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S S, Hegde SV, Agarwal SV, Ns D, Pillai A, Shah SN, S R. Biomarkers of Oxidative Stress and Their Clinical Relevance in Type 2 Diabetes Mellitus Patients: A Systematic Review. Cureus 2024; 16:e66570. [PMID: 39252730 PMCID: PMC11382618 DOI: 10.7759/cureus.66570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 09/11/2024] Open
Abstract
Assessing oxidative stress is vital in managing type 2 diabetes mellitus (T2DM) and its complications. This systematic review aims to identify the most important oxidative stress markers in T2DM patients and predict associated complications. A literature search was conducted from 2013 to 2023, focusing on case-control, cohort, cross-sectional, and randomized control trials. The included studies had open access and scientific methodologies for assessing oxidative stress markers, while the excluded studies were not published in English or lacked primary objectives related to oxidative stress markers and T2DM or its complications. The quality of eligible studies was evaluated using the Newcastle-Ottawa Scale (NOS) for case-control, cohort, and cross-sectional studies and the Jadad Scale for RCTs. Eighteen studies were selected for the review and 25 potential markers like malondialdehyde (MDA), 11 thiobarbituric acid reactive substances (TBARS), 8-hydroxydeoxyguanosine (8-OHdG), glutathione (GSH), superoxide dismutase (SOD), and isoprostanes were found to be the most commonly used markers to assess oxidative stress in T2DM. These markers help to assess oxidative stress levels in T2DM individuals as well as correlate with diabetic complications. Therefore, assessment and understanding of the role of oxidative stress in T2DM pathophysiology are crucial for improving patient care and mitigating complications.
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Affiliation(s)
- Sabitha S
- Department of Biochemistry, Srinivas Institute of Allied Health Sciences, Mangalore, IND
| | - Shreelaxmi V Hegde
- Department of Biochemistry, Srinivas Institute of Medical Sciences and Research Center, Srinivas University, Mangalore, IND
- Department of Biochemistry, Rajiv Gandhi University of Health Science, Bengaluru, IND
| | | | - Delna Ns
- Department of Paramedical Sciences, EMS Memorial Cooperative Hospital and Research Centre - College of Paramedical Sciences, Malappuram, IND
| | - Ajita Pillai
- Biological Sciences, DELBIODESK - Research and Innovations, Bhopal, IND
| | | | - Ramjeela S
- Department of Pathology, Srinivas Institute of Medical Science and Research Center, Mangalore, IND
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2
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Oussaada SM, Kilicarslan M, de Weijer BA, Gilijamse PW, Şekercan A, Virtue S, Janssen IMC, van de Laar A, Demirkiran A, van Wagensveld BA, Houdijk APJ, Jongejan A, Moerland PD, Verheij J, Geijtenbeek TB, Bloks VW, de Goffau MC, Romijn JA, Nieuwdorp M, Vidal-Puig A, Ter Horst KW, Serlie MJ. Tissue-specific inflammation and insulin sensitivity in subjects with obesity. Diabetes Res Clin Pract 2024; 211:111663. [PMID: 38616042 DOI: 10.1016/j.diabres.2024.111663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/16/2024]
Abstract
Obesity is associated with low-grade inflammation and insulin resistance (IR). The contribution of adipose tissue (AT) and hepatic inflammation to IR remains unclear. We conducted a study across three cohorts to investigate this relationship. The first cohort consists of six women with normal weight and twenty with obesity. In women with obesity, we found an upregulation of inflammatory markers in subcutaneous and visceral adipose tissue, isolated AT macrophages, and the liver, but no linear correlation with tissue-specific insulin sensitivity. In the second cohort, we studied 24 women with obesity in the upper vs lower insulin sensitivity quartile. We demonstrated that several omental and mesenteric AT inflammatory genes and T cell-related pathways are upregulated in IR, independent of BMI. The third cohort consists of 23 women and 18 men with obesity, studied before and one year after bariatric surgery. Weight loss following surgery was associated with downregulation of multiple immune pathways in subcutaneous AT and skeletal muscle, alongside notable metabolic improvements. Our results show that obesity is characterised by systemic and tissue-specific inflammation. Subjects with obesity and IR show a more pronounced inflammation phenotype, independent of BMI. Bariatric surgery-induced weight loss is associated with reduced inflammation and improved metabolic health.
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Affiliation(s)
- S M Oussaada
- Amsterdam UMC Location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands
| | - M Kilicarslan
- Amsterdam UMC Location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands
| | - B A de Weijer
- Amsterdam UMC Location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands
| | - P W Gilijamse
- Amsterdam UMC Location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands
| | - A Şekercan
- Amsterdam UMC Location University of Amsterdam, Department of Public Health, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Department of Surgery, Meibergdreef 9, Amsterdam, the Netherlands
| | - S Virtue
- MRC Metabolic Diseases Unit, University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - I M C Janssen
- Nederlandse Obesitas Kliniek, Departement of Science, Huis ter Heide, the Netherlands
| | - A van de Laar
- Spaarne Gasthuis, Department of Surgery, Haarlem, the Netherlands
| | - A Demirkiran
- Red Cross Hospital, Department of Gastrointestinal Surgery, Beverwijk, the Netherlands
| | - B A van Wagensveld
- NMC Royal Hospital, Department of Surgery, Abu Dhabi, United Arab Emirates
| | - A P J Houdijk
- Northwest Clinics, Department of Surgery, Alkmaar, the Netherlands
| | - A Jongejan
- Amsterdam UMC Location University of Amsterdam, Epidemiology and Data Science, Amsterdam, the Netherlands; Amsterdam Public Health, Methodology, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Inflammatory Diseases, Amsterdam, the Netherlands
| | - P D Moerland
- Amsterdam UMC Location University of Amsterdam, Epidemiology and Data Science, Amsterdam, the Netherlands; Amsterdam Public Health, Methodology, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Inflammatory Diseases, Amsterdam, the Netherlands
| | - J Verheij
- Amsterdam UMC Location University of Amsterdam, Department of Pathology, Amsterdam, the Netherlands
| | - T B Geijtenbeek
- Amsterdam UMC Location University of Amsterdam, Laboratory for Experimental Immunology, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Cancer Immunology, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Immunology, Amsterdam, the Netherlands
| | - V W Bloks
- University Medical Center Groningen, Department of Paediatrics, University of Groningen, Groningen, the Netherlands
| | - M C de Goffau
- Amsterdam UMC Location University of Amsterdam, Department of Experimental Vascular Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Wellcome Trust Sanger Institute, Hinxton, UK; Amsterdam UMC, Tytgat Institute for Liver and Intestinal Research, Meibergdreef 9, Amsterdam, the Netherlands
| | - J A Romijn
- Amsterdam UMC Location University of Amsterdam, Department of Internal Medicine, Meibergdreef 9, Amsterdam, the Netherlands
| | - M Nieuwdorp
- Amsterdam UMC Location University of Amsterdam, Department of Vascular Medicine, Meibergdreef 9, Amsterdam, the Netherlands
| | - A Vidal-Puig
- MRC Metabolic Diseases Unit, University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - K W Ter Horst
- Amsterdam UMC Location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands
| | - M J Serlie
- Amsterdam UMC Location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Section of Endocrinology, Yale School of Medicine, New Haven, USA.
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3
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Zu C, Liu M, Su X, Wei Y, Meng Q, Liu C, Ye Z, Gan X, Zhang Y, He P, Zhou C, Hou FF, Qin X. Association of Body Weight Time in Target Range With the Risk of Kidney Outcomes in Patients With Overweight/Obesity and Type 2 Diabetes Mellitus. Diabetes Care 2024; 47:371-378. [PMID: 38079259 DOI: 10.2337/dc23-1727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/28/2023] [Indexed: 02/25/2024]
Abstract
OBJECTIVE We assessed the relationship of body weight time in target range (TTR) with composite kidney outcome in people with overweight/obesity and type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS Included in this study were 3,601 participants with baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 from the Look AHEAD (Action for Health in Diabetes) trial. Body weight TTR was defined as the proportion of time during the first 4 years that body weight was within the weight loss target (a weight loss of ≥7% from baseline). The primary outcome was composite kidney outcome, defined as eGFR decline ≥30% from baseline and to a level <60 mL/min/1.73 m2 at follow-up visit, or end-stage kidney disease. RESULTS During a median follow-up of 8.0 years, 435 cases of composite kidney outcome were documented. Body weight TTR during the first 4 years was inversely associated with the subsequent risk of composite kidney outcome (per SD increment; adjusted hazard ratio [HR] 0.81; 95% CI 0.70-0.93). Accordingly, the adjusted HRs (95% CI) of composite kidney outcome were 1.00 (reference), 0.73 (0.54-1.00), 0.71 (0.52-0.99), and 0.54 (0.36-0.80) for participants with body weight TTR of 0%, >0% to <29.9%, 29.9% to <69.7%, and 69.7% to <100%, respectively. Similar results were found for a doubling of the urine albumin to creatinine ratio (secondary outcome). CONCLUSIONS A higher body weight TTR, with a weight loss target of losing ≥7% of initial weight, was associated with a lower risk of kidney outcomes in participants with overweight/obesity and T2DM.
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Affiliation(s)
- Cheng Zu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xinyue Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Yuanxiu Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Qiguo Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Chengzhang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
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Gajewska A, Strzelecki D, Gawlik-Kotelnicka O. Ghrelin as a Biomarker of "Immunometabolic Depression" and Its Connection with Dysbiosis. Nutrients 2023; 15:3960. [PMID: 37764744 PMCID: PMC10537261 DOI: 10.3390/nu15183960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Ghrelin, a gastrointestinal peptide, is an endogenous ligand of growth hormone secretagogue receptor 1a (GHSR1a), which is mainly produced by X/A-like cells in the intestinal mucosa. Beyond its initial description as a growth hormone (GH) secretagogue stimulator of appetite, ghrelin has been revealed to have a wide range of physiological effects, for example, the modulation of inflammation; the improvement of cardiac performance; the modulation of stress, anxiety, taste sensation, and reward-seeking behavior; and the regulation of glucose metabolism and thermogenesis. Ghrelin secretion is altered in depressive disorders and metabolic syndrome, which frequently co-occur, but it is still unknown how these modifications relate to the physiopathology of these disorders. This review highlights the increasing amount of research establishing the close relationship between ghrelin, nutrition, microbiota, and disorders such as depression and metabolic syndrome, and it evaluates the ghrelinergic system as a potential target for the development of effective pharmacotherapies.
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Affiliation(s)
- Agata Gajewska
- Faculty of Medicine, Medical University of Lodz, 92-216 Lodz, Poland;
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland;
| | - Oliwia Gawlik-Kotelnicka
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland;
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5
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Abulmeaty MMA, Ghneim HK, Alkhathaami A, Alnumair K, Al Zaben M, Razak S, Al-Sheikh YA. Inflammatory Cytokines, Redox Status, and Cardiovascular Diseases Risk after Weight Loss via Bariatric Surgery and Lifestyle Intervention. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:751. [PMID: 37109709 PMCID: PMC10145023 DOI: 10.3390/medicina59040751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: Obesity is a chronic inflammatory condition and is considered a major risk factor for cardiovascular disease (CVD). The effects of obesity management via sleeve gastrectomy (SG) and lifestyle intervention (LS) on inflammatory cytokines, redox status, and CVD risk were studied in this work. Materials and Methods: A total of 92 participants (18 to 60 years old) with obesity (BMI ≥ 35 kg/m2 were divided into two groups: the bariatric surgery (BS) group (n = 30), and the LS group (n = 62). According to the achievement of 7% weight loss after 6 months, the participants were allocated to either the BS group, the weight loss (WL) group, or the weight resistance (WR) group. Assessments were performed for body composition (by bioelectric impedance), inflammatory markers (by ELISA kits), oxidative stress (OS), antioxidants (by spectrophotometry), and CVD risk (by the Framingham risk score (FRS) and lifetime atherosclerotic cardiovascular disease risk (ASCVD)). Measurements were taken before and after six months of either SG or LS (500 kcal deficit balanced diet, physical activity, and behavioral modification). Results: At the final assessment, only 18 participants in the BS group, 14 participants in the WL group, and 24 participants in the WR group remained. The loss in fat mass (FM) and weight loss were greatest in the BS group (p < 0.0001). Levels of IL-6, TNF-a, MCP-1, CRP, and OS indicators were significantly reduced in the BS and WL groups. The WR group had significant change only in MCP-1 and CRP. Significant reductions in the CVD risk in the WL and BS groups were detected only when using FRS rather than ASCVD. The FM loss correlated inversely with FRS-BMI and ASCVD in the BS group, whereas in the WL group, FM loss correlated only with ASCVD. Conclusions: BS produced superior weight and fat mass loss. However, both BS and LS produced a similar reduction in the inflammatory cytokines, relief of OS indicators, and enhancement of antioxidant capacity, and consequently reduced the CVD risk.
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Affiliation(s)
- Mahmoud M. A. Abulmeaty
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.A.); (K.A.); (S.R.)
| | - Hazem K. Ghneim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia; (H.K.G.)
| | - Abdulaziz Alkhathaami
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.A.); (K.A.); (S.R.)
| | - Khalid Alnumair
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.A.); (K.A.); (S.R.)
| | - Mohamed Al Zaben
- Surgery Department, Sultan Bin Abdulaziz Humanitarian City, Riyadh 13571, Saudi Arabia;
| | - Suhail Razak
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.A.); (K.A.); (S.R.)
| | - Yazeed A. Al-Sheikh
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia; (H.K.G.)
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Papagianni G, Panayiotou C, Vardas M, Balaskas N, Antonopoulos C, Tachmatzidis D, Didangelos T, Lambadiari V, Kadoglou NPE. The anti-inflammatory effects of aerobic exercise training in patients with type 2 diabetes: A systematic review and meta-analysis. Cytokine 2023; 164:156157. [PMID: 36842369 DOI: 10.1016/j.cyto.2023.156157] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/07/2023] [Accepted: 02/03/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a low-grade, chronic inflammatory disease, associated with increased cardiovascular risk. The purpose of this systematic review/ meta-analysis was to evaluate the effects of aerobic exercise training (AET) on inflammatory markers in T2DM patients. METHODS The literature search was conducted utilizing PubMed, Web of Science, Embase, and the Cochrane Library from their inception up to April 2022. We screened only for randomized controlled trials (RCTs) investigating the effects of AET on C-reactive protein (CRP) and adipokines: adiponectin, resistin, interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-a), along with changes in anthropometric indices and glycemic control in adult T2DM patients. Pooled post-exercise weighted mean differences (WMDs) with 95% Confidence Intervals (CIs) were calculated for all outcomes of interest between exercise-treated patients and controls. RESULTS Twenty-six RCTs involving 1239 T2DM patients were retrieved from the databases for meta-analysis. The cumulative results showed that post-AET inflammatory markers were lower in exercise-treated patients compared to controls regarding CRP (mg/L): WMD: -0.91; 95%CIs: -1.43, -0.40; p < 0.001 resistin (mg/ml): (WMD: -2.08; 95%CIs: -3.32, -0.84; p < 0.001); TNF-a (pg/ml): (WMD: -2.70; 95%CIs: -4.26, -1.14; p < 0.001), and IL-6 (pg/ml): (WMD: -1.05; 95%CIs: -1.68, -0.43; p < 0.001). Those effects were accompanied by significant amelioration of fasting glucose (mg/dl) (WMD: -13.02; 95%CIs: -25.39, -0.66; p = 0.04), HbA1c (%) (WMD: -0.51; 95%CIs: -0.73, -0.28, p < 0.001), and fat mass (%) (WMD: -3.14; 95%CI: -4.71, -1.58; p < 0.001). Our meta-analysis demonstrated less-consistent results for adiponectin (μg/ml), (WMD: 1.00; 95%CI: -0.12, 2.12; p = 0.08) and body-mass index (kg/m2) (WMD: -1.34; 95%CI: -2.76, 0.08; p = 0.06) tending to differ between AET and control group. CONCLUSIONS AET can significantly reduce the inflammatory burden in T2DM patients. by ameliorating the circulating levels of CRP, resistin, TNF-a and IL-6, even without accompanied significant weight-loss. The clinical impact of those anti-inflammatory effects of AET needs to be determined.
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Affiliation(s)
- Georgia Papagianni
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | | - Constantinos Antonopoulos
- Department of Vascular Surgery, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | | | | | - Vaia Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, Attikon University General Hospital, Athens, Greece
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7
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Salama II, Sami SM, Salama SI, Abdel-Latif GA, Aboulghate A, Raslan HM, Mohsen A, Rasmy H, Ibrahim MH, Ganem MMF, Abdelmohsen AM, El-Etreby LA, Ibrahim NA, Fouad WA, El-Deeb SE. Impact of lifestyle modification on glycemic control and cognitive function among Type II diabetes mellitus patients. Future Sci OA 2023; 9:FSO835. [PMID: 37006227 PMCID: PMC10051212 DOI: 10.2144/fsoa-2022-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
Aim: Assessing impact of lifestyle modification on Type 2 diabetes mellitus (T2DM) glycemic control and cognitive function. Subjects & methods: Prospective study was conducted on T2DM patients (92 patients as interventional group and 92 patients conventional therapy). Results: After 6 months, significant improvements of HbA1c, oxidant and antioxidant, lipid profile, and cognitive function among only the interventional group (p < 0.05). Using logistic analysis, conventional therapy, DM duration >10 years, lower education, HbA1c baseline >7 were significant predictive risks for uncontrolled DM (AOR 4.2, 2.9, 2.7 and 2.2, respectively). While, conventional therapy, baseline mild cognitive impairment (MCI) and females were significant risks for MCI (AOR 11.5, 10.8 and 4.8, respectively). Conclusion: Lifestyle modification is a very important for glycemic control and cognitive function. Clinical Trial Registration: NCT04891887 ( ClinicalTrials.gov )
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Affiliation(s)
- Iman I Salama
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Samia M Sami
- Child Health Department, National Research Center, Cairo, 12622, Egypt
| | - Somaia I Salama
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Ghada A Abdel-Latif
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Ahmed Aboulghate
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Hala M Raslan
- Internal Medicine Department, National Research Center, Cairo, 12622, Egypt
| | - Amira Mohsen
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Hanaa Rasmy
- Clinical & Chemical Pathology Department, Centre of Excellence, National Research Centre, Cairo, 12622, Egypt
| | - Mona Hamed Ibrahim
- Clinical & Chemical Pathology Department, Centre of Excellence, National Research Centre, Cairo, 12622, Egypt
| | - Mona MF Ganem
- Internal Medicine Department, National Research Center, Cairo, 12622, Egypt
| | - Aida M Abdelmohsen
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Lobna A El-Etreby
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Nihad A Ibrahim
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Walaa A Fouad
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Sherif E El-Deeb
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
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8
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Fallah F, Mahdavi R. L-Carnitine and synbiotic co-supplementation: beneficial effects on metabolic-endotoxemia, meta-inflammation, and oxidative-stress biomarkers in obese patients: a double blind, randomized, controlled clinical trial. Food Funct 2023; 14:2172-2187. [PMID: 36752775 DOI: 10.1039/d2fo03348h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Obesity, a chronic pandemic disease, is characterized by low-grade chronic inflammation, accompanied by over-expression of pro-inflammatory cytokines, thereby contributing to metabolic disorders pathogenesis. Oxidative-stress, an adverse cellular response to adipocyte hypertrophy, promotes inflammation. Furthermore, gut-microbiota dysbiosis may induce oxidative-stress, low-grade inflammation, and metabolic-endotoxemia as major drivers of obesity. Functional-foods/nutraceuticals have attracted extensive attention due to their plausible anti-inflammatory/anti-oxidative properties; evidence supports the superiority of the nutraceutical combined-supplementation approach versus conventional mono-therapies. Current data suggest the anti-oxidative/anti-inflammatory properties of either L-carnitine or pre/pro/synbiotics. This trial compared the effects of co-supplementing L-carnitine and multi-species/multi-strain synbiotic versusL-carnitine mono-therapy on inflammatory/anti-inflammatory, oxidative-stress, and metabolic-endotoxemia biomarkers in 46 female obese patients, receiving either co-supplementation (L-carnitine-tartrate (2 × 500 mg d-1) + multi-species/multi-strain synbiotic (1 capsule per day)) or mono-therapy (L-carnitine-tartrate (2 × 500 mg d-1) + maltodextrin (1 capsule per day)) for eight weeks. L-Carnitine + synbiotic co-supplementation significantly decreased interleukin-6 (IL-6, -33.98%), high-sensitivity-C-reactive-protein (hs-CRP, -10%), tumor-necrosis-factor-alpha (TNF-α, -18.73%), malondialdehyde (MDA, -21.73%), and lipopolysaccharide (LPS, -10.14%), whereas the increase in interleukin-10 (IL-10, 7.69%) and total-antioxidant-capacity (TAC, 4.13%) levels was not significant. No significant changes were observed for the above-mentioned parameters in the L-carnitine + placebo group, except for a significant reduction in IL-10 (-17.59%) and TNF-α (-14.78%); however, between-group differences did not reach the significant threshold. Co-supplementing L-carnitine + multi-strain synbiotic led to significant amelioration of inflammatory, oxidative, and metabolic-endotoxemia responses in female obese patients; nevertheless, no improving effects were observed in patients receiving single-supplementation, suggesting that L-carnitine + synbiotic co-supplementation might represent an adjuvant approach to improve oxidative-stress/pro-inflammatory indicators in women with obesity, possibly through beneficial effects of the synbiotic alone. Further longer duration studies with higher doses of L-carnitine in a three-group setting are warranted to elucidate the possibility of synergistic or complementary mechanisms.
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Affiliation(s)
- Farnoush Fallah
- Student Research Committee, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Reza Mahdavi
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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Liu S, Zeng M, Wan W, Huang M, Li X, Xie Z, Wang S, Cai Y. The Health-Promoting Effects and the Mechanism of Intermittent Fasting. J Diabetes Res 2023; 2023:4038546. [PMID: 36911497 PMCID: PMC10005873 DOI: 10.1155/2023/4038546] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 01/15/2023] [Accepted: 01/23/2023] [Indexed: 03/06/2023] Open
Abstract
Intermittent fasting (IF) is an eating pattern in which individuals go extended periods with little or no energy intake after consuming regular food in intervening periods. IF has several health-promoting effects. It can effectively reduce weight, fasting insulin levels, and blood glucose levels. It can also increase the antitumor activity of medicines and cause improvement in the case of neurological diseases, such as memory deficit, to achieve enhanced metabolic function and prolonged longevity. Additionally, IF activates several biological pathways to induce autophagy, encourages cell renewal, prevents cancer cells from multiplying and spreading, and delays senescence. However, IF has specific adverse effects and limitations when it comes to people of a particular age and gender. Hence, a more systematic study on the health-promoting effects and safety of IF is needed. This article reviewed the research on the health-promoting effects of IF, providing a theoretical basis, direction for subsequent basic research, and information related to the clinical application of IF.
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Affiliation(s)
- Simin Liu
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Min Zeng
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Weixi Wan
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Ming Huang
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Xiang Li
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Zixian Xie
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Shang Wang
- College of Clinical Chinese Medicine, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Yu Cai
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan 430065, China
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10
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Parveen S, Alhazmi YA. Impact of Intermittent Fasting on Metabolic Syndrome and Periodontal Disease-A Suggested Preventive Strategy to Reduce the Public Health Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14536. [PMID: 36361416 PMCID: PMC9657467 DOI: 10.3390/ijerph192114536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 05/27/2023]
Abstract
Metabolic syndrome (MetS) prevalence continues to climb significantly worldwide in today's ad libitum society. MetS has tremendous societal and economic ramifications, making it imperative to develop effective strategies for preventing and controlling it to alleviate this growing burden. Periodontal disease and MetS are associated with several risk factors. Studies in the past have demonstrated that obesity, cardiovascular illness, and type 2 diabetes mellitus have a negative effect on the severity of the periodontal disease. Patients with metabolic syndrome have elevated serum levels of proinflammatory mediators such as tumor necrosis factor-alpha interleukin-6 and C-reactive protein. Similar inflammatory mediators, such as interleukin-6, tumor necrosis factor-alpha, and C-reactive protein, are increased in patients with severe periodontal disease. Remarkably, intermittent fasting is underpinned by scientific evidence, claiming to be the most effective non-pharmacological, potential therapeutic alternative for combating a wide range of metabolic, inflammatory, and lifestyle-related diseases. Nonetheless, an insufficient investigation has been performed to determine whether intermittent fasting has therapeutic benefits on periodontal inflammation and diseases. Here, we show the interrelationship between metabolic syndrome and periodontal disease and contextualize the beneficial impact of intermittent fasting in modulating the chronic metabolic and periodontal inflammatory response. We also anticipate that this review paves the way for further exploration of intermittent fasting as a unique research paradigm representing a cost-effective alternative strategy to conventional disease management in patients with periodontal diseases and metabolic syndrome which may serve as the foundation for an integrative vision relevant to primary, diagnostic, and therapeutic purposes.
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Affiliation(s)
- Sameena Parveen
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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11
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Asghari S, Rezaei M, Rafraf M, Taghizadeh M, Asghari-Jafarabadi M, Ebadi M. Effects of Calorie Restricted Diet on Oxidative/Antioxidative Status Biomarkers and Serum Fibroblast Growth Factor 21 Levels in Nonalcoholic Fatty Liver Disease Patients: A Randomized, Controlled Clinical Trial. Nutrients 2022; 14:nu14122509. [PMID: 35745238 PMCID: PMC9231395 DOI: 10.3390/nu14122509] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
Oxidative stress plays a fundamental role in the development and progression of nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the effects of a calorie-restricted (CR) diet on oxidative/anti-oxidative status in patients with NAFLD and the potential mediating role of fibroblast growth factor 21 (FGF-21) in this regard. This randomized, controlled clinical trial was carried out on sixty patients with NAFLD aged 20 to 60 years with body mass index (BMI) ranging from 25 to 35 kg/m2. Participants were randomly assigned to either the CR diet group (received a prescribed low-calorie diet for twelve weeks, n = 30) or the control group (n = 30). Fasting blood samples, anthropometric measurements, dietary intake, and physical activity data were collected for all participants at baseline and at the end of the trial. Significant reductions in weight, BMI, waist circumference, and serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were observed in the CR diet group compared to the control group (all p < 0.05). Liver steatosis grade, serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), and FGF-21, as well as erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities did not show significant changes in the CR group when compared to the controls at the end of the study (p > 0.05). CR diet with moderate weight loss has some favorable effects on NAFLD but was not able to modify oxidative/anti-oxidative status in these patients. Future studies are warranted to target the effects of long-term interventions with a greater weight loss in this patient population.
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Affiliation(s)
- Somayyeh Asghari
- Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 141556117, Iran; (S.A.); (M.R.); (M.T.)
| | - Mahsa Rezaei
- Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 141556117, Iran; (S.A.); (M.R.); (M.T.)
| | - Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran;
| | - Mahdiyeh Taghizadeh
- Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 141556117, Iran; (S.A.); (M.R.); (M.T.)
| | - Mohammad Asghari-Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran;
- Cabrini Research, Cabrini Health, 154 Wattletree Rd, Malvern, VIC 3144, Australia
| | - Maryam Ebadi
- Division of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB T6G 2X8, Canada
- Correspondence: ; Tel.: +1-780-248-1892
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Kanikowska D, Kanikowska A, Swora-Cwynar E, Grzymisławski M, Sato M, Bręborowicz A, Witowski J, Korybalska K. Moderate Caloric Restriction Partially Improved Oxidative Stress Markers in Obese Humans. Antioxidants (Basel) 2021; 10:antiox10071018. [PMID: 34202775 PMCID: PMC8300641 DOI: 10.3390/antiox10071018] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022] Open
Abstract
Oxidative stress and inflammation are implicated in obesity. Therefore, we investigated whether moderate and short-term calorie restriction (CR) reflects a real-life situation, mediates weight loss, and improves oxidative stress markers. We analyzed oxidative stress markers in patients with obesity undergoing moderate CR. Serum oxidative stress markers (myeloperoxidase (MPO), superoxide dismutase (SOD), catalase, total antioxidant status (TAS), and reactive oxygen species (ROS) (generation by endothelial cells in vitro)) were measured in 53 subjects (mean BMI 37.8 ± 5.9 kg/m2) who underwent 8 weeks of CR, which included a reduction of 300-500 kcal/day. MPO was the most CR-sensitive parameter. The mean level of serum MPO in patients with obesity was 20% higher than that in post CR intervention (p < 0.001). SOD increased by 12% after CR (p < 0.05), which was largely due to the improvement in glucose tolerance and the reduction in insulin resistance after CR. Other tested parameters were not modified during the treatment. CR resulted in an expected decrease in body weight (by 5.9 ± 4.6 kg, p < 0.0001) and other anthropometric parameters. Additionally, it was accompanied by a significant change in hsCRP, hsTNF alpha, hsIL-6, leptin (all p < 0.0001), and HOMA-IR (p < 0.05). Cardiovascular and metabolic parameters were also partially improved. Short-term, moderate CR partially improves antioxidant capacity but is enough to substantially change anthropometric parameters in obese patients. Our observations indicate that mimicking real-life situations and low-cost dietary intervention can be successfully implemented in obesity treatment with a simultaneous moderate effect on antioxidant status.
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Affiliation(s)
- Dominika Kanikowska
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.B.); (J.W.); (K.K.)
- Correspondence:
| | - Alina Kanikowska
- Department of Internal Diseases, Metabolism and Nutrition, Poznań University of Medical Science, 60-355 Poznań, Poland; (A.K.); (E.S.-C.); (M.G.)
| | - Ewelina Swora-Cwynar
- Department of Internal Diseases, Metabolism and Nutrition, Poznań University of Medical Science, 60-355 Poznań, Poland; (A.K.); (E.S.-C.); (M.G.)
| | - Marian Grzymisławski
- Department of Internal Diseases, Metabolism and Nutrition, Poznań University of Medical Science, 60-355 Poznań, Poland; (A.K.); (E.S.-C.); (M.G.)
| | - Maki Sato
- Department of Physiology, Institutional Research, Aichi Medical University School of Medicine, Aichi Medical University, Aichi 480-1195, Japan;
| | - Andrzej Bręborowicz
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.B.); (J.W.); (K.K.)
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.B.); (J.W.); (K.K.)
| | - Katarzyna Korybalska
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.B.); (J.W.); (K.K.)
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Mladenovic Djordjevic A, Loncarevic-Vasiljkovic N, Gonos ES. Dietary Restriction and Oxidative Stress: Friends or Enemies? Antioxid Redox Signal 2021; 34:421-438. [PMID: 32242468 DOI: 10.1089/ars.2019.7959] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Significance: It is well established that lifestyle and dietary habits have a tremendous impact on life span, the rate of aging, and the onset/progression of age-related diseases. Specifically, dietary restriction (DR) and other healthy dietary patterns are usually accompanied by physical activity and differ from Western diet that is rich in fat and sugars. Moreover, as the generation of reactive oxidative species is the major causative factor of aging, while DR could modify the level of oxidative stress, it has been proposed that DR increases both survival and longevity. Recent Advances: Despite the documented links between DR, aging, and oxidative stress, many issues remain to be addressed. For instance, the free radical theory of aging is under "re-evaluation," while DR as a golden standard for prolonging life span and ameliorating the effects of aging is also under debate. Critical Issues: This review article pays special attention to highlight the link between DR and oxidative stress in both aging and age-related diseases. We discuss in particular DR's capability to counteract the consequences of oxidative stress and the molecular mechanisms involved in these processes. Future Directions: Although DR is undoubtedly beneficial, several considerations must be taken into account when designing the best dietary intervention. Use of intermittent fasting, daily food reduction, or DR mimetics? Future research should unravel the pros and cons of all these processes. Antioxid. Redox Signal. 34, 421-438.
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Affiliation(s)
- Aleksandra Mladenovic Djordjevic
- Department for Neurobiology, Institute for Biological Research "Sinisa Stankovic," National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Natasa Loncarevic-Vasiljkovic
- Department for Neurobiology, Institute for Biological Research "Sinisa Stankovic," National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Efstathios S Gonos
- Institute of Biology, Medicinal Chemistry and Biotechnology, National Hellenic Research Foundation, Athens, Greece
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Chen X, Sun X, Wang C, He H. Effects of Exercise on Inflammatory Cytokines in Patients with Type 2 Diabetes: A Meta-analysis of Randomized Controlled Trials. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:6660557. [PMID: 33456672 PMCID: PMC7785348 DOI: 10.1155/2020/6660557] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Inflammation is involved in the pathogenesis of type 2 diabetes (T2DM) and the occurrence of insulin resistance. The purpose of this study was to investigate the effects of exercise on inflammatory factors in patients with T2DM. METHODS A systematic review was conducted on five databases, Cochrane, Embase, Pubmed, Web of Science, and EBSCO. All randomized controlled trials (RCTs) published between establishment of the database and November 2020 without restrictions on language were included. Studies evaluated the effects of exercise intervention on inflammatory cytokines in patients with T2DM were selected. RESULTS Twenty-three randomized controlled trials (1350 patients) were included in our meta-analysis. Exercise can significantly reduce the level of C-reactive protein (CRP) (MD: -0.79, 95% CI: -1.26 to -0.33, p = 0.0008), tumor necrosis factor-α (TNF-α) (MD: -2.33, 95% CI: -3.39 to -1.27, p < 0.0001), and interleukin-6 (IL-6) (MD: -0.42, 95% CI: -0.60 to -0.24, p < 0.0001) in T2DM patients. CONCLUSION The findings of this review suggest that exercise reduces inflammatory cytokines (CRP, TNF-α, and IL-6) in T2DM patients. More studies with high methodological qualities and large sample sizes need to be done to confirm which forms of exercise are most effective.
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Affiliation(s)
- Xiaoke Chen
- School of Sport Science, Beijing Sport University, 100084, China
| | - Xinzheng Sun
- School of Sport Science, Beijing Sport University, 100084, China
| | - Chenghao Wang
- School of Sport Science, Beijing Sport University, 100084, China
| | - Hui He
- School of Sport Science, Beijing Sport University, 100084, China
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15
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Chan SW, Tomlinson B. Effects of Bilberry Supplementation on Metabolic and Cardiovascular Disease Risk. Molecules 2020; 25:E1653. [PMID: 32260262 PMCID: PMC7180827 DOI: 10.3390/molecules25071653] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome is a cluster of interrelated conditions that is associated with an increased risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Oxidative stress may impair normal physiological functions, leading to various illnesses. T2DM is considered to be associated with increased oxidative stress, inflammation, and dyslipidemia, which may play a significant role in the development of cardiovascular complications, cancer and vision loss through cataracts and retinopathy. While conventional therapies are a cornerstone for the management of the major risk factors of metabolic syndrome, increasing antioxidant defense by increasing intake of antioxidant-rich foods may improve long term prospects in CVD, obesity and T2DM. Bilberry (Vaccinium myrtillus L.) is one of the richest natural sources of anthocyanins which give berries their red/purple/blue coloration. Anthocyanins are powerful antioxidants and are reported to play an important role in the prevention of metabolic disease and CVD as well as cancer and other conditions. This review focuses on the potential effects of bilberry supplementation on metabolic and cardiovascular risk factors. Although there is evidence to support the use of bilberry supplementation as part of a healthy diet, the potential benefits from the use of bilberry supplementation in patients with T2DM or CVD needs to be clarified in large clinical trials.
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Affiliation(s)
- Sze Wa Chan
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR 999077, China
| | - Brian Tomlinson
- Faculty of Medicine, Macau University of Science & Technology, Macau 853, China
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Jahrami HA, Alsibai J, Clark CCT, Faris MAIE. A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on body weight in healthy subjects aged 16 years and above. Eur J Nutr 2020; 59:2291-2316. [DOI: 10.1007/s00394-020-02216-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/26/2020] [Indexed: 12/13/2022]
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Liu J, Chen S, Biswas S, Nagrani N, Chu Y, Chakrabarti S, Feng B. Glucose-induced oxidative stress and accelerated aging in endothelial cells are mediated by the depletion of mitochondrial SIRTs. Physiol Rep 2020; 8:e14331. [PMID: 32026628 PMCID: PMC7002531 DOI: 10.14814/phy2.14331] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Diabetic complications cause significant morbidity and mortality. Dysfunction of vascular endothelial cells (ECs), caused by oxidative stress, is a main mechanism of cellular damage. Oxidative stress accelerates EC senescence and DNA damage. In this study, we examined the role of mitochondrial sirtuins (SIRTs) in glucose-induced oxidative stress, EC senescence, and their regulation by miRNAs. Human retinal microvascular endothelial cells (HRECs) were exposed to 5 mmol/L (normoglycemia; NG) or 25 mmol/L glucose (hyperglycemia; HG) with or without transfection of miRNA antagomirs (miRNA-1, miRNA-19b, and miRNA-320; specific SIRT-targeting miRNAs). Expressions of SIRT3, 4 and 5 and their targeting miRNAs were examined using qRT-PCR and ELISAs were used to study SIRT proteins. Cellular senescence was investigated using senescence-associated β-gal stain; while, oxidative stress and mitochondrial alterations were examined using 8-OHdG staining and cytochrome B expressions, respectively. A streptozotocin-induced diabetic mouse model was also used and animal retinas and hearts were collected at 2 months of diabetes. In HRECs, HG downregulated the mRNAs of SIRTs, while SIRT-targeting miRNAs were upregulated. ELISA analyses confirmed such downregulation of SIRTs at the protein level. HG additionally caused early senescence, endothelial-to-mesenchymal transition and oxidative DNA damage in ECs. These changes were prevented by the transfection of specific miRNA antagomirs and by resveratrol. Retinal and cardiac tissues from diabetic mice also showed similar reductions of mitochondrial SIRTs. Collectively, these findings demonstrate a novel mechanism in which mitochondrial SIRTs regulate glucose-induced cellular aging through oxidative stress and how these SIRTs are regulated by specific miRNAs. Identifying such mechanisms may lead to the discovery of novel treatments for diabetic complications.
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Affiliation(s)
- Jieting Liu
- Department of Pathology and Laboratory MedicineWestern UniversityLondonONCanada
- Mudanjiang Medical UniversityHeilongjiangPR China
| | - Shali Chen
- Department of Pathology and Laboratory MedicineWestern UniversityLondonONCanada
| | - Saumik Biswas
- Department of Pathology and Laboratory MedicineWestern UniversityLondonONCanada
| | - Niharika Nagrani
- Department of Pathology and Laboratory MedicineWestern UniversityLondonONCanada
| | - Yanhui Chu
- Mudanjiang Medical UniversityHeilongjiangPR China
| | - Subrata Chakrabarti
- Department of Pathology and Laboratory MedicineWestern UniversityLondonONCanada
| | - Biao Feng
- Department of Pathology and Laboratory MedicineWestern UniversityLondonONCanada
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El-Shiekh RA, Al-Mahdy DA, Mouneir SM, Hifnawy MS, Abdel-Sattar EA. Anti-obesity effect of argel (Solenostemma argel) on obese rats fed a high fat diet. JOURNAL OF ETHNOPHARMACOLOGY 2019; 238:111893. [PMID: 30999011 DOI: 10.1016/j.jep.2019.111893] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 04/09/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Solenostemma argel (Argel) is a desert plant commonly used in Egyptian and Sudanese traditional medicine to suppress appetite, for treatment of diabetes, and as an antispasmodic and anti-inflammatory agent. Previously the anti-diabetic, hypolipidemic and lipase inhibitory activities of Argel were reported in animal studies and in-vitro assays. However, its specific mechanism of action as an anti-obesity agent has not been studied before. AIM OF THE STUDY Assessment of the possible anti-obesity effect of Solenostemma argel on diet-induced obesity and elucidation of its mechanism of action, as well as, standardization of the active plant extract. MATERIALS AND METHODS The ethanolic extract (EtOH-E) and its fractions (CH2Cl2-F: methylene chloride and BuOH-F: n-butanol) were prepared from the aerial parts of S. argel and studied at two dose levels; 200 and 400 mg kg-1 in a model of high fat diet (HFD) fed rats. The animals (72 Male Wister rats) were assigned into 9 groups: group (i) fed with normal diet and groups (ii-iv) fed with high fat diet (HFD) for 16 weeks and treated with orlistat, EtOH-E, CH2Cl2-F and BuOH-F in the beginning of the 8th week. At the end of the experiment, blood samples were analysed for lipid and liver biomarkers, glucose and insulin levels, as well as, adipokines and inflammatory markers. Liver and adipose tissues were examined histopathologically and their homogenates were used to determine levels of oxidative stress markers and lipogenesis-related genes. Body weight was monitored weekly during the experiment. RESULTS Our data showed that consumption of S. argel significantly controlled weight gain, attenuated liver steatosis, improved the lipid profile, modulated adipokines activities, increased β-oxidation gene expression, as well as, decreased the expression of lipogenesis-related genes and ameliorated inflammatory and lipid peroxidation derangement. The ethanolic extract was also standardized using LC-MS analysis for its content of stemmoside C. CONCLUSIONS The current study revealed that S. argel is a promising Egyptian natural drug, rich in pregnane glycosides, and could be considered a new therapeutic candidate targeting obesity.
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Affiliation(s)
- Riham A El-Shiekh
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Egypt.
| | - Dalia A Al-Mahdy
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Egypt.
| | - Samar M Mouneir
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Mohamed S Hifnawy
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Egypt.
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Ahmed A, Saeed F, Arshad MU, Afzaal M, Imran A, Ali SW, Niaz B, Ahmad A, Imran M. Impact of intermittent fasting on human health: an extended review of metabolic cascades. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2019. [DOI: 10.1080/10942912.2018.1560312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Aftab Ahmed
- Institute of Home & Food Sciences, Government College University, Faisalabad, Pakistan
| | - Farhan Saeed
- Institute of Home & Food Sciences, Government College University, Faisalabad, Pakistan
| | - Muhammad Umair Arshad
- Institute of Home & Food Sciences, Government College University, Faisalabad, Pakistan
| | - Muhammad Afzaal
- Institute of Home & Food Sciences, Government College University, Faisalabad, Pakistan
| | - Ali Imran
- Institute of Home & Food Sciences, Government College University, Faisalabad, Pakistan
| | - Shinawar Waseem Ali
- Institute of Agricultural Sciences, University of the Punjab, Lahore, Pakistan
| | - Bushra Niaz
- Institute of Home & Food Sciences, Government College University, Faisalabad, Pakistan
| | - Awais Ahmad
- Institute of Home & Food Sciences, Government College University, Faisalabad, Pakistan
| | - Muhammad Imran
- Faculty of Allied Health Sciences, University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
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20
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Jiang F, Zhi X, Xu M, Li B, Zhang Z. Gender-specific differences of interaction between cadmium exposure and obesity on prediabetes in the NHANES 2007-2012 population. Endocrine 2018; 61:258-266. [PMID: 29846900 DOI: 10.1007/s12020-018-1623-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/30/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Data from National Health and Nutrition Examination Survey (NHANES) for the years 2007-2012 were used to evaluate the interactions of cadmium (Cd) exposure with being overweight/obesity on the risk of prediabetes among adults 20 years older. METHODS A total of 3552 subjects were included in the analysis. Urinary cadmium levels (UCd) was used as a biomarker for long-term exposure to Cd. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). RESULTS Following covariates adjustments, we found significant associations of UCd with higher prediabetes prevalence, and this association was more apparent in males (Q4 vs Q1: OR = 1.95, 95%CI: 1.34-2.84); while overweight/obesity was associated with prediabetes both in males and in females. Additionally, there was a significant interaction between Cd exposure and being overweight/obesity on prediabetes risk among males (RERI = 1.18, 95% CI: 0.42-1.93; AP = 0.35, 95% CI: 0.12-0.58; S = 2.00, 95% CI: 0.92-4.34). CONCLUSIONS Our results suggest that being overweight/obesity may substantially amplify the adverse effects of long-term cadmium exposure on prediabetes risk, and this interaction is more severe in male adults. Further studies are needed to confirm these findings.
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Affiliation(s)
- Fei Jiang
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Xueyuan Zhi
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Miao Xu
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Bingyan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Zengli Zhang
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
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21
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Langhardt J, Flehmig G, Klöting N, Lehmann S, Ebert T, Kern M, Schön MR, Gärtner D, Lohmann T, Dressler M, Fasshauer M, Kovacs P, Stumvoll M, Dietrich A, Blüher M. Effects of Weight Loss on Glutathione Peroxidase 3 Serum Concentrations and Adipose Tissue Expression in Human Obesity. Obes Facts 2018; 11:475-490. [PMID: 30537708 PMCID: PMC6341324 DOI: 10.1159/000494295] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/05/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS Altered expression and circulating levels of glutathione peroxidase 3 (GPX3) have been observed in obesity and type 2 diabetes (T2D) across species. Here, we investigate whether GPX3 serum concentrations and adipose tissue (AT) GPX3 mRNA expression are related to obesity and weight loss. METHODS GPX3 serum concentration was measured in 630 individuals, including a subgroup (n = 293) for which omental and subcutaneous (SC) GPX3 mRNA expression has been analyzed. GPX3 analyses include three interventions: 6 months after bariatric surgery (n = 80) or combined exercise/hypocaloric diet (n = 20) or two-step bariatric surgery (n = 24) studies. RESULTS Bariatric surgery-induced weight loss (-25.8 ± 8.4%), but not a moderate weight reduction of -8.8 ± 6.5% was associated with significantly reduced GPX3 serum concentrations. GPX3 mRNA is significantly higher expressed in AT from individuals with normal glucose metabolism compared to T2D patients. SC AT GPX3 expression is significantly higher in lean compared to obese as well as in insulin-sensitive compared insulin-resistant individuals with obesity. Weight loss after bariatric surgery causes a significant increase in SC AT GPX3 expression. AT GPX3 expression significantly correlates with age, BMI, fat distribution, insulin sensitivity (only SC AT), but not with circulating GPX3. CONCLUSION Our data support the notion that SC AT GPX3 expression is associated with obesity, fat distribution and related to whole body insulin resistance.
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Affiliation(s)
- Julia Langhardt
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Gesine Flehmig
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Nora Klöting
- IFB ObesityDiseases, Junior Research Group Animal Models, University of Leipzig, Leipzig, Germany
| | | | - Thomas Ebert
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Matthias Kern
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Michael R Schön
- Städtisches Klinikum Karlsruhe, Clinic of Visceral Surgery, Karlsruhe, Germany
| | - Daniel Gärtner
- Städtisches Klinikum Karlsruhe, Clinic of Visceral Surgery, Karlsruhe, Germany
| | | | | | | | - Peter Kovacs
- IFB ObesityDiseases, University of Leipzig, Leipzig, Germany
| | | | - Arne Dietrich
- Department of Surgery, University of Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany,
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22
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Melatonin Supplementation Lowers Oxidative Stress and Regulates Adipokines in Obese Patients on a Calorie-Restricted Diet. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:8494107. [PMID: 29142618 PMCID: PMC5632922 DOI: 10.1155/2017/8494107] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
Obesity is one of the major global health problems. Melatonin deficiency has been demonstrated to correlate with obesity. The aim of the study was to estimate the effect of melatonin on oxidative stress and adipokine levels in obese patients on a calorie-restricted diet. Thirty obese patients were supplemented with a daily dose of 10 mg of melatonin (n = 15) or placebo (n = 15) for 30 days with a calorie-restricted diet. Serum levels of melatonin, 4-hydroxynonenal (HNE), adiponectin, omentin-1, leptin, and resistin, as well as erythrocytic malondialdehyde (MDA) concentration and Zn/Cu-superoxide dismutase, catalase, and glutathione peroxidase (GPx) activities, were measured at baseline and after supplementation. Significant body weight reduction was observed only in the melatonin group. After melatonin supplementation, the adiponectin and omentin-1 levels and GPx activities statistically increased, whereas the MDA concentrations were reduced. In the placebo group, a significant rise in the HNE and a drop in the melatonin concentrations were found. The results show evidence of increased oxidative stress accompanying calorie restriction. Melatonin supplementation facilitated body weight reduction, improved the antioxidant defense, and regulated adipokine secretion. The findings strongly suggest that melatonin should be considered in obesity management. This trial is registered with CTRI/2017/07/009093.
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23
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Foroozanfard F, Rafiei H, Samimi M, Gilasi HR, Gorjizadeh R, Heidar Z, Asemi Z. The effects of dietary approaches to stop hypertension diet on weight loss, anti-Müllerian hormone and metabolic profiles in women with polycystic ovary syndrome: A randomized clinical trial. Clin Endocrinol (Oxf) 2017; 87:51-58. [PMID: 28316072 DOI: 10.1111/cen.13333] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/12/2017] [Accepted: 03/15/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study was designed to evaluate the effects of the dietary approaches to stop hypertension (DASH diet) on weight loss, anti-Müllerian hormone (AMH) and metabolic profiles in women with polycystic ovary syndrome (PCOS). DESIGN, PATIENTS AND MEASUREMENTS A randomized controlled clinical trial was conducted among 60 overweight or obese patients with PCOS. Patients were randomly assigned to receive either low-calorie DASH (N=30) or control diet (N=30) for 12 weeks. The DASH and control diets were consisted of 52%-55% carbohydrates, 16%-18% proteins and 30% total fats; however, the DASH diet was designed to be rich in fruits, vegetables, whole grains, low-fat dairy products, cholesterol and refined grains. Both diets were equicaloric. RESULTS Adherence to the DASH diet, compared to the control diet, resulted in a significant decrease in BMI (-1.6±0.5 vs -1.2±0.7 kg/m2 , P=.02). Significant decreases in AMH (-1.1±3.1 vs +0.3±0.7 ng/mL, P=.01), insulin (-25.2±51.0 vs -1.2±28.8 pmol/L, P=.02), homoeostasis model of assessment-estimated insulin resistance (-0.9±2.0 vs -0.1±1.0, P=.02), free androgen index (FAI; -0.03±0.09 vs +0.06±0.21, P=.02) and malondialdehyde (MDA) levels (-0.5±0.4 vs +0.2±0.3 μmol/L, P<.001), and significant increases in quantitative insulin sensitivity check index (+0.01±0.03 vs -0.004±0.01, P=.02), sex hormone-binding globulin (SHBG; +3.7±8.5 vs -1.5±7.2 nmol/L, P=.01) and nitric oxide (NO; +9.0±4.9 vs +0.6±2.3 μmol/L, P<.001) were also seen in the DASH group compared with the control group. CONCLUSIONS Adherence to the DASH diet for 12 weeks among PCOS women had beneficial effects on BMI, AMH, insulin metabolism, SHBG, FAI, NO and MDA levels.
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Affiliation(s)
- Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamideh Rafiei
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Gilasi
- Department of Epidemiology and Biostatistics, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Roohangiz Gorjizadeh
- Department of Gynecology and Obstetrics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Heidar
- Department of Gynecology and Obstetrics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Himbert C, Thompson H, Ulrich CM. Effects of Intentional Weight Loss on Markers of Oxidative Stress, DNA Repair and Telomere Length - a Systematic Review. Obes Facts 2017; 10:648-665. [PMID: 29237161 PMCID: PMC5836214 DOI: 10.1159/000479972] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/27/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Altered levels of markers of oxidative stress, DNA repair, and telomere integrity have been detected in obese individuals and may underlie the pathogenesis of obesity-related diseases. However, whether or not such effects are reversed by intentional weight loss has not been systematically reviewed. METHODS A literature search in PubMed/Medline identified 2,388 articles of which 21 studies (randomized controlled trial (RCT) (n = 10) and non-randomized intervention studies (n = 11)) were classified as testing the effects of intentional weight loss on i) oxidative stress (n = 15), ii) DNA repair (n = 2), and iii) telomere length (n = 4). RESULTS Across a broad range of intervention designs, diet-, exercise-, surgery-, balloon-induced weight loss regimens decreased oxidative stress measures. Studies investigating DNA repair capacity or telomere length as endpoints after weight loss were less common in number and yielded null or inconsistent results, respectively. CONCLUSION While this systematic review supports a role for intentional weight loss in reducing obesity-associated oxidative stress, it is not clear whether the effects are primary outcomes or secondary to improvement in obesity-associated insulin resistance and/or chronic inflammation. Although the lack of effect of intentional weight loss on DNA repair capacity might be anticipated given that oxidative stress is reduced, additional studies are needed. The inconsistent effects of weight loss on telomere length or DNA repair suggest the need for a re-assessment of intervention designs and assay methodology to definitively address this topic.
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Affiliation(s)
- Caroline Himbert
- Department of Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Henry Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO, USA
| | - Cornelia M. Ulrich
- Department of Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- *Cornelia M. Ulrich, Department of Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope Drive, Room 4725, Salt Lake City, UT 84112, USA,
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Tumwine JK. Infections interplay with non-communicable diseases. Afr Health Sci 2016; 16:i-iii. [PMID: 27917228 DOI: 10.4314/ahs.v16i3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
No Abstract.
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