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Martinez Bravo G, Paramasivam P, Bellissimo GF, Jacquez Q, Zheng H, Amorim F, Kovell L, Alvidrez RIM. High-Intensity Interval Training Decreases Circulating HMGB1 in Individuals with Insulin Resistance: Plasma Lipidomics Correlate with Associated Cardiometabolic Benefits. FRONT BIOSCI-LANDMRK 2025; 30:31396. [PMID: 40152388 DOI: 10.31083/fbl31396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 01/17/2025] [Accepted: 01/25/2025] [Indexed: 03/29/2025]
Abstract
BACKGROUND Bodyweight high-intensity interval training (BW-HIIT) is an effective, time-efficient exercise method that reduces cardiovascular risk factors and improves muscle endurance without requiring external equipment. High mobility group box 1 (HMGB1) is a proinflammatory protein involved in insulin resistance. Previous studies revealed that HMGB1 knockout mice show improved insulin sensitivity and hyperglycemia. This study investigates whether BW-HIIT exercise can reduce proinflammatory markers, such as HMGB1, in individuals with insulin resistance. METHODS In total, 14 adults (2 male/12 female) aged 18 to 55 were subject to six weeks of BW-HIIT. Additionally, 10-week-old mice were subject to exercise conditioning (5 mice per group (all male)) for 4 weeks of treadmill exercise or sedentary. Human and mouse pre- and post-exercise serum/plasma samples were analyzed for lipidomics, hormonal, and cytokine multiplex assays. Cardiometabolic parameters were also performed on human subjects. RESULTS Post-exercise decreased systolic blood pressure (SBP), cholesterol, triglycerides, high-density lipoprotein (HDL), and cholesterol/HDL ratio in human patients with insulin resistance. Meanwhile, hormones such as amylin, glucagon, and insulin all increased post-BW-HIIT or treadmill exercise in both human and mouse models. Moreover, circulating HMBG1 levels were reduced in insulin-resistant individuals and mice after exercise. Furthermore, treadmill exercise by the animal model increased anti-inflammatory cytokines, including interleukin (IL)-10, IL-12p40, and IL-12p70, and reduced proinflammatory cytokines: eotaxin, IL-2, and macrophage inflammatory protein (MIP)-2 or CXCL2. CONCLUSIONS Six weeks of BW-HIIT exercise can improve cardiometabolic health, anti-inflammatory markers, hormones, and insulin sensitivity in human and mouse models undergoing exercise. Changes in circulating HMBG1 levels following BW-HIIT exercise make HMGB1 a suitable marker for cardiometabolic disease, potentiating its role beyond an alarmin. Further studies are needed to confirm these effects and to elucidate the underlying physiological mechanisms.
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Affiliation(s)
- Gabriela Martinez Bravo
- Pharmaceutical Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM 87106, USA
- Biomedical Engineering Department, University of New Mexico, Albuquerque, NM 87131, USA
- Clinical and Translational Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Prabu Paramasivam
- Pharmaceutical Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM 87106, USA
- Clinical and Translational Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Gabriella F Bellissimo
- Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - Quiteria Jacquez
- Pharmaceutical Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM 87106, USA
- Clinical and Translational Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Huayu Zheng
- Pharmaceutical Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM 87106, USA
| | - Fabiano Amorim
- Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - Lara Kovell
- Cardiovascular Medicine, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Roberto Ivan Mota Alvidrez
- Pharmaceutical Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM 87106, USA
- Biomedical Engineering Department, University of New Mexico, Albuquerque, NM 87131, USA
- Clinical and Translational Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA
- Cardiovascular and Metabolic Diseases (CVMD) Signature Program, University of New Mexico, Albuquerque, NM 87131, USA
- Autophagy, Inflammation, Metabolism CoBRE, University of New Mexico, Albuquerque, NM 87131, USA
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Bravo GM, Paramasivam P, Bellissimo GF, Jacquez Q, Zheng H, Amorim F, Alvidrez RIM. High-Intensity Interval Training Decreases Circulating HMGB1 in Individuals with Insulin Resistance; Plasma Lipidomics Identifies Associated Cardiometabolic Benefits. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.21.608998. [PMID: 39229166 PMCID: PMC11370382 DOI: 10.1101/2024.08.21.608998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Background: Exercise is a fundamental primary standard of care for cardiometabolic health. Body Weight (BW) High-Intensity Interval Training (HIIT) is an effective strategy for reducing cardiometabolic markers in individuals with insulin resistance and Type-2 diabetes (T2D). High-mobility group box 1 (HMGB1), a ubiquitous nuclear factor, plays an ample role beyond an alarmin in T2D development and progression. Our group has described this novel role previously, showing the beneficial effect of whole body HMGB1 silencing in decreasing hyperglycemia in diabetic mice. In the present study we tested the hypothesis that BW-HIIT as an effective exercise training modality will decrease cardiometabolic risk with a concomitant decrease in circulating HMGB1 more prominently in insulin resistant individuals compared to non-insulin resistant individuals contrasting to what we can evidence in a preclinical murine model of insulin resistance; Methods: Human and mouse pre- and post-exercise serum/plasma samples were analyzed for Lipidomics as well as Metabolic and Cytokine Multiplex assays. Standard of care, as well as cardiometabolic parameters, was also performed in human subjects; Results: insulin resistant individuals had the most positive effect, primarily with a decrease in the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). as an index of insulin resistance as well as decreased HMGB1 post-exercise. Lipidomic analysis illustrated the highly beneficial effect of exercise training using a modified HIIT program, showing an enhanced panel of circulating lipids post-exercise exclusively in insulin resistant individuals. Plasma multiplex revealed significant translational heterogeneity in our studies with distinct metabolic hormone responses to exercise conditioning with a decrease in inflammatory markers in insulin resistant individuals; Conclusions: The current study demonstrated that 6-week BW-HIIT training improves cardiometabolic, anti-inflammatory markers, metabolic hormones, and insulin sensitivity in humans, strongly associated with decreased circulating HMGB1. Overall, these experiments reinforce the potential of HMGB1 as a marker of changes in insulin resistance and the positive effect of exercise training on insulin resistance possibly preventing the development of T2D and associated complications.
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Ping WX, Hu S, Su JQ, Ouyang SY. Metabolic disorders in prediabetes: From mechanisms to therapeutic management. World J Diabetes 2024; 15:361-377. [PMID: 38591088 PMCID: PMC10999048 DOI: 10.4239/wjd.v15.i3.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 02/07/2024] [Indexed: 03/15/2024] Open
Abstract
Diabetes, one of the world's top ten diseases, is known for its high mortality and complication rates and low cure rate. Prediabetes precedes the onset of diabetes, during which effective treatment can reduce diabetes risk. Prediabetes risk factors include high-calorie and high-fat diets, sedentary lifestyles, and stress. Consequences may include considerable damage to vital organs, including the retina, liver, and kidneys. Interventions for treating prediabetes include a healthy lifestyle diet and pharmacological treatments. However, while these options are effective in the short term, they may fail due to the difficulty of long-term implementation. Medications may also be used to treat prediabetes. This review examines prediabetic treatments, particularly metformin, glucagon-like peptide-1 receptor agonists, sodium glucose cotransporter 2 inhibitors, vitamin D, and herbal medicines. Given the remarkable impact of prediabetes on the progression of diabetes mellitus, it is crucial to intervene promptly and effectively to regulate prediabetes. However, the current body of research on prediabetes is limited, and there is considerable confusion surrounding clinically relevant medications. This paper aims to provide a comprehensive summary of the pathogenesis of pre-diabetes mellitus and its associated therapeutic drugs. The ultimate goal is to facilitate the clinical utilization of medications and achieve efficient and timely control of diabetes mellitus.
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Affiliation(s)
- Wen-Xin Ping
- Biomedical Research Center of South China, College of Life Sciences, Fujian Normal University, Fuzhou 350117, Fujian Province, China
| | - Shan Hu
- Biomedical Research Center of South China, College of Life Sciences, Fujian Normal University, Fuzhou 350117, Fujian Province, China
| | - Jing-Qian Su
- Biomedical Research Center of South China, College of Life Sciences, Fujian Normal University, Fuzhou 350117, Fujian Province, China
| | - Song-Ying Ouyang
- Biomedical Research Center of South China, College of Life Sciences, Fujian Normal University, Fuzhou 350117, Fujian Province, China
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Peña A, Olson ML, Ayers SL, Sears DD, Vega-López S, Colburn AT, Shaibi GQ. Inflammatory Mediators and Type 2 Diabetes Risk Factors before and in Response to Lifestyle Intervention among Latino Adolescents with Obesity. Nutrients 2023; 15:nu15112442. [PMID: 37299403 DOI: 10.3390/nu15112442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity is associated with chronic inflammation that may contribute to T2D among youth. We examined the association between inflammatory biomarkers and insulin sensitivity and β-cell function and response to lifestyle intervention among Latino youth with obesity. Latino youth (n = 64) were randomized to six months of lifestyle intervention (INT, n = 40) or usual care (UC, n = 24). INT included nutrition education and physical activity. UC involved meeting with a pediatric endocrinologist and registered dietitian to discuss healthy lifestyles. At baseline, multiple linear regression assessed fasting serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), high-molecular weight adiponectin (HMW Adpn), IL-10, IL-1 receptor antagonist (IL-1ra) as predictors of insulin sensitivity (whole-body insulin sensitivity index, WBISI) and β-cell function (oral disposition index, oDI). Changes in outcomes between groups were assessed using covariance pattern models. At baseline, MCP-1 (β ± SE, -0.12 ± 0.05, p = 0.027) and IL-1ra (-0.03 ± 0.01, p = 0.005) were negatively associated with WBISI. Treatment effects were not observed for inflammatory markers. WBISI was significantly increased among both INT (from 1.8 ± 0.2 to 2.6 ± 0.4, p = 0.005) and UC (from 1.6 ± 0.2 to 2.8 ± 0.5, p = 0.002) with no significant differences between the groups. Obesity-related inflammatory mediators were associated with T2D risk factors but were unaffected by lifestyle intervention among Latino youth.
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Affiliation(s)
- Armando Peña
- Department of Health and Wellness Design, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ 85004, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ 85004, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ 85016, USA
| | - Stephanie L Ayers
- Southwestern Interdisciplinary Research Center, Arizona State University, Phoenix, AZ 85004, USA
| | - Dorothy D Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- Southwestern Interdisciplinary Research Center, Arizona State University, Phoenix, AZ 85004, USA
| | - Abigail T Colburn
- Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
- John B. Pierce Laboratory, Yale School of Medicine, New Haven, CT 06519, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ 85004, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ 85016, USA
- Southwestern Interdisciplinary Research Center, Arizona State University, Phoenix, AZ 85004, USA
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Hejazi K, Mohammad Rahimi GR, Rosenkranz SK. Effects of Exercise Training on Inflammatory and Cardiometabolic Risk Biomarkers in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biol Res Nurs 2023; 25:250-266. [PMID: 36213963 DOI: 10.1177/10998004221132841] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The interaction between type 2 diabetes mellitus (T2DM) and cardiometabolic morbidity and mortality stems from the progressive nature of inflammation underpinning both diseases. Exercise training is considered an effective treatment strategy for T2DM and cardiometabolic diseases. OBJECTIVE The current systematic review and meta-analysis investigated the effects of exercise training on inflammatory and cardiometabolic risk biomarkers in patients with T2DM. DATA SOURCES Electronic databases (PubMed/Medline, Embase, Cochrane Library, CINAHL, Google Scholar, Scopus, and Web of Science) were searched for randomized controlled trials (RCTs) from inception to January 2022. We used random effects models to estimate weighted mean differences with 95% confidence intervals. STUDY SELECTION Twenty-five RCTs were included (N = 1257 participants; mean age = 52 years). Included studies had moderate to good overall methodological quality (TESTEX = 9 (range 7-13). RESULTS Meta-analysis indicated that exercise training significantly increased adiponectin and decreased fasting insulin, homeostatic model assessment for insulin resistance, tumor necrosis factor-α, interleukin-6, and C-reactive protein (ps ≤ 0.05). Subgroup analysis by type of training indicated that aerobic exercise had the most consistent beneficial effects as compared to other types of exercise training; however, there was high heterogeneity among studies. CONCLUSION Different types of exercise training increase adiponectin levels and decrease pro-inflammatory cytokines such as TNF-α, IL-6, and CRP, as well as fasting insulin and insulin resistance markers in patients with T2DM. However, these effects were not beneficial for more commonly measured cardiometabolic risk factors (i.e., lipid profiles). Additional relevant clinical trials are required to confirm these results. TRIAL REGISTRATION This systematic review and meta-analysis was prospectively registered in the PROSPERO database (CRD42022307396).
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Affiliation(s)
- Keyvan Hejazi
- Department of Physical Education and Sport Sciences, 185150Hakim Sabzevari University, Sabzevar, Iran
| | - Gholam Rasul Mohammad Rahimi
- Faculty of Sport Sciences, Department of Exercise Physiology, 48440Ferdowsi University of Mashhad, Mashhad, Iran
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, Las Vegas, NV, USA
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Sagastume D, Siero I, Mertens E, Cottam J, Colizzi C, Peñalvo JL. The effectiveness of lifestyle interventions on type 2 diabetes and gestational diabetes incidence and cardiometabolic outcomes: A systematic review and meta-analysis of evidence from low- and middle-income countries. EClinicalMedicine 2022; 53:101650. [PMID: 36119561 PMCID: PMC9475282 DOI: 10.1016/j.eclinm.2022.101650] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/19/2022] [Accepted: 08/12/2022] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND As lifestyle modification offers a unique strategy to prevent diabetes, we evaluated the effectiveness of lifestyle interventions in the prevention of type 2 diabetes and gestational diabetes in low- and middle-income countries (LMICs). METHODS We did a systematic literature review and meta-analysis. We searched MEDLINE, Embase, Web of Science, and Cochrane Library for randomised controlled trials published in English, Spanish, French, and Portuguese between 1 January 2000 and 15 June 2022, evaluating multi-target and multi-component lifestyle interventions in at-risk populations conducted in LMICs. The main outcomes were incidence of type 2 diabetes and gestational diabetes, and indicators of glycaemic control. We assessed the methodological quality of the studies using the Cochrane risk of bias tool. Inverse-variance random-effects meta-analyses estimated the overall effect sizes. Sources of heterogeneity and study bias were evaluated. The study protocol was registered in PROSPERO (CRD42021279174). FINDINGS From 14 330 abstracts, 48 (0·3%) studies with 50 interventions were eligible of which 56% were conducted in lower-middle-income countries, 44% in upper-middle, and none in low-income. 54% of the studies were assessed as moderate risk of bias and 14% as high risk. A median of 246 (IQR 137-511) individuals participated in the interventions with a median duration of 6 (3-12) months. Lifestyle interventions decreased the incidence risk ratio of type 2 diabetes by 25% (0·75 [95% CI 0·61 to 0·91]), and reduced the levels of HbA1c by 0·15% [-0·25 to -0·05], fasting plasma glucose by 3·44 mg/dL [-4·72 to -2·17], and 2-hr glucose tolerance by 4·18 mg/dL [-7·35 to -1·02]. No publication bias was suggested for these outcomes. High levels of heterogeneity (I²≥ 81%) were found in most meta-analyses. Exploration using meta-regressions could not identify any explanatory variable, except for fasting glucose for which the quality score of the articles seems to be an effect modifier decreasing slightly the heterogeneity (72%) in the low risk of bias pooled estimate. The effect on gestational diabetes could not be evaluated due to the scarcity of available studies. INTERPRETATION Comprehensive lifestyle interventions are effective strategies to prevent type 2 diabetes among at-risk populations in LMICs. The heterogeneity identified in our results should be considered when using these interventions to address the onset of type 2 diabetes. FUNDING None.
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Affiliation(s)
- Diana Sagastume
- Corresponding author at: Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
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Cobos-Palacios L, Ruiz-Moreno MI, Vilches-Perez A, Vargas-Candela A, Muñoz-Úbeda M, Benítez Porres J, Navarro-Sanz A, Lopez-Carmona MD, Sanz-Canovas J, Perez-Belmonte LM, Mancebo-Sevilla JJ, Gomez-Huelgas R, Bernal-Lopez MR. Metabolically healthy obesity: Inflammatory biomarkers and adipokines in elderly population. PLoS One 2022; 17:e0265362. [PMID: 35679338 PMCID: PMC9182320 DOI: 10.1371/journal.pone.0265362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/28/2022] [Indexed: 12/11/2022] Open
Abstract
Background and aims Obesity is linked to elevated levels of inflammatory serum markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFa). Adiponectin and resistin are adipokines related to obesity. It has been described that adipose tissue presents a high production and secretion of these diverse pro-inflammatory molecules, which may have local effects on the physiology of fat cells as well as systemic effects on other organs. Our aim was to evaluate the impact that lifestyle modifications, by following a Mediterranean Diet (MedDiet) program and physical activity (PA) training, would have on inflammatory biomarkers and adipokine profile in a Metabolically Healthy Obese (MHO) elderly population from Malaga (Andalusia, Spain). Subjetcs and methods Subjects aged ≥65 years (65 to 87 years old) with obesity (BMI ≥30 kg/m2) were included in this study if they met ≤1 of the following criteria: systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥ 85 mmHg; triglycerides ≥150 mg/dL; HDL-C <40mg/dL in men and <50mg/dL women; and fasting blood glucose ≥100mg/dL. Selected subjects underwent a personalized intensive lifestyle modification. Anthropometric measurements, PA, MedDiet adherence, analytical parameters, and inflammatory biomarkers were analyzed after 12 months of intervention. Results 166 MHO elderly subjects, 40 (24.1%) male and 126 (75.9%) female (p < 0.0001), aged 71.7±5.2 years old (65 to 87 years old) were included in the study. After 12 months of intervention, only the waist circumference was significantly reduced in all the population (-2.5 cm, p<0.0001), although weight and BMI were maintained. MedDiet adherence increased significantly (p<0.001), but all intensity levels of PA decreased significantly (p<0.001). Concerning inflammatory biomarkers, only TNFa serum increased their levels after the intervention (p<0.001). Regarding the adipokine profile, adiponectin concentrations experienced a significant increment (p<0.001); besides, resistin concentrations decreased significantly (p<0.001). In this sense, only TNFa, adiponectin, and resistin correlated with PA. Adiponectin also correlates with insulin, triglycerides and HDL-c in baseline conditions and after 12 months of intervention; CRP, IL-6, TNFa, adiponectin, and resistin concentrations correlated with anthropometric parameters and some intensities of PA. In addition, adiponectin levels correlates with insulin, triglycerides and HDL-c. In baseline conditions, resistin levels correlated positively with TNFa (p = 0.01) and CRP (p<0.0001) levels. TNFa and IL-6 correlated positively with CRP (p = 0.03 and p<0.0001, respectively). After 12 months of intervention, only IL-6 correlated positively with CRP (p = 0.006). In addition, adipokines levels correlated positively during the process of lifestyle modification. However, during this process, only IL-6 correlated positively with itself (p<0.0001) and with CRP (p = 0.03). Conclusion Healthy aging is a multifactorial biological process in which lifestyle is essential. The presence of obesity in elderly metabolically healthy population is not a problem necessarily. Elderly MHO population who eat a MedDiet and practice regularly PA are capable to modulate their production of inflammatory cytokines (CRP, IL-6, TNFa) and adipokines profile (adiponectin, resistin), preventing other metabolic disorders.
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Affiliation(s)
- Lidia Cobos-Palacios
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - María Isabel Ruiz-Moreno
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Alberto Vilches-Perez
- Department of Endocrinology and Nutrition, Instituto de Investigacion Biomedica de Malaga (IBIMA), University Hospital Virgen de la Victoria, Malaga, Spain
| | - Antonio Vargas-Candela
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Mónica Muñoz-Úbeda
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Javier Benítez Porres
- Physical Education and Sports Area, Faculty of Medicine, University of Malaga, Malaga, Spain
| | | | - María Dolores Lopez-Carmona
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Jaime Sanz-Canovas
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Luis M. Perez-Belmonte
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Juan José Mancebo-Sevilla
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Ricardo Gomez-Huelgas
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- * E-mail: (MRBL); (RGH)
| | - María Rosa Bernal-Lopez
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- * E-mail: (MRBL); (RGH)
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Jiang Q, Li JT, Sun P, Wang LL, Sun LZ, Pang SG. Effects of lifestyle interventions on glucose regulation and diabetes risk in adults with impaired glucose tolerance or prediabetes: a meta-analysis. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:157-167. [PMID: 35289514 PMCID: PMC9832886 DOI: 10.20945/2359-3997000000441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The prevalence of diabetes mellitus is increasing and is related to sedentary lifestyles and obesity. Many studies were published on the effect of lifestyle interventions on glucose regulation and delay the onset of diabetes in adults with impaired glucose tolerance (IGT) or prediabetes. This study aimed to investigate the role of lifestyle interventions in individuals with IGT or prediabetes using a meta-analytic approach. PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases were searched from their inception up to January 2020 to select eligible randomized controlled trials (RCTs). The weighted mean difference (WMD; for fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPPG)) or relative risk (RR; for the risk of diabetes) with 95% confidence interval (CI) were calculated for pooled effect estimates using the random-effects model. Thirteen RCTs involving 3376 individuals with IGT or prediabetes were selected for this meta-analysis. The results showed that lifestyle interventions were associated with lower FPG (WMD: -0.14; 95% CI: -0.24 to -0.05 mmol/L; p=0.004) and 2hPPG (WMD: -0.66; 95% CI: -1.12 to -0.20 mmol/L; p=0.005) in adults with IGT or prediabetes. Moreover, the risk of diabetes was significantly reduced in individuals who received lifestyle interventions (RR: 0.75; 95% CI: 0.60-0.95; p=0.015). Lifestyle interventions could help improve glucose dysregulation and prevent the progression of diabetes in adults with IGT or prediabetes. Further large-scale RCTs should be conducted to assess the effects of long-term lifestyle interventions on diabetic complications in adults with IGT or prediabetes.
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Affiliation(s)
- Qiang Jiang
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China,
| | - Jian-Ting Li
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Pei Sun
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Lu-Lu Wang
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Li-Zhi Sun
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shu-Guang Pang
- Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China,
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Adiposity and Smoking Mediate the Relationship Between Depression History and Inflammation Among Young Adults. Int J Behav Med 2022; 29:787-795. [PMID: 35141821 DOI: 10.1007/s12529-022-10060-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Depression is associated with inflammation, but the mechanisms underlying this association are unclear. We examined adiposity and smoking as potential pathways through which childhood depression may lead to an elevated inflammatory status among young adults. METHODS The sample included 294 subjects with histories of depression (probands), 270 never-depressed siblings of probands (high-risk siblings), and 169 controls. C-reactive protein (CRP), interleukin-6 (IL-6), and soluble intercellular adhesion molecule-1 (sICAM-1) were assessed in serum samples. An adiposity score was computed from body mass index and waist circumference. Smoking behavior was evaluated during an interview. Mixed-effects models were used to test whether adiposity and smoking mediate the relationship between depression and inflammation. RESULTS Probands (p = .004), but not siblings (p = .071), had higher levels of sICAM-1 compared to controls. However, depression history and risk status had no direct effects on CRP (ps > .13) or IL-6 (ps > .16). Importantly, adiposity indirectly mediated the effect of group (probands vs. controls; siblings vs. controls) on all three inflammatory markers. Smoking indirectly mediated the effect of group (probands vs. controls; siblings vs. controls) on sICAM-1 only. CONCLUSIONS Among young adults, the adverse inflammatory consequences of depression history are significant for sICAM-1. Adiposity and smoking are pathways through which depression can indirectly impact several inflammatory markers, suggesting possible preventive interventions to improve the immunologic and cardiovascular health of depression-prone individuals.
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Blood-derived miRNA levels are not correlated with metabolic or anthropometric parameters in obese pre-diabetic subjects but with systemic inflammation. PLoS One 2022; 17:e0263479. [PMID: 35120179 PMCID: PMC8815902 DOI: 10.1371/journal.pone.0263479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/19/2022] [Indexed: 12/29/2022] Open
Abstract
As blood-derived miRNAs (c-miRNAs) are modulated by exercise and nutrition, we postulated that they might be used to monitor the effects of a lifestyle intervention (LI) to prevent diabetes development. To challenge this hypothesis, obese Asian Indian pre-diabetic patients were submitted to diet modifications and physical activity for 4 months (LI group) and compared to a control group which was given recommendations only. We have considered 2 periods of time to analyze the data, i.e.; a first one to study the response to the intervention (4 months), and a second one post-intervention (8 months). At basal, 4 months and 8 months post-intervention the levels of 17 c-miRNAs were quantified, selected either for their relevance to the pathology or because they are known to be modulated by physical activity or diet. Their variations were correlated with variations of 25 metabolic and anthropometric parameters and cytokines. As expected, fasting-glycaemia, insulin-sensitivity, levels of exercise- and obesity-induced cytokines were ameliorated after 4 months. In addition, the levels of 4 miRNAs (i.e.; miR-128-3p, miR-374a-5p, miR-221-3p, and miR-133a-3p) were changed only in the LI group and were correlated with metabolic improvement (insulin sensitivity, cytokine levels, waist circumference and systolic blood pressure). However, 8 months post-intervention almost all ameliorated metabolic parameters declined indicating that the volunteers did not continue the protocol on their own. Surprisingly, the LI positive effects on c-miRNA levels were still detected, and were even more pronounced 8 months post-intervention. In parallel, MCP-1, involved in tissue infiltration by immune cells, and Il-6, adiponectin and irisin, which have anti-inflammatory effects, continued to be significantly and positively modified, 8 months post-intervention. These data demonstrated for the first time, that c-miRNA correlations with metabolic parameters and insulin sensitivity are in fact only indirect and likely associated with the level systemic inflammation. More generally speaking, this important result explains the high variability between the previous studies designed to identify specific c-miRNAs associated with the severity of insulin-resistance. The results of all these studies should take into account the level of inflammation of the patients. In addition, this finding could also explain why, whatever the pathology considered (i.e.; cancers, diabetes, neurodegenerative disorders, inflammatory diseases) the same subset of miRNAs is always found altered in the blood of patients vs healthy subjects, as these pathologies are all associated with the development of inflammation.
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11
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Jonas DE, Crotty K, Yun JDY, Middleton JC, Feltner C, Taylor-Phillips S, Barclay C, Dotson A, Baker C, Balio CP, Voisin CE, Harris RP. Screening for Prediabetes and Type 2 Diabetes: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2021; 326:744-760. [PMID: 34427595 DOI: 10.1001/jama.2021.10403] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Type 2 diabetes is common and is a leading cause of morbidity and disability. OBJECTIVE To review the evidence on screening for prediabetes and diabetes to inform the US Preventive Services Task Force (USPSTF). DATA SOURCES PubMed/MEDLINE, Cochrane Library, and trial registries through September 2019; references; and experts; literature surveillance through May 21, 2021. STUDY SELECTION English-language controlled studies evaluating screening or interventions for prediabetes or diabetes that was screen detected or recently diagnosed. DATA EXTRACTION AND SYNTHESIS Dual review of abstracts, full-text articles, and study quality; qualitative synthesis of findings; meta-analyses conducted when at least 3 similar studies were available. MAIN OUTCOMES AND MEASURES Mortality, cardiovascular morbidity, diabetes-related morbidity, development of diabetes, quality of life, and harms. RESULTS The review included 89 publications (N = 68 882). Two randomized clinical trials (RCTs) (25 120 participants) found no significant difference between screening and control groups for all-cause or cause-specific mortality at 10 years. For harms (eg, anxiety or worry), the trials reported no significant differences between screening and control groups. For recently diagnosed (not screen-detected) diabetes, 5 RCTs (5138 participants) were included. In the UK Prospective Diabetes Study, health outcomes were improved with intensive glucose control with sulfonylureas or insulin. For example, for all-cause mortality the relative risk (RR) was 0.87 (95% CI, 0.79 to 0.96) over 20 years (10-year posttrial assessment). For overweight persons, intensive glucose control with metformin improved health outcomes at the 10-year follow-up (eg, all-cause mortality: RR, 0.64 [95% CI, 0.45 to 0.91]), and benefits were maintained longer term. Lifestyle interventions (most involving >360 minutes) for obese or overweight persons with prediabetes were associated with reductions in the incidence of diabetes (23 RCTs; pooled RR, 0.78 [95% CI, 0.69 to 0.88]). Lifestyle interventions were also associated with improved intermediate outcomes, such as reduced weight, body mass index, systolic blood pressure, and diastolic blood pressure (pooled weighted mean difference, -1.7 mm Hg [95% CI, -2.6 to -0.8] and -1.2 mm Hg [95% CI, -2.0 to -0.4], respectively). Metformin was associated with a significant reduction in diabetes incidence (pooled RR, 0.73 [95% CI, 0.64 to 0.83]) and reduction in weight and body mass index. CONCLUSIONS AND RELEVANCE Trials of screening for diabetes found no significant mortality benefit but had insufficient data to assess other health outcomes; evidence on harms of screening was limited. For persons with recently diagnosed (not screen-detected) diabetes, interventions improved health outcomes; for obese or overweight persons with prediabetes, interventions were associated with reduced incidence of diabetes and improvement in other intermediate outcomes.
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Affiliation(s)
- Daniel E Jonas
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- Department of Internal Medicine, The Ohio State University, Columbus
| | - Karen Crotty
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- RTI International, Research Triangle Park, North Carolina
| | - Jonathan D Y Yun
- Thayer Internal Medicine, MaineGeneral Health, Waterville, Maine
| | - Jennifer Cook Middleton
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Cynthia Feltner
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
- Department of Medicine, University of North Carolina at Chapel Hill
| | - Sian Taylor-Phillips
- Warwick Medical School, University of Warwick, Coventry, West Midlands, United Kingdom
| | - Colleen Barclay
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- Department of Internal Medicine, The Ohio State University, Columbus
| | - Andrea Dotson
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Claire Baker
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Casey P Balio
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Christiane E Voisin
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Russell P Harris
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
- Department of Medicine, University of North Carolina at Chapel Hill
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12
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Jadhav RA, Maiya GA, Hombali A, Umakanth S, Shivashankar KN. Effect of physical activity promotion on adiponectin, leptin and other inflammatory markers in prediabetes: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol 2021; 58:419-429. [PMID: 33211181 PMCID: PMC8053655 DOI: 10.1007/s00592-020-01626-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
AIMS Inflammatory stage in prediabetes is associated with increase in level of adipokines and pro-inflammatory cytokines. Physical activity promotion considered as a first-line therapeutic strategy to treat prediabetes. We have conducted the systematic review and meta-analysis to strengthen the evidence on the impact of physical activity promotion on inflammatory markers in prediabetes. METHODS Studies were identified using electronic search and manual search techniques by choosing keywords for prediabetes, physical activity and inflammatory marker. Randomized controlled trials on individuals diagnosed with prediabetes and provided intervention in the form of physical activity were included in this review. Adiponectin, leptin, C-reactive protein, interleukin-6 and tumour necrosis factor-α were the considered outcome measures. RESULTS Our search retrieved 1,688 citations, 31 full-text articles assessed for eligibility of inclusion. Nine studies satisfied the pre-specified criteria for inclusion. Meta-analysis found that physical activity with or without dietary or lifestyle modification reduces level of leptin (MD-2.11 ng/mL, 95% CI -3.81 - -0.42) and interleukin-6 (MD -0.15 pg/mL, 95% CI -0.25--0.04). It has no effect on level of adiponectin (MD 0.26 µg/mL, 95% CI -0.42- 0.93), C-reactive protein (MD -0.05 mg/L, 95% CI -0.33-0.23) and tumour necrosis factor-α (MD 0.67 pg/mL, 95% CI -2.56-3.89). CONCLUSIONS This review suggests that physical activity promotion with dietary and lifestyle modification may reduce the level of leptin and interleukin-6 but are uncertain if there is any effect on levels of adiponectin, C-reactive protein and tumour necrosis factor-α in the individuals with prediabetes.
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Affiliation(s)
- Radhika Aditya Jadhav
- Department of Physiotherapy, Centre for Diabetic Foot Care and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - G Arun Maiya
- Department of Physiotherapy, Centre for Diabetic Foot Care and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Aditi Hombali
- Independent Systematic Reviewer, Luton, Bedfordshire, UK
| | - Shashikiran Umakanth
- Department of Medicine, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - K N Shivashankar
- Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
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13
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Vargas-Ortiz K, Lira-Mendiola G, Gómez-Navarro CM, Padilla-Estrada K, Angulo-Romero F, Hernández-Márquez JM, Villa-Martínez AK, González-Mena JN, Macías-Cervantes MH, Reyes-Escogido MDL, Guardado-Mendoza R. Effect of a family and interdisciplinary intervention to prevent T2D: randomized clinical trial. BMC Public Health 2020; 20:97. [PMID: 31969136 PMCID: PMC6977289 DOI: 10.1186/s12889-020-8203-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 01/13/2020] [Indexed: 01/25/2023] Open
Abstract
Background Lifestyle changes can reduce the risk of T2D; however, no study has evaluated the effect of a lifestyle intervention involving patients´ family. The aim of this study was to compare the impact of an interdisciplinary family (FI) Vs individual intervention (II) on glucose metabolism, insulin resistance (IR), pancreatic β-cell function and cardiovascular risk markers in patients with prediabetes, as well as to measure the impact on their families’ metabolic risk. Methods Randomized Clinical Trial (RCT) to compare the impact of FI and II on IR and pancreatic β-cell function in subjects with prediabetes. There were 122 subjects with prediabetes (and 101 family members) randomized to FI or II. Data were collected in 2015–2016 and analyzed in 2017–2018. FI group had the support of their family members, who also received personalized diet and exercise recommendations; patients and their family members attended monthly a lifestyle enhancement program. II group received personalized diet and exercise recommendations. The follow-up was for 12 months. Glucose, IR, pancreatic β-cell function and secondary outcomes (body composition and lipid profile) were assessed at baseline, 6 and 12 months. Results FI group improved area under the glucose curve (AUC) (from 18,597 ± 2611 to 17,237 ± 2792, p = 0.004) and the Matsuda index (from 3.5 ± 2.3 to 4.7 ± 3.5, p = 0.05) at 12 months. II group improved Disposition Index (from 1.5 ± 0.4 to 1.9 ± 0.73, p < .0001) at 12 months. The improvements achieved in weight and lipids at 6 months, were lost in II group at 12 moths, whereas in FI persisted. Adherence up to 12 months was not different between the study groups (FI 56% Vs II 60%). Conclusions FI intervention was more effective by improving glucose AUC, insulin sensitivity and lipid profile, besides that, metabolic risk in family members of the FI group was maintained, while the risk of II group was increased. Trial registration This study was retrospectively registered at clinicaltrials.gov on December 15, 2015 (NTC026365646).
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Affiliation(s)
- Katya Vargas-Ortiz
- Department of Medical Sciences, University of Guanajuato, Campus León, Guanajuato, Mexico
| | - Georgina Lira-Mendiola
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | - Claudia M Gómez-Navarro
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | - Katya Padilla-Estrada
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | - Fabiola Angulo-Romero
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | - José M Hernández-Márquez
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | - Ana K Villa-Martínez
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | - Jessica N González-Mena
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | | | - Maria de Lourdes Reyes-Escogido
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico
| | - Rodolfo Guardado-Mendoza
- Metabolic Research Laboratory, Department of Medicine and Nutrition, University of Guanajuato, Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos C.P. 37670; León, Guanajuato, Mexico.
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14
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Kulkarni S, Xavier D, George B, Umesh S, Fathima S, Bantwal G. Effect of intensive lifestyle modification & metformin on cardiovascular risk in prediabetes: A pilot randomized control trial. Indian J Med Res 2019; 148:705-712. [PMID: 30778004 PMCID: PMC6396550 DOI: 10.4103/ijmr.ijmr_1201_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background & objectives: Prediabetes is associated with increased prevalence of cardiovascular disease (CVD). In participants with prediabetes, the effects of exercise and metformin were evaluated on high-sensitivity C-reactive protein (hsCRP) and carotid intima-media thickness (CIMT), surrogate markers of atherosclerosis and CVD compared with standard care. Methods: In a pilot randomized control trial, the participants were randomized in to three arms: standard care (STD), intensive lifestyle modification (ILSM) or ILSM and metformin (ILSM+Met) and followed up for six months. Monitoring of ILSM was done by a trained healthcare facilitator. hsCRP, CIMT and other relevant parameters were measured before and after intervention. Results: A total of 103 participants were randomized into three arms and followed up for six months. At six months, there was a reduction from baseline in weight and fasting blood sugar (FBS) (P<0.01) in all three arms and a reduction in haemoglobin A1c (P=0.03) only in the ILSM+Met arm. The differences in hsCRP over six months within the STD, ILSM and ILSM+Met arms were −0.12 (95% confidence interval, −1.81, 2.08), −0.58 (−2.64, 0.43) and −0.11 (−1.84, 1.56), respectively. There was no difference in hsCRP, CIMT (right) or CIMT (left) between the three arms at six months. Interpretation & conclusions: There was a reduction in weight and FBS from baseline in all three arms. There was, however, no difference seen in hsCRP and CIMT in the two intervention arms compared to standard care. Larger studies with long-term follow up need to be done to detect differences in risk markers for CVD in prediabetes.
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Affiliation(s)
- Shruthi Kulkarni
- Department of Medicine, St. John's Medical College Hospital, Bengaluru, India
| | - Denis Xavier
- Department of Pharmacology, St. John's Medical College Hospital; Division of Clinical Research & Training, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Belinda George
- Department of Endocrinology, St. John's Medical College Hospital, Bengaluru, India
| | - Soumya Umesh
- Department of Medicine, St. John's Medical College Hospital, Bengaluru, India
| | - Saba Fathima
- Department of Medicine, St. John's Medical College Hospital, Bengaluru, India
| | - Ganapathi Bantwal
- Department of Endocrinology, St. John's Medical College Hospital, Bengaluru, India
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15
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Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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16
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Abdul Rahim MBH, Chilloux J, Martinez-Gili L, Neves AL, Myridakis A, Gooderham N, Dumas ME. Diet-induced metabolic changes of the human gut microbiome: importance of short-chain fatty acids, methylamines and indoles. Acta Diabetol 2019; 56:493-500. [PMID: 30903435 PMCID: PMC6451719 DOI: 10.1007/s00592-019-01312-x] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 02/21/2019] [Indexed: 02/07/2023]
Abstract
The human gut is a home for more than 100 trillion bacteria, far more than all other microbial populations resident on the body's surface. The human gut microbiome is considered as a microbial organ symbiotically operating within the host. It is a collection of different cell lineages that are capable of communicating with each other and the host and has an ability to undergo self-replication for its repair and maintenance. As the gut microbiota is involved in many host processes including growth and development, an imbalance in its ecological composition may lead to disease and dysfunction in the human. Gut microbial degradation of nutrients produces bioactive metabolites that bind target receptors, activating signalling cascades, and modulating host metabolism. This review covers current findings on the nutritional and pharmacological roles of selective gut microbial metabolites, short-chain fatty acids, methylamines and indoles, as well as discussing nutritional interventions to modulate the microbiome.
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Affiliation(s)
- Mohd Badrin Hanizam Abdul Rahim
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
- Department of Biochemistry, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Julien Chilloux
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
| | - Laura Martinez-Gili
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
| | - Ana L Neves
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
| | - Antonis Myridakis
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
| | - Nigel Gooderham
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
| | - Marc-Emmanuel Dumas
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Imperial College London, Exhibition Road, London, SW7 2AZ, UK.
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17
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Xue W, Fan Z, Li L, Lu J, Zhai Y, Zhao J. The chemokine system and its role in obesity. J Cell Physiol 2018; 234:3336-3346. [PMID: 30375006 DOI: 10.1002/jcp.27293] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 07/31/2018] [Indexed: 12/27/2022]
Abstract
The chemokine system is a complex arrangement of molecules that attract leukocytes to the site of injury or inflammation. This chemotactic behavior gives the system the name "Chemokine." The intricate and redundant nature of the chemokine system has made it a subject of ongoing scientific investigation. Obesity is characterized as low-grade systemic or chronic inflammation that is responsible for the release of cytokines, adipokines, and chemokines. Excessive tissue fat expansion triggers the release of chemokines, which in turn attract various leukocytes and activate the resident immune surveillance system, eventually leading to worsening of obesity and other related comorbidities. To date, 50 chemokines and 20 chemokine receptors that belong to the G-protein-coupled receptor family have been discovered, and over the past two decades, the physiological and pathological roles of many of these chemokines and their receptors have been elucidated. The objective of this review is to present an update on the link between chemokines and obesity under the light of recent knowledge.
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Affiliation(s)
- Wenhua Xue
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhirui Fan
- Department of Oncology, Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lifeng Li
- Department of Oncology, Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jingli Lu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yunkai Zhai
- Center of Telemedicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Engineering Laboratory for Digital Telemedicine Service, Zhengzhou, Henan, China
| | - Jie Zhao
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Center of Telemedicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Engineering Laboratory for Digital Telemedicine Service, Zhengzhou, Henan, China
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