO (200 and 400 mg/kg) or metformin (150 mg/kg) orally for 30 days, with some animals serving as positive and negative controls. NSO significantly (p < .05) reversed diabetes-induced impaired glucose metabolism, dyslipidaemia, and oxido-inflammatory imbalances typified by changes in the NADH/NAD+ ratio (p < .001) and increases in the mRNA or protein levels of C-reactive protein, 4-hydroxynonenal, and pro-inflammatory cytokines (TNF-α and Il-1β) among others in the hepatic or pancreatic tissues of diabetic animals. The histological evaluation of the pancreatic tissue corroborated the protective effect of NSO. The findings showed that the antidiabetic effect of NSO proceeded through its hypolipidemic effect and modulation of redox and inflammatory signalling events in the tissues of animals.

The dichloromethane fraction from Calotropis gigantea (L.) dryand. Stem bark extract prevents liver cancer in SDT rats with insulin-independent diabetes mellitus

ETHNOPHARMACOLOGICAL RELEVANCE

Calotropis gigantea (L.) Dryand. (C. gigantea) is a traditional medicinal plant, recognized for its effectiveness in managing diabetes, along with its notable antioxidant, anti-inflammatory, and anticancer properties. Type II diabetes mellitus (T2DM) is characterized by chronic metabolic disorders associated with an elevated risk of hepatocellular carcinoma (HCC) due to hyperglycemia and impaired insulin response. The scientific validation of C. gigantea's ethnopharmacological efficacy offers advantages in alleviating cancer progression in T2DM complications, enriching existing knowledge and potentially aiding future clinical cancer treatments.

AIM

This study aimed to investigate the preventive potential of the dichloromethane fraction of C. gigantea stem bark extract (CGDCM) against diethylnitrosamine (DEN)-induced HCC in T2DM rats, aiming to reduce cancer incidence associated with diabetes while validating C. gigantea's ethnopharmacological efficacy.

MATERIALS AND METHODS

Spontaneously Diabetic Torii (SDT) rats were administered DEN to induce HCC (SDT-DEN-VEH), followed by treatment with CGDCM. Metformin was used as a positive control (SDT-DEN-MET). All the treatments were administered for 10 weeks after the initial DEN injection. Diabetes-related parameters, including serum levels of glucose, insulin, and glycosylated hemoglobin (HbA1c), as well as liver function enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase), were quantified. Serum inflammation biomarkers interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were evaluated. Liver tissue samples were analyzed for inflammation protein expression (IL-6, TNF-α, transforming growth factor-β1 (TGF-β1), and α-smooth muscle actin (α-SMA)). Histopathological evaluation was performed to assess hepatic necrosis, inflammation, and fibrosis. Liver cell proliferation was determined using immunohistochemistry for Ki-67 expression.

RESULTS

Rats with SDT-DEN-induced HCC treated with CGDCM exhibited reduced serum glucose levels, elevated insulin levels, and decreased HbA1c levels. CGDCM treatment also reduced elevated hepatic IL-6, TNF-α, TGF-β1, and α-SMA levels in SDT-DEN-VEH rats. Additionally, CGDCM treatment prevented hepatocyte damage, fibrosis, and cell proliferation. No adverse effects on normal organs were observed with CGDCM treatment, suggesting its safety for the treatment of HCC complications associated with diabetes. Additionally, the absence of adverse effects in SD rats treated with CGDCM at 2.5 mg/kg further supports the notion of its safe usage.

CONCLUSIONS

These findings suggest that C. gigantea stem bark extract exerts preventive effects against the development of HCC complications in patients with T2DM, expanding the potential benefits of its ethnopharmacological advantages.

Investigating the Effects of Gossypetin on Cardiovascular Function in Diet-Induced Pre-Diabetic Male Sprague Dawley Rats

Gossypetin (GTIN) is a naturally occurring flavonoid recognised for its pharmacological properties. This study examined the effects of GTIN on cardiovascular function in a diet-induced pre-diabetic rat model, which has not been previously studied. Pre-diabetes was induced using a high-fat high-carbohydrate (HFHC) diet supplemented with 15% fructose water for 20 weeks. Thereafter, the pre-diabetic animals were sub-divided into five groups (n = 6), where they were either orally treated with GTIN (15 mg/kg) or metformin (MET) (500 mg/kg), both in the presence and absence of dietary intervention for 12 weeks. The results demonstrated that the pre-diabetic (PD) control group exhibited significantly higher plasma triglyceride, total cholesterol, low-density lipoprotein and very low-density lipoprotein levels, along with decreased high-density lipoprotein (HDL) levels in comparison to the non-pre-diabetic (NPD) group. This was accompanied by significantly higher mean arterial pressure (MAP), body mass index (BMI), waist circumference (WC) and plasma endothelial nitric oxide (eNOS) levels in PD control. Additionally, there were increased heart malondialdehyde levels, reduced heart superoxide dismutase and glutathione peroxidase activity as well as increased plasma interleukin-6, tumour necrosis factor alpha and c-reactive protein levels present in the PD control group. Notably, both GTIN-treated groups showed significantly reduced plasma lipid levels and increased HDL, as well as decreases in MAP, BMI, WC and eNOS levels in comparison to PD control. Additionally, GTIN significantly decreased heart lipid peroxidation, enhanced antioxidant activity and decreased plasma inflammation markers. These findings may suggest that GTIN administration in both the presence and absence of dietary intervention may offer therapeutic potential in ameliorating cardiovascular disturbances associated with the PD state. However, future studies are needed to determine the physiological mechanisms by which GTIN improves cardiovascular function in the PD state.

Fermented Rice Bran Mitigated the Syndromes of Type 2 Diabetes in KK-Ay Mice Model

Background: Diabetes is a devastating disease that causes millions of deaths. Fermented rice bran (FRB), made by fermenting rice bran with Aspergillus kawachii and a mixture of lactic acid bacteria, was hypothesized to b able to improve diabetes-related symptoms. This study aimed to investigate the effects of FRB supplementation in mitigating type 2 diabetes symptoms and identifying FRB bioactive compounds. Methods: In this study, KK-Ay mice (4 w.o. male) were used as a model for type 2 diabetes. Mice were divided into three different groups. The first group received a control diet, the second received a 12.5% non-fermented rice bran (RB) supplemented diet, and the last group was fed a 12.5% FRB-supplemented diet. Supplementation was done for 4 weeks. Results: FRB supplementation lowered the blood glucose level, OGTT, HOMA-IR, total cholesterol, liver RAGE protein, and glucokinase in KK-Ay mice. Metabolome analysis of RB and FRB showed that fermentation increased bioactive compounds in rice bran, such as GABA, L-theanine, and carnitine. It also increased the levels of various free amino acids while converting some amino acids such as arginine, tyrosine, and tryptophan into other metabolites. Conclusions: This research showed the potency of FRB supplementation as a preventive agent against type 2 diabetes.

Endogenous/exogenous stimuli‐responsive smart hydrogels for diabetic wound healing

Diabetes significantly impairs the body's wound‐healing capabilities, leading to chronic, infection‐prone wounds. These wounds are characterized by hyperglycemia, inflammation, hypoxia, variable pH levels, increased matrix metalloproteinase activity, oxidative stress, and bacterial colonization. These complex conditions complicate effective wound management, prompting the development of advanced diabetic wound care strategies that exploit specific wound characteristics such as acidic pH, high glucose levels, and oxidative stress to trigger controlled drug release, thereby enhancing the therapeutic effects of the dressings. Among the solutions, hydrogels emerge as promising due to their stimuli‐responsive nature, making them highly effective for managing these wounds. The latest advancements in mono/multi‐stimuli‐responsive smart hydrogels showcase their superiority and potential as healthcare materials, as highlighted by relevant case studies. However, traditional wound dressings fall short of meeting the nuanced needs of these wounds, such as adjustable adhesion, easy removal, real‐time wound status monitoring, and dynamic drug release adjustment according to the wound's specific conditions. Responsive hydrogels represent a significant leap forward as advanced dressings proficient in sensing and responding to the wound environment, offering a more targeted approach to diabetic wound treatment. This review highlights recent advancements in smart hydrogels for wound dressing, monitoring, and drug delivery, emphasizing their role in improving diabetic wound healing. It addresses ongoing challenges and future directions, aiming to guide their clinical adoption.

The Role of Reactive Oxygen Species in Alzheimer's Disease: From Mechanism to Biomaterials Therapy

Alzheimer's disease (AD) is a chronic, insidious, and progressive neurodegenerative disease that remains a clinical challenge for society. The fully approved drug lecanemab exhibits the prospect of therapy against the pathological processes, while debatable adverse events conflict with the drug concentration required for the anticipated therapeutic effects. Reactive oxygen species (ROS) are involved in the pathological progression of AD, as has been demonstrated in much research regarding oxidative stress (OS). The contradiction between anticipated dosage and adverse event may be resolved through targeted transport by biomaterials and get therapeutic effects through pathological progression via regulation of ROS. Besides, biomaterials fix delivery issues by promoting the penetration of drugs across the blood-brain barrier (BBB), protecting the drug from peripheral degradation, and elevating bioavailability. The goal is to comprehensively understand the mechanisms of ROS in the progression of AD disease and the potential of ROS-related biomaterials in the treatment of AD. This review focuses on OS and its connection with AD and novel biomaterials in recent years against AD via OS to inspire novel biomaterial development. Revisiting these biomaterials and mechanisms associated with OS in AD via thorough investigations presents a considerable potential and bright future for improving effective interventions for AD.

A novel synthetic compound, deferiprone-resveratrol hybrid (DFP-RVT), promotes hepatoprotective effects and ameliorates iron-induced oxidative stress in iron-overloaded β-thalassemic mice

A high amount of iron in β-thalassemia patients can lead to oxidative stress and organ dysfunction, especially liver, the main iron accumulated organ. Iron catabolism causes the generation of reactive oxygen species (ROS), triggering liver inflammation, fibrosis, and cirrhosis. Deferiprone-resveratrol hybrid (DFP-RVT) is chemically synthesized by combining deferiprone (DFP) and resveratrol (RVT) which shows an iron-chelating property along with antioxidant activity. This study explored the hepatoprotective effect of DFP-RVT in iron overloaded β-knockout (BKO) thalassemic mice. The results revealed that DFP-RVT treatment improved liver function in iron-overloaded BKO mice by reducing liver enzymes and increasing hepcidin levels compared to iron overload control mice. Both DFP alone and DFP-RVT treatment groups demonstrated iron chelation effects by decreasing liver iron content (LIC), iron profiles, and iron deposition in the liver. Moreover, DFP-RVT powerfully showed antioxidant properties by decreasing liver and plasma thiobarbituric acid reactive substances (TBARs) and increasing reduced glutathione (GSH) and superoxide dismutase (SOD). Interestingly, transforming growth factor β1 (TGFβ1), which can contribute to chronic liver disease through liver injury, inflammation, fibrosis, and cirrhosis, is highly expressed in iron-overloaded mice. However, both DFP and DFP-RVT treatment significantly reduced TGFβ1 levels compared to the iron-overloaded group. Therefore, DFP-RVT could be a potent hepatoprotective compound through the mobilization of iron, reduction of ROS, improvement of liver enzymes, and alleviation of liver damage, potentially relieving liver dysfunction in iron-overloaded BKO mice.

Oxidative stress gene signature construction to identify subtypes and prognosis of patients with lung adenocarcinoma

Background

Although oxidative stress and malignancies are intimately connected, it is unknown how lung adenocarcinoma (LUAD) is affected by oxidative stress response-related genes (OSRGs).Our goal in this work was to create a genetic signature based on OSRGs that might both predict prognosis and hint to potential treatment options for LUAD.

Methods

Clinicopathological and transcriptome information on LUAD patients was obtained from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. A model for predicting risk was created using LASSO regression. The TCGA, GSE72094, and GSE41271 cohorts all demonstrated the risk model's prediction ability. Immune cell infiltration was measured using the CIBERSORT method, and the TIDE platform was implemented to evaluate the therapeutic efficacy of immune checkpoint inhibition (ICI). Chemotherapy sensitivity was predicted using drug activity data by the Genomics of Drug Sensitivity. An investigation into gene expression was conducted using qRT-PCR. CCK-8 and transwell assays were employed to look into how DKK1 affected the migration and proliferation of LUAD cells.

Results

A gene signature consisting of ANLN, FAM83A, DKK1, LOXL2, RHOV, IGFBP1, CCR2, GNG7, and C11orf16 was efficiently determined and used to calculate a patient-specific risk score, this functioned as a stand-alone biomarker for prediction. Correlations were found between risk scores and immune cell infiltration frequency, ICI therapy response rate, estimated chemotherapeutic drug susceptibility and autophagy-related genes.Furthermore, DKK1 knockdown reduced the ability of LUAD cells to multiply and migrate.

Conclusion

Our thorough transcriptome study of OSRGs generated a biological framework effective in forecasting outcome and responsiveness to therapy in LUAD patients.

Association of triglyceride-glucose index, low and high-density lipoprotein cholesterol with all-cause and cardiovascular disease mortality in generally Chinese elderly: a retrospective cohort study

Background

The impact of baseline triglyceride-glucose (TyG) index and abnormal low or high-density lipoprotein cholesterol (LDL-C or HDL-C) levels on all-cause and cardiovascular disease (CVD) mortality remains unclear. This study aimed to investigate the relationship between TyG index and LDL-C or HDL-C and all-cause and CVD mortality.

Methods

This retrospective cohort study analyzed data from health examinations of 69,068 older adults aged ≥60 in Xinzheng City, Henan Province, China, between January 2013 and January 2023. Cox proportional risk regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the TyG index and LDL-C or HDL-C about all-cause and CVD mortality. Restricted cubic spline was used to assess the dose-response relationship.

Results

During 400,094 person-years of follow-up (median follow-up 5.8 years [interquartile range 3.0-9.12]), 13,664 deaths were recorded, of which 7,045 were due to CVD. Compared with participants in the second quartile of the TyG index, participants in the fourth quartile had a 16% increased risk of all-cause mortality (HR: 1.16, 95% CI: 1.12,1.22), and an 8% increased risk of CVD mortality (HR: 1.08, 95% CI: 1.01,1.16). Similar results were observed in LDL-C and HDL-C, with all-cause and CVD mortality risks for participants in the fourth quartile compared with participants in the third quartile for LDL-C of (HR: 1.07, 95% CI: 1.02,1.12) and (HR: 1.09, 95% CI: 1.01,1.17), respectively. The risk of all-cause and CVD mortality in participants in the fourth quartile group compared with those in the second HDL-C quartile group was (HR: 1.10, 95% CI: 1.05,1.16) and (HR: 1.11, 95% CI: 1.04,1.18), respectively. We found that the TyG index was nonlinearly associated with all-cause and CVD mortality (P non-linear <0.05), and LDL-C was nonlinearly associated with all-cause mortality (P non-linear <0.05) but linearly associated with CVD mortality (P non-linear >0.05). HDL-C, on the other hand, was in contrast to LDL-C, which showed a non-linear association with CVD mortality. We did not observe a significant interaction between TyG index and LDL-C or HDL-C (P >0.05).

Conclusion

TyG index and LDL-C or HDL-C increased the risk of all-cause and CVD mortality, especially a high TyG index combined with abnormal LDL-C.

Li-Fraumeni Syndrome: Narrative Review Through a Case Report with Ten Years of Primary Tumor Remission Associated with Sechium H387 07 Supplementation

There are hereditary mutations that predispose individuals to cancer development, such as pathogenic variants in the germ line of the tumor protein 53 (TP53) suppressor gene. This leads to a rare condition known as Li-Fraumeni syndrome (LFS), characterized by a high risk of developing multiple cancers throughout life by the precancerous niche that promotes the tumor microenvironment. LFS presents a significant challenge due to its limited therapeutic and chemoprophylactic options. Recently, protocols involving metformin as a prophylactic medication have been developed to target precancerous niches. However, this approach is still in the clinical phase, and no established therapeutic regimen is available. Therefore, new alternatives are needed to impact this disease effectively. Novel studies suggest that Sechium extract, rich in polyphenols, exhibits chemoprophylactic, antineoplastic, anti-inflammatory, and antioxidant activities, all involved in the tumor microenvironment of LFS. However, the specific role of Sechium extract in preventing recurrent neoplastic development in LFS remains unclear. We conducted this research through a case report of an LFS-diagnosed patient who has experienced multiple malignancies and cutaneous neoformations. This patient received a chemoprophylactic supplementation based on Sechium H387 07 extract over 11 years without reporting new primary malignancy events or recurrences, as evidenced by laboratory and positron emission tomography/computed tomography (PET/CT) studies. An extensive literature review on the disease, precancerous niche, tumor microenvironment, and potential mechanisms of Sechium H387 07 extract components was conducted to explain cancer absence in LFS. This review promotes the research and use of polyphenols as powerful chemoprophylactic agents to prevent and treat proliferative diseases like LFS.