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Backgroud: Pregnancy is a state of increased metabolic demand, and poor maternal nutrition can exacerbate these changes, potentially increasing the risk of cardiometabolic disorders.This study is significant as it investigates the effect of high energy nutritional supplements on cardio metabolic risk markers in underweight primigravidas. Methodology: A single blinded randomized controlled trial was conducted from April 2018- August 2019 among the Pakistani tertiary care facilities of Khyber Pakhtunkhwa. A total of thirty six participants were randomized into two groups receiving either high energy nutritional supplement 'MAAMTA' or Placebo. They were instructed to take Placebo/Supplement alongside to their regular prenatal care and food from their first antenatal visit till a week postnatally. Anthropometric measurements and blood samples for biochemical parameters insulinlevels, fasting blood glucose & lipid profile were taken at baseline visit, between 16 and 20 weeks gestation and a post natal visit. Results: The two-way repeated measures ANOVA showed that there was a highly significant time effect on participant's Insulin level (F (1.8, 53.6) = 10.64, P < 0 0.000, ηp2 = 0.269). A highly significant time effect on participant's insulin resistance (F (2, 68) = 8.116,P < 0 0.001, ηp2 = 0.193) was also observed. There was a highly significant time effect on participant's LDL level as well (F (2, 68) = 11.82, P < 0 0.000, ηp2 = 0.258). Conclusion: Supplementation with high energy nutritional supplements may improve insulin levels and insulin sensitivity in underweight primigravidas. Trial registration: https://www.ClinicalTrials.govClinicalTrials.gov Identifier: ISRCTN 10088578. Registered on 27 March 2018. https://www.isrctn.com/ISRCTN10088578. [ABSTRACT FROM AUTHOR]

Abstract Backgroud Pregnancy is a state of increased metabolic demand, and poor maternal nutrition can exacerbate these changes, potentially increasing the risk of cardiometabolic disorders.This study is significant as it investigates the effect of high energy nutritional supplements on cardio metabolic risk markers in underweight primigravidas. Methodology A single blinded randomized controlled trial was conducted from April 2018- August 2019 among the Pakistani tertiary care facilities of Khyber Pakhtunkhwa. A total of thirty six participants were randomized into two groups receiving either high energy nutritional supplement ‘MAAMTA’ or Placebo. They were instructed to take Placebo/Supplement alongside to their regular prenatal care and food from their first antenatal visit till a week postnatally. Anthropometric measurements and blood samples for biochemical parameters insulinlevels, fasting blood glucose & lipid profile were taken at baseline visit, between 16 and 20 weeks gestation and a post natal visit. Results The two-way repeated measures ANOVA showed that there was a highly significant time effect on participant’s Insulin level (F (1.8, 53.6) = 10.64, P

Evidence of an anti-inflammatory effect of WB-EMS is growing. However, applying comparable impulse-protocols, studies reporting positive effects on inflammatory markers, possibly including adipokines, used high volume, superimposed WB-EMS protocols that differ from the time-efficient, non-superimposed concepts mainly used in scientific and commercial settings. The aim of the present trial was to determine the effect of "standard WB-EMS" on inflammatory markers and adipokines in overweight to obese adults. Seventy-two overweight to obese adults 40-70 years old with osteoarthritis (OA) of the knee, were randomly allocated to a 29-week standard WB-EMS application 1.5x20min/week (WB-EMS) or to a usual care control groups (CG) with six sessions of physiotherapy. Study outcomes were changes of ultra-sensitive CRP, lL-1b, adiponectin, leptin, total and LDL-cholesterol. Intention to treat analyses with multiple imputation with an ANCOVA adjusted for baseline group difference was applied. Six participants (WB-EMS=5) were lost to follow-up. Attendance rate averaged 88±10% in the WB-EMS group and >90% in the CG. After the intervention, we did not observe any significant change ofusCRP, lL-1b, adiponectin, leptin, total and LDL-cholesterol levels or significant between group differences (i.e. "effects"). Adverse effects related to the intervention were not observed or reported. The present low-volume, non-superimposed WB-EMS (standard) approach does not seem to have a significant effect on the analyzed inflammatory biomarkers and adipokines in overweight to obese adults with knee OA. [ABSTRACT FROM AUTHOR]

Purpose: Whole-body Electromyostimulation training (WB-EMS) is a time-efficient and safe alternative to conventional resistance-type exercise. The aim of the present study was to evaluate the effect of WB-EMS, modifications of daily activity and diet on cardiometabolic risk in premenopausal overweight and obese women. Methods: Ninety premenopausal overweight women were randomly assigned to three groups (n=30 each). The control group (CG) was energy-restricted by 500 kcal/day via carbohydrate reduction with a protein intake of 1.2 g/kg body mass/d. The "physical activity" (PA) group was instructed to achieve the same negative energy balance (-500 kcal/d), albeit half (-250 kcal/d) via increased physical activity. Protein intake ofthe PA groups was specified as 1.7 g/kg body mass/d. Finally, the "Whole-Body Electromyostimulation" (WB-EMS) group completed a 20-minute WB-EMS 1.5x/week in addition to the modifications ofgroup PA. Primary endpoint was the change in the metabolic syndrome Z-score (MetS-Z) after 16 weeks of intervention analyzed by the intention to treat principle with multiple imputation. Results: In summary, the WB-EMS intervention featured the lowest drop-out and the highest compliance rate. While no significant between-group differences (p=.226) were determined, only the WB-EMS group saw the MetS Z-score improve significantly (p=.003 vs. CG: p=.647 vs. PA: p=. 119). Conclusion: Despite the lack of significant effects compared to control groups with dietary optimization and/or increased daily activity, we consider adjuvant WB-EMS application to be a promising combination for improving cardiometabolic variables in premenopausal overweight and obese women. [ABSTRACT FROM AUTHOR]

Abstract Background The available evidence indicates that the severity of metabolic syndrome tends to worsen progressively over time. We assessed the trajectory of age and sex-specific continuous MetS severity score (cMetS-S) and its association with the development of diabetes during an 18-year follow-up. Methods In a prospective population-based Tehran Lipid and Glucose Study, 3931 eligible participants free of diabetes, aged 20–60 years, were followed at three-year intervals. We examined the trajectories of cMetS-S over nine years using latent growth mixture modeling (LGMM) and subsequent risks of incident diabetes eight years later. The prospective association of identified trajectories with diabetes was examined using the Cox proportional hazard model adjusting for age, sex, education, and family history of diabetes, physical activity, obesity (BMI ≥ 30 kg/m2), antihypertensive and lipid-lowering medication, and baseline fasting plasma glucose in a stepwise manner. Results Among 3931 participants, three cMetS-S trajectory groups of low (24.1%), medium (46.8%), and high (29.1%) were identified during the exposure period. Participants in the medium and high cMetS-S trajectory classes had HRs of 2.44 (95% CI: 1.56–3.81) and 6.81 (95% CI: 4.07–10.01) for future diabetes in fully adjusted models, respectively. Normoglycemic individuals within the high cMetS-S class had an over seven-fold increased risk of diabetes (HR: 7.12; 95% CI: 6.05–12.52). Conclusion Although most adults exhibit an unhealthy metabolic score, its severity usually remains stable throughout adulthood over ten years of follow-up. The severity score of metabolic syndrome has the potential to be utilized as a comprehensive and easily measurable indicator of cardiometabolic dysfunction. It can be employed in clinical settings to detect and track individuals at a heightened risk of developing T2DM, even if their glucose levels are normal.

Background: The available evidence indicates that the severity of metabolic syndrome tends to worsen progressively over time. We assessed the trajectory of age and sex-specific continuous MetS severity score (cMetS-S) and its association with the development of diabetes during an 18-year follow-up. Methods: In a prospective population-based Tehran Lipid and Glucose Study, 3931 eligible participants free of diabetes, aged 20–60 years, were followed at three-year intervals. We examined the trajectories of cMetS-S over nine years using latent growth mixture modeling (LGMM) and subsequent risks of incident diabetes eight years later. The prospective association of identified trajectories with diabetes was examined using the Cox proportional hazard model adjusting for age, sex, education, and family history of diabetes, physical activity, obesity (BMI ≥ 30 kg/m2), antihypertensive and lipid-lowering medication, and baseline fasting plasma glucose in a stepwise manner. Results: Among 3931 participants, three cMetS-S trajectory groups of low (24.1%), medium (46.8%), and high (29.1%) were identified during the exposure period. Participants in the medium and high cMetS-S trajectory classes had HRs of 2.44 (95% CI: 1.56–3.81) and 6.81 (95% CI: 4.07–10.01) for future diabetes in fully adjusted models, respectively. Normoglycemic individuals within the high cMetS-S class had an over seven-fold increased risk of diabetes (HR: 7.12; 95% CI: 6.05–12.52). Conclusion: Although most adults exhibit an unhealthy metabolic score, its severity usually remains stable throughout adulthood over ten years of follow-up. The severity score of metabolic syndrome has the potential to be utilized as a comprehensive and easily measurable indicator of cardiometabolic dysfunction. It can be employed in clinical settings to detect and track individuals at a heightened risk of developing T2DM, even if their glucose levels are normal. [ABSTRACT FROM AUTHOR]

Background: There is a handful of controversial data from observational studies on the serum levels of mannose and risks of coronary artery disease (CAD) and other cardiometabolic risk factors. We applied Mendelian Randomization (MR) analysis to obtain estimates of the causal effect of serum mannose on the risk of CAD and on cardiometabolic risk factors. Methods: Two-sample MR was implemented by using summary-level data from the largest genome-wide association studies (GWAS) conducted on serum mannose and CAD and cardiometabolic risk factors. The inverse variance weighted method (IVW) was used to estimate the effects, and a sensitivity analysis including the weighted median (WM)-based method, MR-Egger, MR-Pleiotropy RESidual Sum and Outlier (PRESSO) were applied. Radial MR Methods was applied to remove outliers subject to pleiotropic bias. We further conducted a leave-one-out analysis. Results: Mannose had no significant effect on CAD (IVW: odds ratio: 0.96 (95% Confidence Interval (95%CI): 0.71−1.30)), total cholesterol (TC) (IVW: 95%CI: 0.60−1.08), low density lipoprotein (LDL) (IVW: 95%CI = 0.68−1.15), high density lipoprotein (HDL) (IVW: 95%CI = 0.85−1.20), triglycerides (TG) (IVW: 95%CI = 0.38−1.08), waist circumference (WC) (IVW: 95%CI = 0.94−1.37), body mass index (BMI) (IVW: 95%CI = 0.93−1.29) and fasting blood glucose (FBG) (IVW: 95%CI = 0.92−1.33), with no heterogeneity for CAD, HDL, WC and BMI (all p > 0.092), while a significant heterogeneity was observed for TC (IVW: Q = 44.503), LDL (IVW: Q = 33.450), TG (IVW: Q = 159.645) and FBG (IVW: Q = 0. 32.132). An analysis of MR-PRESSO and radial plots did not highlight any outliers. The results of the leave-one-out method demonstrated that the links were not driven by a single instrument. Conclusions: We did not find any effect of mannose on adiposity, glucose, TC, LDL, TG and CAD.

Background: Metabolic syndrome (MetS) is a complex clustering cardiovascular risk factors such as abdominal obesity, hypertension, diabetes and dyslipidemia. It has been a growing health problem in Iranian adults in recent decade. The objective of this article was to review the prevalence of MetS and the corresponding risk factors among Iranian adults.Methods: We conducted a systematic review to extract the published articles regarding metabolic syndrome and its risk factors among Iranian adults aged >19 years by searching in PubMed, Google Scholar, SID, Magiran and Iranmedex databases. The forty-three published articles were selected regarding MetS among Iranian adults in this review during 2005-2014.Results: From the 43 studies, the rate of MetS varied from 10% to 60% depending on sex, age and region. The highest rate reported among postmenopausal women in Shiraz was over 60%. There was almost a consistent finding that the rate of MetS was higher among women compared with men across national level except in one study. A very sharp difference (43.3% vs. 17.1%) was observed in western Iran (Kordestan province) between sexes. MetS was significantly more prevalent among older adults, postmenopausal women, less-educated people, those living in urban areas and those with low physical activity and unhealthy eating habits across national level consistently.Conclusion: An emerging high rate of MetS across national level highlights the lifestyle modification as preventive measures in Iranian population by focusing primarily on high risk profiles such as low socioeconomic background, low level of education, older age and postmenopausal women.

Background: There is a handful of controversial data from observational studies on the serum levels of mannose and risks of coronary artery disease (CAD) and other cardiometabolic risk factors. We applied Mendelian Randomization (MR) analysis to obtain estimates of the causal effect of serum mannose on the risk of CAD and on cardiometabolic risk factors. Methods: Two-sample MR was implemented by using summary-level data from the largest genome-wide association studies (GWAS) conducted on serum mannose and CAD and cardiometabolic risk factors. The inverse variance weighted method (IVW) was used to estimate the effects, and a sensitivity analysis including the weighted median (WM)-based method, MR-Egger, MR-Pleiotropy RESidual Sum and Outlier (PRESSO) were applied. Radial MR Methods was applied to remove outliers subject to pleiotropic bias. We further conducted a leave-one-out analysis. Results: Mannose had no significant effect on CAD (IVW: odds ratio: 0.96 (95% Confidence Interval (95%CI): 0.71−1.30)), total cholesterol (TC) (IVW: 95%CI: 0.60−1.08), low density lipoprotein (LDL) (IVW: 95%CI = 0.68−1.15), high density lipoprotein (HDL) (IVW: 95%CI = 0.85−1.20), triglycerides (TG) (IVW: 95%CI = 0.38−1.08), waist circumference (WC) (IVW: 95%CI = 0.94−1.37), body mass index (BMI) (IVW: 95%CI = 0.93−1.29) and fasting blood glucose (FBG) (IVW: 95%CI = 0.92−1.33), with no heterogeneity for CAD, HDL, WC and BMI (all p > 0.092), while a significant heterogeneity was observed for TC (IVW: Q = 44.503), LDL (IVW: Q = 33.450), TG (IVW: Q = 159.645) and FBG (IVW: Q = 0. 32.132). An analysis of MR-PRESSO and radial plots did not highlight any outliers. The results of the leave-one-out method demonstrated that the links were not driven by a single instrument. Conclusions: We did not find any effect of mannose on adiposity, glucose, TC, LDL, TG and CAD. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a complex clustering cardiovascular risk factors such as abdominal obesity, hypertension, diabetes and dylipedemia. It has been a growing health problem in Iranian adults in recent decade. The objective of this article was to review the prevalence of MetS and the corresponding risk factors among Iranian adults., Methods: We conducted a systematic review to extract the published articles regarding metabolic syndrome and its risk factors among Iranian adults aged >19 years by searching in PubMed, Google Scholar, SID, Magiran and Iranmedex databases. The forty-three published articles were selected regarding MetS among Iranian adults in this review during 2005-2014., Results: From the 43 studies, the rate of MetS varied from 10% to 60% depending on sex, age and region. The highest rate reported among postmenopausal women in Shiraz was over 60%. There was almost a consistent finding that the rate of MetS was higher among women compared with men across national level except in one study. A very sharp difference (43.3% vs. 17.1%) was observed in western Iran (Kordestan province) between sexes. MetS was significantly more prevalent among older adults, postmenopausal women, less-educated people, those living in urban areas and those with low physical activity and unhealthy eating habits across national level consistently., Conclusion: An emerging high rate of MetS across national level highlights the lifestyle modification as preventive measures in Iranian population by focusing primarily on high risk profiles such as low socioeconomic background, low level of education, older age and postmenopausal women.