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Introduction 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters such as; maximum standardized uptake values, standard metabolic tumor volume and otal lesion glycosis are important prognostic biomarkers in cancers. Objective To investigate the prognostic value of these parameters in patients with head and neck cancers. Methods We performed a retrospective study including 47 patients with head and neck cancer who underwent18F-fluorodeoxyglucose positron emission tomography/computed tomography prior to treatment. Standard metabolic tumor volume, otal lesion glycosis and standardized uptake were measured for each patient. The prognostic value of quantitative 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters and clinicopathologic variables on disease free survival and overall survival were analyzed. Results The median (range) standard metabolic tumor volume and otal lesion glycosis and standardized uptake were 7.63 cm3 (0.6-34.3), 68.9 g (2.58-524.5 g), 13.89 (4.89-33.03 g/mL), respectively. Lymph node metastases and tumour differentiation were significant variables for disease free survival and overall survival, however, all 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters were not associated with disease- free survival and overall survival. Conclusion Pretreatment quantities positron emission tomography parameters did not predict survival in head and neck cancer. Resumo Introdução Os parâmetros da tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose, como os máximos valores de captação padronizados, o volume metabólico tumoral padrão e a glicólise total da lesão são importantes biomarcadores prognósticos de câncer. Objetivo Investigar o valor prognóstico desses parâmetros em pacientes com câncer de cabeça e pescoço. Método Fizemos um estudo retrospectivo que incluiu 47 pacientes com câncer de cabeça e pescoço e que foram submetidos à tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose antes do tratamento. Volume metabólico tumoral, glicólise total da lesão e valores de captação padronizados foram aferidos em cada paciente. O valor prognóstico de parâmetros quantitativos da tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose e das variáveis clínico-patológicas sobre a sobrevida livre de doença e a sobrevida geral foi analisado. Resultados A média (intervalo) de volume metabólico tumoral e glicólise total da lesão e valores de captação padronizados foram 7,63 cm3 (0,6-34,3), 68,9 g (2,58-524,5) e 13,89 g/mL (4,89-33,03), respectivamente. Metástase nos nódulos linfáticos e diferenciação tumoral foram variáveis significativas de sobrevida livre de doença e sobrevida geral; contudo, nenhum parâmetro da tomografia por emissão de pósitrons/tomografia computadorizada com 18F-fluordesoxiglicose estava associado a sobrevida livre de doença e sobrevida geral. Conclusão As quantidades dos parâmetros da tomografia por emissão de pósitrons pré-tratamento não previram a sobrevida em câncer de cabeça e pescoço.

Lixia Zhang,1 Zhe Ren,2 Caiyun Xu,1 Qiushuang Li,3 Jinyan Chen1 1Department of Nuclear Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People’s Republic of China; 2Department of Chest Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People’s Republic of China; 3Department of Clinical Evaluation Centers, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, People’s Republic of ChinaCorrespondence: Lixia Zhang Tel +86-0571-86620310Email lixiazh@yeah.netObjective: This study aims to explore factors influencing metabolic and volumetric parameters of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging in non-small cell lung cancer (NSCLC) and the predictive value for prognosis of NSCLC.Methods: Retrospective analysis was performed on 133 NSCLC patients who received 18F-FDG PET/CT imaging. After 18F-FDG injection at 3.7 MBq/kg, 1 h early imaging and 2 h delayed imaging were performed. The metabolic and volumetric parameters such as SUVmax, SUVpeak, SULmax, SULpeak, MTV and TLG were measured. The tumor markers including CFYRA21-1, NSE, SCC-ag and the immunohistochemical biomarkers including Ki-67, P53 and CK-7 were examined. All patients were followed up for 24 months, and the 1-year and 2-year overall survival rate (OS) were recorded.Results: There were significant differences in metabolic and volumetric parameters (SUVmax, SUVpeak, SULmax, SULpeak and TLG) between adenocarcinoma and squamous cell carcinoma of NSCLC. SUVmax, SUVpeak, SULmax, SULpeak, MTV and TLG were correlated with tumor marker NSE and TNM stage. MTV and TLG were related to CYFRA21-1, and only MTV was associated with SCC-ag. SUVpeak and SULmax were related to P53. In addition, early SULpeak and delayed MTV were significant prognostic factors of 1-year OS, while early SUVpeak, delayed TLG and delayed MTV were predictive factors of 2-year OS in NSCLC.Conclusion: The metabolic and volumetric parameters of 18F-FDG PET/CT were related to a variety of factors such as NSE, CFYRA21-1, SCC-ag, P53 and TNM stage, and have a predictive value in prognosis of NSCLC.Keywords: NSCLC, 18F-FDG, PET/CT, metabolic parameters, volumetric parameters

Purpose of the report This article aims to explore the prognostic role of 18F-FDG PET/CT metabolic parameters in stage I lung adenocarcinoma patients. Patients and methods One hundred eighty pathological stage I lung adenocarcinoma patients were retrospectively reviewed. Semiquantitative analysis of FDG tumor uptake was performed with TrueD software on the Siemens Leonardo workstation. SUVmean and MTV were calculated using SUV threshold of 41% of SUVmax; the total lesion glycolysis (TLG) was calculated as the product of SUVmean and MTV. Correlation was evaluated using Spearman correlation coefficient. Maximally selected rank statistics was performed to detect the optimal cutoff used for dichotomizing each PET parameter (6.5 for SUVmean, 9.6 for SUVmax, and 19.1 for TLG). Results Our main finding was the significant correlation between 18F-FDG PET/CT parameters (SUVmean, SUVmax, and TLG) and disease-free survival in pathologic stage I non-small cell lung cancer. SUVmean has the greatest accuracy in recurrence prediction (integrated area under the curve, 0.803; 95% confidence interval, 0.689-0.918). We run the maximally selected rank statistics to provide the classification of observations in 2 groups by a continuous predictor parameter; the free from recurrence rate was significantly greater in patients with SUVmean ≤6.5, SUVmax ≤9.6, and TLG ≤19.1. Conclusions Our research supports the hypothesis that SUVmean, SUVmax, and TLG are well correlated with free from recurrence rate in stage I adenocarcinoma patients, subjected to pulmonary lobectomy. Our findings also indicate these markers as promising prognostic indicators.

Objectives The study was done experimentally to test the effect of diabetes on body mass index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure, diastolic blood pressure, fasting blood glucose and postprandial blood glucose. Methods In the randomization performed, with 80 percent power, 80 people with Type 2 diabetes were found to be suitable for sampling. Personal data forms were filled in by conducting a face-to-face interview with both the experimental and control groups for randomization purposes. In the study, monitoring of BMI, LDL, HDL, systolic blood pressure, diastolic blood pressure, fasting blood glucose and postprandial blood glucose were used as outcome measures. Parameters were monitored pre-trial and at the 3rd, 6th, 9th, and 12th months. Data from the experimental group were collected online while data belonging to the control group were collected by the researcher from patients’ medical records in the Endocrinology Outpatient Clinic. Repeated measures analysis of variance (rANOVA) was performed to analyze pre-trial, 3rd, 6th, 9th, and 12th-month data. Results BMI, LDL, HDL, systolic and diastolic blood pressure, fasting and postprandial blood glucose average of the experimental group at 12 months were proven to be ameliorated compared to the average values at the start of the study (month 0). Conclusions The metabolic data of the experimental group, who had web-based diabetes education, significantly improved between the start of the study (month 0) and the 12th month. In this era of technology, the importance of web-based monitoring of diabetes patients was once again proven.

Background This study is aimed to investigate the association between clinical, metabolic, inflammatory and environmental (photoperiod defined as daily sunlight exposure) parameters and suicide re-attempts after the index suicide attempt. Possible predictors of suicide re-attempts were also explored. Methods Overall, 432 subjects with suicide attempts, of which 79 relapsed within the following six months were included in this prospective study. We adopted the Joiner's definition of suicide lethality, as “the acquired ability to enact lethal self-injury”. The Cox regression was used to test the association between the mentioned variables and Kaplan-Meier plots showed the trend of suicide re-attempts. Results Among participants, 30.8% committed a high-lethality suicide attempt. Cox regression confirmed the association between lifetime suicide attempts and number of suicide attempts in the study time-frame and suicide-reattempts. The longer photoperiod (Spring/Summer) was associated with suicide re-attempts, particularly patients with admission in June/July for the index event. Total cholesterol (TC), low-density lipo-protein cholesterol and c-reactive protein serum levels were significantly associated with suicide re-attempts but Cox regression confirmed only the association between lower TC serum levels and suicide re-attempt. Limitations Patients’ seasonal environment, psychological factors, presence of acute life-events fostering the suicidal crisis and detailed medical history have been not investigated. Findings were derived from a single psychiatric unit. Conclusions Lifetime suicide attempts, higher number of previous suicide attempts, lower total cholesterol levels, and suicide attempt during longer photoperiod were significant predictors of suicide re-attempts. Further studies are needed in order to better characterize single- vs. multiple suicide attempter's profiles.

Patients with type 1 diabetes have a higher incidence of osteoarthritis and early manifestation than in the general population. The role of insulin deficiency and hyperglycaemia in the initiation of the destructive process has been proven, but the processes of local and systemic regulation of the balance between anabolic and catabolic processes in the joint and their role in the development of diabetes-associated osteoarthritis remain poorly understood. The aim:to study the role of osteoprotegerin (soluble receptor for tumour necrosis factor - alpha) in the development and progression of diabetes-associated osteoarthritis and its relationship with major metabolic parameters in patients with diabetes mellitus. Materials and methods.40 patients with type 1 diabetes (17 men and 23 women) were examined, the mean age of the patients was 38.0±2.0 years, the duration of the diabetes was 18.3±1.9 years, the average level of НВА1с was 8.6±0.3 % and 49 patients with type 2 diabetes mellitus (23 men and 26 women), mean age of patients 61.7±1.3 years, duration of diabetes 12.1±1.1 years, mean level HBa1c 7.6±0.1 %. Arthropathy was established in 70.0±7.3 % patients with type 1 diabetes, in 69.4±6.6 % in patients with type 2 diabetes. By sex and type of diabetes, the proportions of patients with and without arthropathy were not statistically different (p> 0.05). The serum content of osteoprotegerin was determined by ELISA using a kit of reagents from Diaclone (France) and enzyme-linked analyser Stat fax 3200 (USA). Results. In patients with arthropathy, a significant increase in osteoprotegerin levels was found. The risk of developing arthropathy in patients with type 1 diabetes with an increased levels of osteoprotegerin is 2.3 times higher than at the normal level (relative risk (RR)=2.33; confidence interval (CI 1.42–3.82; p Conclusions.Diabetes-associated osteoarthritis occurs on the background of increased serum osteoprotegerin levels. An increase in the level of osteoprotegerin with an increase in the stage of osteoarthritis was established, so that its level reflects the severity of osteoarthritis. Osteoprotegerin established a direct relationship with the level of creatinine and negatively associated with glomerular filtration rate, i.e. the development and progression of osteoarthritis progression takes place against the background of other vascular complications of diabetes, in particular diabetic nephropathy. An increase in osteoprotegerin is more typical for male patients and depends on the duration of diabetes

Background: The associations between psoriasis, metabolic syndrome, and cardiovascular events are increasingly recognized. Studies have shown decreased cardiovascular events with the treatment of methotrexate and anti-tumor necrosis factor-α. However, effects of interleukin (IL)-12/23 blockade remain debatable. Objectives: Our study sought to investigate the effect of IL-12/23 blockade on the metabolic parameters in patients with psoriasis. Methods: We performed a retrospective cohort study to assess 93 consecutive patients with moderate-to-severe plaque-type psoriasis who received IL-12/23 blockade (ustekinumab) for 24 weeks between January 2012 and May 2016. Results: Metabolic parameters and disease activity (psoriasis area severity index score) at baseline and 24 weeks of treatment were collected. At week 24 (wk24), the disease activity improved significantly (mean: baseline, wk0: 21.35 ± 11.55 to wk24: 6.87 ± 6.81, P < 0.0001), with a significant reduction of erythrocyte sedimentation rate. Conversely, body mass index was significantly elevated in PASI-75 responders at wk24 of treatment and was independent of disease severity. Fasting sugar and triglyceride level were elevated at wk24. Cholesterol (Chol), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) remained unchanged. These metabolic parameters were not correlated with the improvement in disease severity after ustekinumab treatment. Nonetheless, the atherogenic index, LDL/HDL ratio, and Chol/HDL ratio remained unchanged. Male gender is a predictor of elevated plasma triglyceride level. Conclusion: Our results suggest that despite tremendous improvement in disease activity after ustekinumab treatment, obesity, fasting sugar, and hypertriglyceridemia are still present in these patients. Regular screening of lipid profile and obesity control is advised during the treatment of ustekinumab, especially in male psoriasis patients with predisposing cardiovascular risks.

18F-fluorodeoxyglucose positron emission tomography-computed tomography-derived metabolic parameters can play a role in prognostication. We investigated the prognostic value of various metabolic parameters such as maximum standardized uptake value (SUVmax), mean SUV (SUVmean), whole-body metabolic tumor volume (WBMTV), and whole-body total lesion glycolysis (WBTLG) in surgically resected non-small cell lung cancer (NSCLC) patients. We retrospectively reviewed 153 patients with NSCLC who underwent surgical resection. The SUVmax, SUVmean, WBMTV, and WBTLG of the tumor were measured. Continuous PET parameters were stratified by receiver operating characteristic curve analysis. Prognostic factors were estimated using the Kaplan–Meier method and Cox proportional hazards model. The median follow-up was 36.9 months. Fifty-six patients died and 78 patients had recurrence. On univariate analysis, tumor-node-metastasis (TNM) stage; male sex; no adjuvant treatment; and higher SUVmax, SUVmean, WBMTV, and WBTLG were statistically significant and were associated with poor overall survival (OS). TNM stage; no adjuvant treatment; and higher SUVmax, SUVmean, WBMTV, and WBTLG were statistically significant and were associated with poor disease-free survival (DFS). On multivariate analysis, higher WBTLG (hazard ratio [HR] = 3.08, P = 0.007) for DFS and higher WBTLG (HR = 2.70, P = 0.041) and TNM staging (HR = 1.63, P = 0.035) for OS were statistically significant. Whole-body tumor burden assessment with TLG has independent prognostic value in patients with operated lung cancer. Incorporation of TLG into clinical practice can identify patients benefitted from additional therapy.

Background Anemia and electrolyte disturbances are adverse outcomes of chronic kidney disease (CKD). This study explored the association between metabolic parameters with anemia and electrolyte and mineral disorders among CKD patients in Taiwan. Methods This cross-sectional study with a total of 2176 CKD stages 3–5 patients were collected from the Department of Nephrology at Shuang Ho Hospital, Taipei Medical University through the “Chronic Kidney Disease Common Care Network” database from December 2008 to April 2019. A multivariable-adjusted logistic regression expressed as odd ratios (OR) was performed to assess the association of metabolic parameters with anemia and electrolyte and mineral disorders. Results Elevated diastolic blood pressure, fasting blood glucose, and glycated hemoglobin A1c (HbA1c) were associated with presence of anemia. Similarly, elevated fasting blood glucose and HbA1c were associated with hyponatremia (OR = 1.59 and 1.58, P for both P for both P for all Conclusions Elevated diastolic blood pressure, fasting blood glucose, HbA1c and blood lipids are associated with anemia or electrolyte and mineral disorders in CKD patients.

The one-carbon metabolism pathway is a suitable candidate for studying the genetic and epigenetic factors contributing to metabolic abnormalities in patients with schizophrenia. We recruited 232 patients with schizophrenia and analyzed their serum folate, vitamin B12, and homocysteine levels and metabolic parameters to investigate the associations of genetic variants of methylenetetrahydrofolate reductase (MTHFR) and folate levels with metabolic parameters. MTHFR C677T and MTHFR A1298C were genotyped. Results showed that MTHFR 677T allele carriers had lower levels of total cholesterol and low-density lipoprotein cholesterol than those with the 677CC genotype. Metabolic parameters did not differ between MTHFR 1298C and 1298AA carriers. Patients with a low folate level had a lower high-density lipoprotein cholesterol level than those with a normal folate level, but the effect disappeared after adjustment for age, sex, and types of antipsychotics used. We found significant interactions between MTHFR A1298C and the folate level status (low vs. normal) in terms of body mass index and waist circumference. In conclusion, genetic variants in one-carbon metabolism might play a role in antipsychotic-induced metabolic abnormalities. Prospective studies on drug-naïve, first-episode patients with schizophrenia are warranted to identify key regions of DNA methylation changes accounting for antipsychotic-induced metabolic abnormalities.

Previous studies have identified social jetlag (SJL) as a risk factor for non-communicable chronic diseases (NCCDs), but its association with metabolic control over time is unclear in the literature. Therefore, we examined the influence of SJL on metabolic parameters and blood pressure (BP) in patients with NCCDs over a 1-year follow-up. This retrospective, longitudinal study included 625 individuals (age: 56.0 +12.0 years; 76% female) with NCCDs [type 2 diabetes mellitus (TD2), systemic arterial hypertension (SHA), obesity, or dyslipidemia]. SJL was calculated based on the absolute difference between mid-sleep time on weekends and weekdays. Current metabolic parameters and BP of the patients were compared with data from a year prior. Generalized estimating equations (GEE) and multiple linear regression analyses were used to examine the association among SJL, metabolic parameters, and BP. Multiple linear regression analyses adjusted for confounders showed that SJL was positively associated with the delta difference of fasting glucose (β = 0.11, p = 0.02) and triglyceride levels (β = 0.09, p = 0.04) among all subjects with NCCDs, and with fasting glucose (β = 0.30, p = 0.0001) and triglyceride levels (β = 0.22, p = 0.01) in the TD2 group. GEE analysis demonstrated an isolated effect of SJL on diastolic BP. High SJL impaired clinical and metabolic control in individuals with NCCDs, leading to a worse profile after a 1-year follow-up, particularly among type II diabetics.

Graphical abstract, Resveratrol was recognized as the major factor responsible for the beneficial properties of red wine. Several resveratrol-based dietary supplements are available, but their efficacy has not been sufficiently tested. This study was designed to examine the effect of resveratrol supplementation, using a commercially available product, on the metabolic status of experimental animals with induced hyperlipidemia or type 2 diabetes mellitus (T2DM). Hyperlipidemia was induced by feeding the rats a standard pellet diet supplemented with cholesterol. T2DM was induced by adding 10% fructose to drinking water and streptozotocin. Treatment with resveratrol-based supplement improved glycemic control in diabetic animals and significantly decreased serum low-density-lipoprotein (LDL) and triglyceride levels, concurrently increasing the high-density-lipoprotein (HDL) levels in animals with hyperlipidemia. Resveratrol-treated animals had improved tolerance to glucose loading. Supplementation did not induce alterations in parameters of liver and renal function. Findings indicate that commercial resveratrol supplement improves metabolic control in rats with induced hyperlipidemia and T2DM.

USTUNER TOP, FADIME/0000-0002-7341-5704 WOS: 000493608400021 PubMed: 31124009 The aim of the study was to determine the effect of health-promoting lifestyle education on the physio-psychosocial and metabolic parameters of obese adolescents. This quasi-experimental study was conducted at a city center in Turkey through a pretest and a post-test (n = 73). Following the collection of the first assessment data from the study and control groups, an 8-week education program was applied to students in the study group. The study found that the BMI values and obesity-related risk factors of study group decreased, the means of the self-esteem scale and total ALS and sub-scale scores increased, and the pretest and post-test inter-group difference was significant (p < 0.05). The study found a decrease in cholesterol, LDL, Hb1Ac and Triglyceride levels in the study group and an increase in HDL levels. The study concluded that health-promoting lifestyle education for obese adolescents contributed to improving their physio-psychosocial and metabolic parameters. Giresun UniversityGiresun University [SAG-BAP-A-160317-76] This research was supported by Giresun University Scientific Research Projects coordination (SAG-BAP-A-160317-76).

Objective The present study investigated the prognosis value of preoperative fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with local advanced gastric cancer (LAGC). Methods In total, 144 patients [median age 63 (range: 48−80) years old] with LAGC underwent18F-FDG PET/CT prior to any treatment. The maximum standardized uptake values (SUVmax), mean standardized uptake values (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary lesion were measured on PET/CT and correlated with clinicopathological features and survival. Results Significant differences in SUVmean, SUVmax, MTV and TLG were found according to Lauren’s classification, histologic grade and T category (P

Introduction Invasive fungal infections (IFIs) occur mostly in immunosuppressed patients and can be life-threatening. Inadequate treatment is associated with high morbidity and mortality. We examined the role of 2-fluorodeoxyglucose positron emission tomography integrated with CT (FDG-PET/CT) in monitoring IFIs and therapy decision-making, and evaluated the role of baseline metabolic parameters in predicting the metabolic response. Methods All patients between October 2009 and March 2018, diagnosed with IFIs, treated with antifungal drugs, and who underwent FDG-PET/CT at baseline and at one or more timepoints during treatment were retrospectively included. The electronic patient files were reviewed for pathology, microbiology, and laboratory findings. All FDG-PET/CT scans were performed according to standardized European Association of Nuclear Medicine/EANM Research Limited (EANM/EARL) protocols. For each scan, the global total lesion glycolysis (TLG) and metabolic volume (MV), highest maximum standardized uptake value (SUVmax), and peak standardized uptake value (SUVpeak) were determined. The role of FDG-PET/CT on monitoring antifungal therapy was assessed by looking at the clinical decision made as result of the scan. Furthermore, the added value of the baseline metabolic parameters in predicting metabolic response to the antifungal treatment was evaluated. Results Twenty-eight patients with in total 98 FDG-PET/CT scans were included with a mean age of 43 ± 22 years. FDG-PET/CT altered management in 14 out of the 28 patients (50%). At the final FDG-PET/CT scan, 19 (68%) had a complete metabolic response (CMR), seven a partial response and two patients were defined as having progressive disease. Using receiver operative analysis, the cut-off value, sensitivity, specificity, and significance for the baseline TLG and MV to discriminate patients with CMR were 160, 94%, 100%, p

Objectives: Examine the effect of fasting during Ramadan on kidney functions in patients with chronic kidney disease. Methods: The study was conducted on 130 patients with stage III-IV chronic kidney disease (CKD), who were admitted to the Ordu University nephrology polyclinic during the month before Ramadan and one month after Ramadan in 2019. Blood samples were taken in the morning after 12 hours of fasting. Results: There was a statistically significant difference between BUN in the fasting group before and after the month of Ramadan. The median BUN before Ramadan was 26.65 mg/dl, the median after Ramadan was 24.05 mg/dl (p=0.004).There was a statistically significant difference between the nonfasting groups before and after Ramadan with respect to creatinine level. Median creatinine before Ramadan was 1.69 mg/dl,and the median after Ramadan was 1.86 mg/dl (p

Introduction Non-alcoholic fatty liver disease (NAFLD) is one of the main causes of chronic liver disease worldwide. Flavonoids, a group of natural compounds, have garnered a great deal of attention in the management of NAFLD because of their profitable effects on glucose and lipid metabolism, inflammation, and oxidative stress which are the pivotal pathophysiological pathways in NAFLD. Naringenin is a citrus-derived flavonoid with a broad spectrum of potential biological effects including anti-inflammatory and antioxidant properties, which may exert protective effects against NAFLD. The present clinical trial aims to examine the efficacy of naringenin supplementation on plasma adiponectin and neurogulin-4 (NRG-4) concentrations, metabolic parameters, and liver function indices in overweight/obese patients with NAFLD. Methods and analysis This is a double-blind, randomized, placebo-controlled clinical study that will investigate the impacts of naringenin supplementation in overweight/obese patients with NAFLD. Liver ultrasonography will be applied to diagnose NAFLD. Forty-four eligible overweight/obese subjects with NAFLD will be selected and randomly assigned to receive naringenin capsules or identical placebo (each capsule contains 100 mg of naringenin or cellulose), twice daily for 4 weeks. Participants will be asked to remain on their usual diet and physical activity. Safety of naringenin supplementation was confirmed by the study pharmacist. The primary outcome of this study is changes in adiponectin circulating levels. The secondary outcomes include changes in NRG-4 levels, liver function indices, metabolic parameters, body weight, body mass index (BMI), waist circumference (WC), blood pressure, and hematological parameters. Statistical analysis will be conducted using the SPSS software (version 25), and P value less than 0.05 will be regarded as statistically significant. Discussion We hypothesize that naringenin administration may be useful for treating NAFLD by modulating energy balance, glucose and lipid metabolism, oxidative stress, and inflammation through different mechanisms. The current trial will exhibit the effects of naringenin, whether negative or positive, on NAFLD status. Ethical aspects The current trial received approval from the Medical Ethics Committee of Tehran University of Medical Sciences, Tehran, Iran (IR.TUMS.MEDICNE.REC.1399.439). Trial registration Iranian Registry of Clinical Trials IRCT201311250155336N12. Registered on 6 June 2020

Background Polycystic ovary syndrome (PCOS) is characterized by reproductive disorder and increased risk of metabolic syndrome. This study aimed to assess the metabolic parameters in the cord blood of neonate of mothers with obese PCOS and comparison with non-obese PCOS and controls. Methods This retrospective cohort study was conducted in Arash and Kamali Hospital in 2017–2018. The biochemical test was conducted on 78 neonates from obese PCOS mothers, 78 neonates from non-obese PCOS mothers, and 78 neonates from healthy mothers. Finally, cord blood lipid profile and insulin and blood sugar were determined by specific kits. Correlations between variables were compared with chi-square, Mann-Whitney’s U, Kruskal-Wallis H tests and regression model by SPSS 23 and P Results Triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were higher in cord blood of newborn of obese PCOS women than non-obese PCOS and controls (P = 0.02, P P = 0.01). But in the study, there was no significant difference between the mean of umbilical cord low-density lipoprotein cholesterol (LDL), total cholesterol and blood sugar in three groups. The logistic regression model showed that metabolic parameters were related to PCOS. Conclusions In the present study, there was a significant difference between the mean of umbilical cord HDL, cholesterol, and the insulin level in the three groups. But, there was no significant association between the mean of blood sugar, LDL, and TG in the groups. The metabolic disorder in PCOS might affect cord blood lipid and insulin and adulthood health.

PurposeDual-time-point 18F-fluorodeoxyglucose positron emission tomography (DTP 18F-FDG PET), which reflects the dynamics of tumor glucose metabolism, may also provide a novel approach to the characterization of both cancer cells and immune cells within the tumor immune microenvironment (TIME). We investigated the correlations between the metabolic parameters (MPs) of DTP 18F-FDG PET images and the tumor microenvironment immune types (TMITs) in patients with non-small cell lung cancer (NSCLC).MethodsA retrospective analysis was performed in 91 patients with NSCLC who underwent preoperative DTP 18F-FDG PET/CT scans. MPs in the early scan (eSUVmax, eSUVmean, eMTV, eTLG) and delayed scan (dSUVmax, dSUVmean, dMTV, dTLG) were calculated, respectively. The change in MPs (ΔSUVmax, ΔSUVmean, ΔMTV, ΔTLG) between the two time points were calculated. Tumor specimens were analyzed by immunohistochemistry for PD-1/PD-L1 expression and CD8+ tumor-infiltrating lymphocytes (TILs). TIME was classified into four immune types (TMIT I ~ IV) according to the expression of PD-L1 and CD8+ TILs. Correlations between MPs with TMITs and the immune-related biomarkers were analyzed. A composite metabolic signature (Meta-Sig) and a combined model of Meta-Sig and clinical factors were constructed to predict patients with TMIT I tumors.ResultseSUVmax, eSUVmean, dSUVmax, dSUVmean, ΔSUVmax, ΔSUVmean, and ΔTLG were significantly higher in PD-L1 positive patients (p = 0.0007, 0.0006, < 0.0001, < 0.0001, 0.0002, 0.0002, 0.0247, respectively), and in TMIT-I tumors (p = 0.0001, < 0.0001, < 0.0001, < 0.0001, 0.0009, 0.0009, 0.0144, respectively). Compared to stand-alone MP, the Meta-Sig and combined model displayed better performance for assessing TMIT-I tumors (Meta-sig: AUC = 0.818, sensitivity = 86.36%, specificity = 73.91%; Model: AUC = 0.869, sensitivity = 77.27%, specificity = 82.61%).ConclusionHigh glucose metabolism on DTP 18F-FDG PET correlated with the TMIT-I tumors, and the Meta-Sig and combined model based on clinical and metabolic information could improve the performance of identifying the patients who may respond to immunotherapy.

Introduction: Only 20-40% of patients respond to therapy with immune checkpoint inhibitors (ICIs). Therefore, the early identification of subjects that can benefit from such therapeutic regimen is mandatory. Areas covered: The immunobiological mechanisms of ICIs are briefly illustrated. Furthermore, the limitations of traditional radiological approaches are covered. Then, the pros and cons of molecular imaging through positron emission computed tomography (PET/CT) are reviewed, with a particular focus on 18f-fluorodeoxyglucose (18F-FDG) and PET-derived metabolic parameters. Lastly, translational perspective of radiopharmaceuticals others than 18F-FDG such as 89zirconium (89Zr) or fluorine-18 (18F) labeled monoclonal antibodies (e.g.89Zr-atezolizumab, 89Zr-nivolumab) binding to specific biomarkers are discussed. Expert opinion: Molecular imaging presents a prominent role for the management of oncological patients treated with ICIs. Preliminary clinical data indicate that PET/CT with 18F-FDG is useful for assessing the response to treatment and for the imaging of immune-related adverse effects. Nevertheless, the methodological approach (iPERCIST, PERCIMT, or others) to be used for an optimal diagnostic accuracy and patients' evaluation is still a debated issue. PET/CT with radioligands directed toward ICIs biomarkers, although is still in a translational phase, holds the promise of accurately predicting the response to treatment and revealing the acquired resistance to immunotherapy.

Background Dietary fatty acids are important dietary determinants of metabolic disorders in human. However, it is important to develop an index that considers not only the amount of dietary fatty acids but also the structure, fluidity and melting point of them. In the current study we investigated the association between a novel dietary lipophilic index (LI) with metabolic profile and dyslipidemia in a community based study in Tabriz-Iran. Methods Dietary data were collected using a validated, 79-food item, semi-quantitative food frequency questionnaire, and dietary LI was calculated. Anthropometric variables were measured and metabolic profile including blood sugar, serum lipids and liver enzymes were assessed. Metabolic syndrome was defined according to the adult treatment panel (ATP) III criteria. Results The mean age of the participants was 42.53 ± 12.03 years and most of the participants were women. Mean of dietary LI was 34.99 ± 6.91. Higher dietary LI was associated with higher body mass index (BMI) (β = 0.17, P P P Conclusion The novel dietary LI was considered as a useful tool in prediction of cardio-metabolic risk factors including general and central obesity, dyslipidemia and metabolic syndrome in a population-based study in Iran. Further researches in other disease and populations could highlight the application of this index in clinical settings.

Metabolic syndrome is a disorder characterized by a constellation of clinical findings such as elevated blood glucose, hyperinsulinemia, dyslipidemia, hypertension, and obesity. A positive correlation has been found between metabolic syndrome or its components and retinopathy, mainly at microvascular level, in patients without a history of diabetes. Here, we extend the investigations beyond the vascular component analyzing functional changes as well as neuronal and glial response in retinas of Apolipoprotein E knockout (ApoE-KO) mice fed with 10% w/v fructose diet. Given that autophagy dysfunction is implicated in retinal diseases related to hyperglycemia and dyslipidemia, the activation of this pathway was also analyzed. Two months of fructose intake triggered metabolic derangements in ApoE-KO mice characterized by dyslipidemia, hyperglycemia and hyperinsulinemia. An increased number of TUNEL positive cells, in addition to the ganglion cell layer, was observed in the inner nuclear layer in retina. Vascular permeability, evidenced by albumin–Evans blue leakage and extravasation of albumin was also detected. Furthermore, a significant decrease of the glial fibrillary acidic protein expression was confirmed by Western blot analysis. Absence of both Müller cell gliosis and pro-angiogenic response was also demonstrated. Finally, retinas of ApoE-KO FD mice showed defective autophagy activation as judged by LC3B mRNA and p62 protein levels correlating with the increased cell death. These results demonstrated that FD induced in ApoE-KO mice biochemical alterations compatible with metabolic syndrome associated with neuronal impairment and mild vascular alterations in the retina.

Background: Dietary fats have been variably associated with the risk of cardiovascular disease. The aim of our study was to evaluate the association between everyday mainly used dietary fats in cooking and as seasoning and hemodynamic and lipid parameters. Methods: For this study, we selected from the Brisighella Heart Study cohort subjects who were not treated with antihypertensive drugs and report with certainty their daily mean intake of dietary fats in cooking and as seasoning. Depending on the main source of dietary fat, the involved subjects were classified as prevalent extra-virgin olive oil (EVO) users, prevalent corn oil users, prevalent users of different vegetable oils and prevalent animal fat users, and we compared their characteristics. Results: Everyday consumption of EVO as a main seasoning and cooking fat source was significantly associated to lower body mass index, visceral adiposity index, blood pressure, arterial stiffness, and cholesterolemia, when compared with predominantly animal fat users. Corn oil users also had lower blood pressure, arterial stiffness, and cholesterolemia, when compared with predominantly animal fat users, as well. In particular, in an age and systolic blood pressure adjusted model, the predictors of carotid-femoral pulse wave velocity were the prevalent use of EVO (RR = 0.84, 95%CI 0.67–0.94 vs. other prevalent fat sources), LDL-Cholesterol (RR= 1.12, 95% CI 1.02–1.42), serum uric acid (RR = 1.21, 95%CI 1.09–1.54) and estimated GFR (RR= 0.77, 95%CI 0.59–0.99). Conclusions: According to our findings, the choice of everyday seasoning and cooking fat is associated with a different metabolic and haemodynamic pattern.

Methods of treating obesity, such as changes in lifestyle, physical activity, restrictive diets, and psychotherapy, are not sufficient. Currently, it is considered that in the case of patients who meet the eligibility criteria for surgery, the treatment of choice should be bariatric surgery. The aim of this study was to assess the weight loss and metabolic changes in a group of adults with obesity undergoing bariatric surgery. The study involved 163 patients whose body mass index (BMI) exceeded 40 or 35 kg/m2, concurrent with at least one metabolic sequelae. In 120 of the cases (74%), sleeve gastrectomy was used, in 35 (21%), gastric bypass was used, and in 8 (5%), laparoscopic Roux-en-Y bypass was used. Metabolic parameters such as total cholesterol, LDL-cholesterol (low-density lipoprotein cholesterol), HDL-cholesterol (high-density lipoprotein cholesterol), triglycerides, and glucose were measured preoperatively and postoperatively, as well as the creatinine, creatine kinase (CK-MB), and leptin activity. In patients undergoing bariatric surgery, a significant decrease in excess weight (p &lt, 0.001) was observed at all the analyzed time points, compared to the pre-surgery value. Weight loss after surgery was associated with a significant improvement in glycemia (109.6 &plusmn, 48.0 vs. 86.6 &plusmn, 7.9 mg/dL &gt, 24 months after surgery, p = 0.003), triglycerides (156.9 &plusmn, 79.6 vs. 112.7 &plusmn, 44.3 mg/dL &gt, p = 0.043) and leptin (197.50 &plusmn, 257.3 vs. 75.98 &plusmn, 117.7 pg/mL 12 months after surgery, p = 0.0116) concentration. The results of the research confirm the thesis on the effectiveness of bariatric surgery in reducing excess body weight and improving metabolic parameters in patients with extreme obesity.

The objective of this work is to investigate the effects of Carnipure® Tartrate (CT) supplementation with or without exercise on endurance capacity, recovery, and fatigue by assessing time to exhaustion as well as body weight and composition in rats. In addition, antioxidant capacity has been evaluated by measuring malondialdehyde (MDA) levels and antioxidant enzyme (superoxide dismutase, SOD, catalase, CAT, glutathioneperoxidase, GSHPx) activities. Fifty-six male Wistar rats were divided into eight groups including seven rats each. A control group did not receive CT nor exercise. Another control group received 200 mg/kg CT without exercise. The other six groups of rats went through an exercise regimen consisting of a 5-day training period with incremental exercise capacity, which was followed by 6 weeks of the run at 25 m/min for 45 min every day. CT was supplemented at 0, 25, 50, 100, 200, and 400 mg/kg per day during the 6 weeks. Rats submitted to exercise and supplemented with CT had a significant and dose-dependent increase in time to exhaustion and this effect seems to be independent of exercise (p &lt, 0.05). Additionally, recovery and fatigue were improved, as shown by a significant and dose-dependent decrease in myoglobin and lactic acid plasma levels, which are two markers of muscle recovery. CT supplementation led to a dose-response decrease in body weight and visceral fat. These effects become significant at 200 and 400 mg/kg doses (p &lt, 0.05). Additionally, the antioxidant capacity was improved, as shown by a significant and dose-dependent increase in SOD, CAT, and GSHPx. Serum MDA concentrations decreased in exercising rats with CT supplementation. CT supplementation led to a decrease in serum glucose, triglycerides, and total cholesterol concentrations with the lowest levels observed at 400 mg/kg dose (p &lt, 0.05). These effects correlated with a significant dose-dependent increase in serum total L-carnitine, free L-carnitine, and acetyl-carnitine, which linked the observed efficacy to CT supplementation. These results demonstrate that CT supplementation during exercise provides benefits on exercise performance, recovery, and fatigue as well as improved the lipid profile and antioxidant capacity. The lowest dose leads to some of these effects seen in rats where 25 mg/kg corresponds to 250 mg/day as a human equivalent.

Ghrelin, a 28-amino acid peptide, is a strong growth hormone secretagogue and a regulator of food intake. In addition, ghrelin is thought to play a role in insulin secretion and in glucose homeostasis. A lot of contradictory data have been reported in the literature regarding the co-localization of ghrelin with other hormones in the islet of Langerhans, its role in insulin secretion and attenuation of type 2 diabetes mellitus. In this study, we investigate the effect of chronic ghrelin treatment on glucose, body weight and insulin level in normal and streptozotocin-induced diabetic male Wistar rats. We have also examined the distribution pattern and co-localization of ghrelin with insulin in pancreatic islet cells using immunohistochemistry and immune-electron microscopy and the ability of ghrelin to stimulate insulin release from the CRL11065 beta cell line. Control, non-diabetic groups received intraperitoneal injection of normal saline, while treated groups received intraperitoneal injection of 5 &micro, g/kg body weight of ghrelin (amino acid chain 24&ndash, 51) on a daily basis for a duration of four weeks. Our results show that the administration of ghrelin increases the number of insulin-secreting beta cells and serum insulin level in both normal and diabetic rats. We also demonstrated that ghrelin co-localizes with insulin in pancreatic islet cells and that the pattern of ghrelin distribution is altered after the onset of diabetes. Moreover, ghrelin at a dose of 10-6M and 10&ndash, 12M increased insulin release from the CRL11065 beta cell line. In summary, ghrelin co-localizes with insulin in the secretory granules of pancreatic beta cells and enhances insulin production.

Objectives This study aimed to examine the relationship between severity of liver steatosis and metabolic parameters in a sample of Iranian adults. In this cross-sectional study, a total of 95 subjects aged > 20 years newly diagnosed with NAFLD were recruited. NAFLD was diagnosed using ultrasonography by a single expert radiologist in a fasting state. Results The mean age of the patients was 49.27 (SD 9.7) years, with 53.68% males and 46.32% females. Most patients had grade I NAFLD (72.63%), 25.26% were grade II, and 2.11% were grade III on ultrasonography. With increasing severity of liver steatosis, there were statistically significant increases in mean body mass index (P = 0.001), serum triglycerides (P = 0.026), alanine aminotransferase (P

This study aimed to compare the effects of an acute Pilates program under hypoxic vs. normoxic conditions on the metabolic, cardiac, and vascular functions of the participants. Ten healthy female Pilates experts completed a 50-min tubing Pilates program under normoxic conditions (N trial) and under 3000 m (inspired oxygen fraction = 14.5%) hypobaric hypoxia conditions (H trial) after a 30-min exposure in the respective environments on different days. Blood pressure, branchial ankle pulse wave velocity, and flow-mediated dilation (FMD) in the branchial artery were measured before and after the exercise. Metabolic parameters and cardiac function were assessed every minute during the exercise. Both trials showed a significant increase in FMD, however, the increase in FMD was significantly higher after the H trial than that after the N trial. Furthermore, FMD before exercise was significantly higher in the H trial than in the N trial. In terms of metabolic parameters, minute ventilation, carbon dioxide excretion, respiratory exchange ratio, and carbohydrate oxidation were significantly higher but fat oxidation was lower during the H trial than during the N trial. In terms of cardiac function, heart rate was significantly increased during the H trial than during the N trial. Our results suggested that, compared to that under normoxic conditions, Pilates exercise under hypoxic conditions led to greater metabolic and cardiac responses and also elicited an additive effect on vascular endothelial function.

Background/Aim: In patients with type 2 diabetes (T2D), malnutrition has been recognized as a serious health problem mainly in hospitalized conditions, but there is little data regarding malnutrition outside hospital settings. The aim of this study was to evaluate the risk of malnutrition and associated metabolic changes in ambulatory patients with T2D. Material and methods: This analysis used data collected from 161 patients with T2D enrolled in a larger cross-sectional study. Several anthropometric and metabolic parameters were obtained. Nutritional status was evaluated using the Controlling Nutritional Status (CONUT) score. Correlations between nutritional status and metabolic and anthropometric parameters of interest were examined. Results: Of all T2D patients, 29.8% had mild malnutrition (CONUT score 2–4). These patients presented lower triglyceride (124.8 ± 42.3 mg/dL vs. 165.7 ± 84.3 mg/dL, p Conclusion: In patients with T2D, malnutrition associated with lower triglycerides concentrations, even in the presence of obesity. Malnutrition and/or obesity associated with higher HOMA-IR, serum leptin levels and lower C peptide/leptin ratio.

Objective: Positron Emission Tomography (PET) with F-18-Fluoro-deoxy-glucose (FDG) emerged as a prognostic tool to predict treatment outcome in Hodgkin Lymphoma (HL). Moreover, a FDG-PET adapted strategy is currently assessed in clinical trial to minimize the toxic effect while maintaining the efficacy of treatment in HL. Purpose was to analyze the quantitative parameters to support the prognostic role of FDG-PET today based on the semi-quantitative Deauville 5-point Scale (D5-PS). Methods: This retrospective study included 53 patients diagnosed with advanced-stage HL between 2009 and 2014, enrolled in the PET response-adapted clinical trial HD 0607. FDG-PET was performed at baseline (PET0) and after two cycles of chemotherapy (PET2). Analysis was based on two main approaches: on the single lesion presenting the higher FDG uptake and on the five hottest lesions. Different metabolic parameters were analyzed. Patients were classified into responders and nonresponders. Optimal cut-offs were derived from Receiver Operating Characteristic (ROC) curves. Results were correlated with Progression Free Survival (PFS) using Kaplan-Meier. Results: A 71% threshold in SUVmax reduction (?SUVmax) was found to be the best cutoff quantitative parameter able to identify responders vs. non-responders, also with a multivariate analysis, joining clinical data with SUVmax. After a mean follow-up of 34.2 months (95% CI, 26.2 to 39.1), the median PFS for non-responders was 8 months vs. not reached for responders. These results were superimposable to that obtained by an independent group of reviewers using the D5-PS. Conclusion: Semi-quantitative analysis by ?SUVmax outperforms qualitative assessment by D5-PS in predicting treatment outcome in ABVD-treated advanced-stage HL.

WOS:000481832500004 OBJECTIVE: This research aims to compare the effects of sertraline and agomelatine on outpatients diagnosed with a "major depressive episode" in terms of sleep quality, sexual functioning, and metabolic parameters related to metabolic syndrome. METHODS: This observational, open-labelled, 12-week follow-up study was carried out in the outpatient psychiatry clinic of a state research hospital. Included in the study were 60 outpatients admitted to the adult psychiatry clinic diagnosed with a "major depressive episode" who were subsequently prescribed agomelatine (25 mg/day) or sertraline (50 mg/day). Arizona Sexual Experience Scale (ASEX) and Pittsburgh Sleep Quality Index (PSQI) were performed during the 1st, 2nd, 4th, 8th and 12th weeks of treatment. The metabolic parameters; Body Mass Index, waist circumference, systolic and diastolic blood pressure, fasting blood glucose, liver enzymes (Alanine transaminase (ALT), Aspartate transaminase (AST) and lipid profiles - total cholesterol and total triglycerides, low density lipoprotein (LDL), high density lipoprotein and very low density lipoprotein - were assessed after the first interview (pre-treatment) and in the 12th week of treatment (post-treatment). RESULTS: The PSQI scores of both the sertraline and agomelatine groups had declined significantly by the end of the follow-up, with the decline in PSQI scores in the agomelatine group being higher than the decline in the sertraline group. The decline in the ASEX scores of the sertraline group was not significant, while the score was significant in the agomelatine group at the end of the follow-up. However, the difference in the changes in the ASEX scores between the study groups was not significant. The unfavourable changes noted in metabolic parameters were: elevation of the mean LDL level in patients using sertraline, and an elevation in liver enzymes (AST and ALT) in the patients using agomelatine. CONCLUSION: The favourable effects of agomelatine on sleep quality and the rapid onset of this effect may be beneficial in particular cases. Agomelatine may be an alternative drug for patients who complain of sexual side effects. Clinicians should evaluate the lipid profile of patients using sertraline, while liver function should be monitored in patients using agomelatine. Neither treatment led to unfavourable outcomes on most of the metabolic parameters.

Aim: Gestational diabetes mellitus (GDM) is associated with an increased risk for type 2 DM and metabolic dysfunction after pregnancy. Therefore, we aimed to evaluate the metabolic parameters in women with a history of GDM. Methods: In this study, we included a total of 40 patients with high fasting and postprandial glucose levels and abnormal oral glucose tolerance test at 22-28 weeks of pregnancy who attended the endocrinology outpatient clinic between 2011 and 2014. We evaluated the metabolic parameters, weight, height and body mass index (BMI) at six months postpartum. In addition, fasting and postprandial glucose, insulin, hemoglobin A1c (HbA1c), urea, and creatinine levels, spot urine protein-to-creatinine ratio, and lipid profile were analyzed. Results: Postpartum DM was detected in seven patients (17.5%) in the follow-up period. Mean fasting glucose level and HbA1c values were statistically significantly higher in subjects with postpartum diabetes (p=0.001, p=0.005, respectively). Mean BMI, waist circumference, and triglyceride levels were similar between those with and without postpartum diabetes (p=0.521, p=0.607, p=0.240, respectively). Conclusion: In our study, there was no finding predicting postpartum DM in patients with GDM, however, GDM increases the risk of postpartum DM.

The criteria for surgical cure of acromegaly have become more stringent during the past decades and a change from Cortina to new consensus criteria has recently been proposed. However, the superiority of the new consensus over Cortina criteria with respect to postoperative metabolic parameters remains to be ascertained. We retrospectively assessed metabolic parameters, the body habitus, and other health-related parameters of 48 patients with surgically controlled acromegaly who met the Cortina criteria [normalized insulin-like growth factor-1 (IGF-1) level and nadir growth hormone (GH) level

The distribution of height, weight, and body mass index of Swiss conscripts widened over the last 140 years. There are now more underweight and overweight conscripts who show similar increases in inflam-matory and metabolic fault blood parameters. Both facts indicate a possible role of relaxed natural selection on genes affecting metabolism and body composition., Background and objectives The body mass index (BMI) is an established anthropometric index for the development of obesity-related conditions. However, little is known about the distribution of BMI within a population, especially about this distribution’s temporal change. Here, we analysed changes in the distribution of height, weight and BMI over the past 140 years based on data of Swiss conscripts and tested for correlations between anthropometric data and standard blood parameters. Methods Height and weight were measured in 59 504 young Swiss males aged 18–19 years during conscription in 1875–79, 1932–36, 1994 and 2010–12. For 65% of conscripts in 2010–12, results of standard blood analysis were available. We calculated descriptive statistics of the distribution of height, weight and BMI over the four time periods and tested for associations between BMI and metabolic parameters. Results Average and median body height, body weight and BMI increased over time. Height did no longer increase between 1994 and 2010–12, while weight and BMI still increased over these two decades. Variability ranges of weight and BMI increased over time, while variation of body height remained constant. Elevated levels of metabolic and inflammatory blood parameters were found at both ends of BMI distribution. Conclusions and implications Both overweight and underweight subgroups showed similar changes in inflammation parameters, pointing toward related metabolic deficiencies in both conditions. In addition to environmental influences, our results indicate a potential role of relaxed natural selection on genes affecting metabolism and body composition.

Trimethylamine N-oxide (TMAO) and its precursors, including choline, betaine, and L-carnitine, are gut microbiota-related metabolites associated with the risk of obesity. We aimed (1) to comprehensively examine whether the changes in plasma TMAO and its precursors induced by lifestyle intervention are associated with the improvements in plasma metabolic parameters, and (2) to identify the fecal microbiome profiles and nutrient intakes associated with these metabolites and metabolic index. Data from 40 participants (obese children and adolescents) having the plasma metabolites data related to the changes in BMI z-scores after 6-month lifestyle intervention were analyzed. In this study, we observed that choline and the betaine-to-choline ratio (B/C) showed different patterns depending on the changes in BMI z-scores by the response to lifestyle intervention. During the 6 months, an increase in choline and a decrease in B/C were observed in non-responders. We also found that changes in choline and B/C were associated with the improvements in plasma lipid levels. Individuals who showed reduced choline or increased B/C from the baseline to 6 months had a significant decrease in LDL-cholesterol over 6 months compared to those with increased choline or decreased B/C, respectively. In addition, the increase in choline or decrease in B/C was associated with the increase in plasma triglycerides. The distribution of gut microbiota belonging to the Firmicutes, such as Clostridia, Clostridiales, Peptostreptococcaceae, Romboutsia, and Romboutsia timonensis was altered to be lower during the 6 months both as choline decreased and B/C increased. Moreover, the decrease in choline and the increase in B/C were associated with reduced fat intake and increased fiber intake after the 6-month intervention. Finally, lower abundance of Romboutsia showed the association with lower LDL-cholesterol and higher intake of fiber. In summary, we demonstrated that reduced choline and increased B/C by lifestyle intervention were associated with the improvements of LDL-cholesterol and triglycerides, low-fat and high-fiber intakes, and low abundance of Firmicutes. These indicate that changes to circulating choline and B/C could predict individuals’ changes in metabolic compositions in response to the lifestyle intervention.

This study aims to determine main health-related anthropometric and metabolic parameters in young physically active male students in their first year of study. Sixty one male students from a Polish university of physical education were studied twice–at the beginning of their first and second academic years. Body weight, height, waist circumference, and body composition were measured. Plasma levels of thyroid-stimulating hormone (TSH), leptin, cortisol, and insulin, as well as insulin resistance (IR) using the homeostatic model assessment (HOMA) were determined. In 64% of the participants body weight and body mass index (BMI) significantly increased during the study. An average students’ weight gain amounted to 1.2 kg. In most of the subjects it resulted from the increase of fat-free mass ( r = .886, p < .001). TSH and leptin levels did not change, but a significant increase of cortisol levels and a tendency toward decreased insulin levels and also HOMA-IR values were observed. However, there were no significant correlations identified between the changes in anthropometric and biochemical parameters. The study revealed that body weight gain seen in male students during their first year at the university of physical education was mainly due to the increase in fat-free mass. Apart from anthropometrics, changes in their insulin and cortisol levels were also detected, but further studies are required to evaluate these findings. The documented insufficient energy and carbohydrates consumption in physically active male students proves the need for nutritional education among them.

This study investigated the impact of anthropometric parameters, adiponectin, leptin, homeostatic model assessment for insulin resistance (HOMA-IR), beta-isomerised C-terminal telopeptide of collagen type I (β-CTX), and routine biochemical tests on one-year mortality in hip fracture patients. We found that male patients with high adiponectin, leptin, and β-CTX levels had a 5-fold increase in all-cause one-year mortality.Several predictors of one-year hip fracture mortality have been identified including advanced age, male sex, low bone mineral density, and preexisting comorbidities. However, the impact of metabolic parameters on hip fracture mortality remains unknown. The aim of this study was to examine the effect of serum leptin and adiponectin levels, as well as other metabolic parameters on all-cause one-year hip fracture mortality.This prospective study included 236 patients of all ages with non-traumatic hip fractures. Anthropometric parameters, adiponectin, leptin, HOMA-IR, β-CTX, and routine biochemical tests were recorded at admission and correlated with one-year mortality by using multivariate Cox proportional hazard models.The median patient age was 82 (75-87) years, and one-year mortality rate was 28.4%. In univariate analysis, adiponectin, age, β-CTX, and renal function were associated with mortality. However, in a multivariate model, male gender, high β-CTX, adiponectin, and leptin were independently associated with increased mortality. Thus, we constructed a nomogram that included all the latter variables in addition to age. The nomogram predicted mortality with a sensitivity of 74.8% (66.0-82.3) and specificity of 74.4% (57.9-87.0), and had an area under the curve of 0.784. Patients that scored9.2 had a mortality of 10.1%, while those with9.2 had a mortality of 49.2% (relative risk 5.4, 95% CI 2.8-10.2, P 0.001).Male patients with high adiponectin, leptin, and β-CTX levels have a 5-fold increase in all-cause one-year mortality after hip fracture.

Purpose: To investigate the correlation between 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) metabolic parameters and clinicopathological factors in pathological subtypes of invasive lung adenocarcinoma and prognosis.Patients and Methods: Metabolic parameters and clinicopathological factors from 176 consecutive patients with invasive lung adenocarcinoma between August 2008 and August 2016 who underwent 18F-FDG PET/CT examination were retrospectively analyzed. Invasive lung adenocarcinoma was divided into five pathological subtypes:lepidic predominant adenocarcinoma (LPA), acinar predominant adenocarcinoma (APA), papillary predominant adenocarcinoma (PPA), solid predominant adenocarcinoma (SPA), and micropapillary predominant adenocarcinoma (MPA). The differences in metabolic parameters [maximal standard uptake value (SUVmax), mean standard uptake value (SUVmean), total lesion glycolysis (TLG), and metabolic tumor volume (MTV)] and tumor diameter for different pathological subtypes were analyzed. Patients were divided into two groups according to their prognosis: good prognosis group (LPA, APA, PPA) and poor prognosis group (SPA, MPA). Logistic regression was used to filter predictors and construct a predictive model, and areas under the receiver operating curve (AUC) were calculated. Cox regression analysis was performed on prognostic factors.Results: 82 (46.6%) females and 94 (53.4%) males of patients with invasive lung adenocarcinoma were enrolled in this study. Metabolic parameters and tumor diameter of different pathological subtype had statistically significant (P < 0.05). The predictive model constructed using independent predictors (Distant metastasis, Ki-67, and SUVmax) had good classification performance for both groups. The AUC for SUVmax was 0.694 and combined with clinicopathological factors were 0.745. Cox regression analysis revealed that Stage, TTF-1, MTV, and pathological subtype were independent risk factors for patient prognosis. The hazard ratio (HR) of the poor prognosis group was 1.948 (95% CI 1.042–3.641) times the good prognosis group. The mean survival times of good and poor prognosis group were 50.2621 (95% CI 47.818–52.706) and 35.8214 (95% CI 27.483–44.159) months, respectively, while the median survival time was 47.00 (95% CI 45.000–50.000) and 31.50 (95% CI 23.000–49.000) months, respectively.Conclusion: PET/CT metabolic parameters combined with clinicopathological factors had good classification performance for the different pathological subtypes, which may provide a reference for treatment strategies and prognosis evaluation of patients.

INTRODUCTION: Apple vinegar (AV) has been proclaimed to have different health benefits, such as a weight loss, the ability to lower blood glucose levels, and reducing the risk of heart diseases. Studies on animals have demonstrated effects of AV consumption, deepening our knowledge of the beneficial effects and side effects.AIM: The aims of this study were to evaluate the evidence of the effect of AV on metabolic parameters and body weight in humans, furthermore, to evaluate the safety and side effects of ingesting AV, and additionally to evaluate the evidence of the effect of AV on metabolic parameters, safety, and side effects of AV from studies performed on animals (mammals).METHODS: A systematic literature search was performed. The databases PubMed (MEDLINE), PsycInfo (Ebsco), CINAHL (Ebsco), and Embase (Ovid) were searched for relevant articles. Primary outcomes were glycated hemoglobin, postprandial glucose, and synonyms for blood glucose. Secondary outcomes were waist circumference, visceral fat, high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol. Studies performed on humans and animals were included. The included studies performed on humans were quality assessed for risk of bias using a version of the Cochrane Collaboration's tool.RESULTS: A total of 487 papers were identified in the literature search. Of these, 13 studies performed on humans and 12 studies performed on animals were included. There may be beneficial health effects from the consumption of AV. The risk of side effects when ingested in recommended quantities and in recommended ways seems inconsiderable.CONCLUSION: Due to inadequate research of high quality, the evidence for the health effects of AV is insufficient. Therefore, more large-scale, long-term clinical studies with a low risk of bias are needed before definitive conclusions can be made.

Purpose: This study assessed the ability of metabolic parameters from 18Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and clinicopathological data to predict epidermal growth factor receptor (EGFR) expression/mutation status in patients with lung adenocarcinoma and to develop a prognostic model based on differences in EGFR expression status, to enable individualized targeted molecular therapy.Patients and Methods: Metabolic parameters and clinicopathological data from 200 patients diagnosed with lung adenocarcinoma between July 2009 and November 2016, who underwent 18F-FDG PET/CT and EGFR mutation testing, were retrospectively evaluated. Multivariate logistic regression was applied to significant variables to establish a prediction model for EGFR mutation status. Overall survival for both mutant and wild-type EGFR was analyzed to establish a multifactor Cox regression model.Results: Of the 200 patients, 115 (58%) exhibited EGFR mutations and 85 (42%) were wild-type. Among selected metabolic parameters, metabolic tumor volume (MTV) demonstrated a significant difference between wild-type and mutant EGFR mutation status, with an area under the receiver operating characteristic curve (AUC) of 0.60, which increased to 0.70 after clinical data (smoking status) were combined. Survival analysis of wild-type and mutant EGFR yielded mean survival times of 34.451 (95% CI 28.654–40.249) and 53.714 (95% CI 44.331–63.098) months, respectively. Multivariate Cox regression revealed that mutation type, tumor stage, and thyroid transcription factor-1 (TTF-1) expression status were the main factors influencing patient prognosis. The hazard ratio for mutant EGFR was 0.511 (95% CI 0.303–0.862) times that of wild-type, and the risk of death was lower for mutant EGFR than for wild-type. The risk of death was lower in TTF-1-positive than in TTF-1-negative patients.Conclusion:18F-FDG PET/CT metabolic parameters combined with clinicopathological data demonstrated moderate diagnostic efficacy in predicting EGFR mutation status and were associated with prognosis in mutant and wild-type EGFR non-small-cell lung cancer (NSCLC), thus providing a reference for individualized targeted molecular therapy.

Objectives The current study aimed at investigating the correlation of circulating levels of serum C1q/TNF-related protein-3 (CTRP3) with cardiac autonomic functions and metabolic parameters in obesity. Methods Thirty drug naive subjects newly diagnosed with obesity and body mass index (BMI) 25 - 35 kg/m2 of both genders aged 19 - 40 years, with no associated comorbidity were recruited as cases. Same number of age, gender and socioeconomic status matched subjects with BMI 19 - 23 kg/m2 were taken as controls. Autonomic function test results including heart rate variability (HRV) were recorded in both groups. Serum metabolic parameters -CTRP3, leptin, adiponectin, insulin, blood glucose, glycated hemoglobin (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, and triglycerides were also determined and compared between the groups. Results Significantly lower circulating levels of CTRP3 (P ≤ 0.001) and adiponectin (P = 0.025), and significantly higher mean of BMI (P < 0.001), fasting blood glucose (P < 0.001), LDL-cholesterol (P < 0.05), serum triglycerides (P < 0.001), insulin (P = 0.003), HOMA-IR (homeostasis model assessment of insulin resistance) (P < 0.001), and leptin (P = 0.043) were observed in the group with obesity compared to the controls. CTRP3 levels inversely correlated with serum triglyceride (r = -0.09, P < 0.001), atherogenic index (r = -0.37, P = 0.04), leptin (r = -0.39, P = 0.02), and positively with adiponectin (r = 0.42, P = 0.02) in the group with obesity. Significant reduction in the results of parasympathetic autonomic function tests (pNN50, RMSSD, excitation: inhibition (E:I) ratio, 30:15 ratio, and Valsalva ratio) and an increase in sympathovagal balance (low frequency to high frequency (LF:HF) ratio) was also observed (P < 0.05). CTRP3 levels were also positively correlated with parasympathetic indices (pNN50: r = 0.17, P < 0.05); 30:15 ratio: (r = 0.62, P < 0.01), and inversely correlated with LF: HF ratio (r = -0.35, P < 0.01) in the group with obesity. Conclusions Higher circulating levels of CTRP3 promoted a favorable autonomic and metabolic profile in obesity. Hence, CTRP3 may be considered as a potential novel biomarker to facilitate the prognosis of obesity and its comorbidities.

Purpose Metabolic parameters are increasingly being used to characterize tumors. Motion artifacts due to patient respiration introduce uncertainties in quantification of metabolic parameters during positron emission tomography (PET) image acquisition. The present study investigates the impact of amplitude-based optimal respiratory gating (ORG) on quantification of PET-derived image features in patients with pancreatic ductal adenocarcinoma (PDAC), in correlation with overall survival (OS). Methods Sixty-nine patients with histologically proven primary PDAC underwent 2′-deoxy-2′-[18F]fluoroglucose ([18F]FDG) PET/CT imaging during diagnostic work-up. Standard image acquisition and reconstruction was performed in accordance with the EANM guidelines and ORG images were reconstructed with a duty cycle of 35%. PET-derived image features, including standard parameters, first- and second-order texture features, were calculated from the standard and corresponding ORG images, and correlation with OS was assessed. Results ORG significantly impacts the quantification of nearly all features; values of single-voxel parameters (e.g., SUVmax) showed a wider range, volume-based parameters (e.g., SUVmean) were reduced, and texture features were significantly changed. After correction for motion artifacts using ORG, some features that describe intra-tumoral heterogeneity were more strongly correlated to OS. Conclusions Correction for respiratory motion artifacts using ORG impacts the quantification of metabolic parameters in PDAC lesions. The correlation of metabolic parameters with OS was significantly affected, in particular parameters that describe intra-tumor heterogeneity. Therefore, interpretation of single-voxel or average metabolic parameters in relation to clinical outcome should be done cautiously. Furthermore, ORG is a valuable tool to improve quantification of intra-tumoral heterogeneity in PDAC.

To evaluate the prognostic role of pretreatment 18F-FDG PET/CT metabolic parameters in non-endemic Epstein–Barr Virus (EBV DNA)-related nasopharyngeal cancer (NPC) patients treated with curative intensity-modulated radiation therapy (IMRT) with or without chemotherapy (CHT). We retrospectively reviewed clinical data of 160 consecutive non-metastatic NPC patients who received IMRT with or without CHT. Forty-nine out of 160 patients that underwent whole body 18F-FDG PET/CT at our institution for disease staging with a minimum follow-up to 12 months were included in this study. We evaluated the relationship between maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume and total lesion glycolysis (TLG) of primary tumor and cervical lymph nodes with disease-free survival (DFS) and overall survival (OS). We also investigated the prognostic role of clinical variables such as age, disease stage, plasma EBV DNA load (copies/ml), gross tumor volume of primary tumor and lymph nodes. Median follow-up was 55 months. Two- and 5-year OS were 95.8% and 90.5%, respectively, while DFS was 83.4% at both time points. SUVmax of primary tumor ≥ 18.8 g/ml and primary tumor TLG ≥ 203.1 g were significant prognostic factors of worse OS. Furthermore, stages IVB and EBV DNA load ≥ 3493 copies/ml were significantly associated with lower DFS. No correlation was found between PET parameters and plasma EBV DNA load. Even in a limited series, our data suggested that SUVmax, SUVmean and TLG of primary tumor could predict a poor outcome in NPC patients also in non-endemic area hypothesizing their use for refinement of prognostication.

Background: Metabolic syndrome (MetS) is a common problem in schizophrenia patients and associated with increased mortality due to cardiovascular disease. Second-generation antipsychotics (SGAs) play an important role in facilitating MetS. Objective: The study aimed to assess weight changes and alterations of indicators of body fat composition and lipid-glucose metabolism induced by reinitiating atypical antipsychotics in patients with schizophrenia when with or without MetS. Methods: After giving informed consent, newly admitted patients with a clinical diagnosis of schizophrenia (ICD-10: F20) and an age between 18 and 55 years were included. MetS was diagnosed according to International Diabetes Federation (IDF) criteria. At entry and after 6 weeks of treatment, anthropometry and biochemical analysis were carried out. Total and visceral fats were measured with the use of non-invasive bioimpedance analysis and subcutaneous fat with calculation of total adipose tissue with the use of caliperometry. Based on biochemical assessments low density (LDL) and very low-density lipoproteins (VLDL), atherogenic index and Homeostatic Model Assessment of Insulin Resistance (IR-HOMA) were calculated. Statistical analysis was conducted using Wilcoxon signed-rank test, Mann-Whitney U-test, and chi-squared test. Differences were considered statistically significant at p < 0.05. Results: A total of 114 patients (59M/55F) with schizophrenia were examined; they were divided into two groups with (n = 43; 37.7%) and without (n = 71; 62.3%) MetS. After a 6-week SGA treatment, only the total fat fold, waist circumference, triglyceride level, and atherogenic index underwent statistically significant changes in patients with MetS. In those without MetS, statistically significant changes across all fat indicators were noted. Also, a significant increase in blood glucose and HOMA-IR parameters, triglyceride, and VLDL levels and atherogenic index was observed in this group. Discussion: The study illustrates the benefits of estimating both anthropometric and biochemical parameters shortly after (re)installing treatment of schizophrenia in order to minimize the risk of MetS development.

Мета дослідження полягала у вивченні асоціації генетичного поліморфізму маркера G276T гена адипонектину зі змінами метаболічних показників у пацієнтів із гіпертонічною хворобою (ГХ) і супутнім ожирінням. Обстежено 300 пацієнтів із ГХ віком від 45 до 55 років, які дали інформовану письмову згоду на участь у дослідженні і відповідали критеріям включення. До першої групи ввійшло 200 пацієнтів із ГХ у поєднанні з ожирінням І–ІІ ступенів, до другої групи – 50 пацієнтів із ГХ і нормальною масою тіла, до третьої групи – 50 пацієнтів із ГХ та надлишковою масою тіла. Контрольну групу становили30 практично здорових осіб, в яких ГХ та ожиріння були виключені на підставі даних клініко-інструментального дослідження. У результаті проведеного дослідження встановлена асоціація алеля Т поліморфного маркера G276T гена адипонектину з розвитком коморбідності ГХ та ожиріння. Доведено, що поліморфізм гена адипонектину впливав на зміни метаболічних показників у пацієнтів із ГХ та ожирінням: при G/Т- і Т/Т-генотипах мали місце більш виражені порушення метаболічних показників, ніж при G/G-генотипі. G/Т- і Т/Т-генотипи поліморфного маркера G276T гена адипонектину були пов’язані з достовірно більшим індексом маси тіла, вищими рівнями тригліцеридів, більш вираженою інсулінорезистентністю та дисбалансом адипокінів. Цель исследования заключалась в изучении ассоциации генетического полиморфизма маркера G276T гена адипонектина с изменениями метаболических показателей у пациентов с гипертонической болезнью (ГБ) и сопутствующим ожирением. Обследовано 300 пациентов с ГБ в возрасте от 45 до 55 лет, давших информированное письменное согласие на участие в исследовании и соответствовавших критериям включения. В группу 1 вошли 200 пациентов с ГБ в сочетании с ожирением I-II степени, в группу 2 - 50 пациентов с ГБ и нормальной массой тела,, в группу 3 - 50 пациентов с ГБ и избыточной массой тела. Контрольная группа состояла из 30 практически здоровых лиц, у которых ГБ и ожирение были исключены на основании данных клинико-инструментального обследования. В результате проведенного исследования установлена ассоциация аллеля Т полиморфного маркера G276T гена адипонектина с развитием коморбидности ГБ и ожирения. Доказано, что полиморфизм гена адипонектина влиял на изменения метаболических показателей у пациентов с ГБ и ожирением: при G/Т и Т/Т генотипах имели место более выраженные нарушения метаболических показателей, чем при G/G генотипе. G/Т и Т/Т генотипы полиморфного маркера G276T гена адипонектина были связаны с достоверно большим индексом массы тела, более высокими уровнями триглицеридов, более выраженной инсулинорезистентностью и дисбалансом адипокинов. Relevance. The main component of the metabolic syndrome (MS) is the abdominal obesity (AO) which inevitably leads to insulin resistance (IR). Adiponectin (AN) secreted by the adipocytes protects from the IR development, increases the sensitivity of skeletal muscles to insulin, reduces intake of free fatty acids in a liver and, thus reduces the synthesis of atherogenic lipoproteins. Some investigations prove that the level of the adiponectin in blood plasma correlates back with the mass of the fatty tissue, the waist-hip ratio and IR expressiveness. With obesity, AN secretion decreases, losing its protective role as for the risk of IR development and metabolic violations. It is known that ADIPOQ gene has several polymorphic sites, which influence the production and activity of AN. Allelic options of its polymorphic marker G276T are associated with the development of the AO, IR, and diabetes. The aim of the study was to investigate the association of the genetic polymorphism of the G276T marker of the adiponectin gene with changes in metabolic parameters in patients with arterial hypertension (AH) and concomitant obesity. We examined 300 patients with AH 45 to 55 years old who gave informed written consent to participate in the study and met the inclusion criteria. Group 1 consisted of 200 patients with AH and class I–II obesity, group 2 – 50 patients with AH and normal body weight, group 3 – 50 patients with AH and overweight. The control group consisted of 30 practically healthy individuals, in whom AH and obesity were excluded on the basis of clinical and instrumental examination data. As a result of the study the association of T-allele of the polymorphic marker G276T of the adiponectin gene with the development of comorbidity of AH and obesity was established. It has been proven that adiponectin gene polymorphism influenced changes in metabolic parameters in hypertensive patients with obesity: more pronounced impairment of metabolic parameters in G/T and T/T genotypes as compared to G/G genotype. G/T and T/T genotypes of the polymorphic marker G276T of the adiponectin gene were associated with a significantly higher body mass index, higher triglyceride levels, more pronounced insulin resistance and adipokine imbalance.

Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, Basel, C1 [Sonmez, Alper; Haymana, Cem; Demirci, Ibrahim] Univ Hlth Sci, Gulhane Sch Med, Dept Endocrinol & Metab, TR-06018 Ankara, Turkey., [Yumuk, Volkan] Istanbul Univ, Cerrahpasa Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey., [Barcin, Cem] Univ Hlth Sci, Gulhane Sch Med, Dept Cardiol, Ankara, Turkey., [Kiyici, Sinem] Univ Hlth Sci, Bursa Yuksek Ihtisas Training & Res Hosp, Dept Endocrinol & Metab, Bursa, Turkey., [Guldiken, Sibel] Trakya Univ, Med Fac, Dept Endocrinol & Metab, Edirne, Turkey., [Oruk, Gonca] Izmir Katip Celebi Univ, Ataturk Educ & Res Hosp, Dept Endocrinol & Metab, Izmir, Turkey., [Saydam, Basak Ozgen] Dokuz Eylul Univ, Med Fac, Dept Endocrinol & Metab, Izmir, Turkey., [Baldane, Suleyman] Selcuk Univ, Med Fac, Dept Endocrinol & Metab, Konya, Turkey., [Kutluturk, Faruk] Gaziosmanpasa Univ, Med Fac, Dept Endocrinol & Metab, Tokat, Turkey., [Kucukler, Ferit Kerim] Hitit Univ, Med Fac, Dept Endocrinol & Metab, Corum, Turkey., [Deyneli, Oguzhan] Marmara Univ, Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey., [Cetinarslan, Berrin] Kocaeli Univ, Med Fac, Dept Endocrinol & Metab, Kocaeli, Turkey., [Sabuncu, Tevfik] Harran Univ, Med Fac, Dept Endocrinol & Metab, Urfa, Turkey., [Bayram, Fahri] Erciyes Univ, Med Fac, Dept Endocrinol & Metab, Kayseri, Turkey., [Satman, Ilhan] Istanbul Univ, Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey., [Ayturk, Semra] Trakya Univ, Sch Med, Dept Endocrinol & Metab, Edirne, Turkey., [Yilmaz, Murat] Corlu REYAP Private Hosp, Dept Endocrinol & Metab, Corlu, Turkey., [Asik, Mehmet] Canakkale 18 March Univ, Sch Med, Dept Endocrinol & Metab, Canakkale, Turkey., [Dinccag, Nevin; Cakmak, Ramazan; Turker, Fulya; Idiz, Cemile; Hacisahinogullari, Hulya; Bagdemir, Elif; Yildiz, Busra; Haliloglu, Ozlem] Istanbul Univ, Sch Med, Dept Endocrinol & Metab, Cerrahpasa, Turkey., [Sancak, Seda] Univ Hlth Sci, Sch Med, Fatih Sultan Mehmet Training & Res Hosp, Dept Endocrinol & Metab, Istanbul, Turkey., [Ozsari, Levent; Cagiltay, Eylem] Univ Hlth Sci, Sch Med, Sultanabdulhamit Training & Res Hosp, Dept Endocrinol & Metab, Istanbul, Turkey., [Imre, Eren] Marmara Univ, Sch Med, Dept Endocrinol & Metab, Istanbul, Turkey., [Sait Gonen; Boysan, S. Nur] Istanbul Sci Univ, Sch Med, Dept Endocrinol & Metab, Istanbul, Turkey., [Altuntas, Yuksel; Ozturk, Feyza Yener] Univ Hlth Sci, Sch Med, Sisli Hamidiye Etfal Training & Res Hosp, Dept Endocrinol & Metab, Istanbul, Turkey., [Mert, Meral; Piskinpasa, Hamide] Univ Hlth Sci, Istanbul Bakirkoy Dr Sadi Konuk Training & Res Ho, Sch Med, Dept Endocrinol & Metab, Istanbul, Turkey., [Aydin, Hasan] Yeditepe Univ, Sch Med, Dept Endocrinol & Metab, Istanbul, Turkey., [Ersoy, Canan; Oz Gul, Ozen] Uludag Univ, Sch Med, Dept Endocrinol & Metab, Bursa, Turkey., [Selek, Alev] Kocaeli Univ, Sch Med, Dept Endocrinol & Metab, Kocaeli, Turkey., [Dogru, Teoman; Kirik, Ali] Balikesir Univ, Sch Med, Dept Internal Med, Balikesir, Turkey., [Kebapci, Nur; Efe, Belgin] Eskisehir Osmangazi Univ, Sch Med, Dept Endocrinol & Metab, Odunpazari Eskisehir, Turkey., [Kaya, Ahmet; Cordan, Ilker] Necmettin Erbakan Univ, Sch Med, Dept Endocrinol & Metab, Konya, Turkey., [Kirac, Cem Onur] Selcuk Univ, Sch Med, Dept Endocrinol & Metab, Konya, Turkey., [Capa, Zehra] Univ Hlth Sci, Gulhane Sch Med, Ankara, Turkey., [Capa, Zehra] Gulhane Training & Res Hosp, Dept Endocrinol & Metab, Ankara, Turkey., [Cesur, Mustafa] Private Guven Hosp, Dept Endocrinol & Metab, Ankara, Turkey., [Yetkin, Ilhan] Gazi Univ, Sch Med, Dept Endocrinol & Metab, Ankara, Turkey., [Corapcioglu, Demet; Canlar, Sule] Ankara Univ, Sch Med, Dept Endocrinol & Metab, Ankara, Turkey., [Yildiz, Okan Bulent; Sendur, Suleyman Nahit] Hacettepe Univ, Sch Med, Dept Endocrinol & Metab, Ankara, Turkey., [Cakir, Bekir; Ozdemir, Didem] Yildirim Beyazit Univ, Sch Med, Dept Endocrinol & Metab, Ankara, Turkey., [Corakci, Ahmet] Ufuk Univ, Sch Med, Dept Endocrinol & Metab, Ankara, Turkey., [Kutlu, Mustafa] Private Bayindir Hosp, Dept Endocrinol & Metab, Ankara, Turkey., [Bascil Tutuncu, Neslihan; Bozkus, Yusuf] Baskent Univ, Sch Med, Dept Endocrinol & Metab, Ankara, Turkey., [Cakal, Erman] Univ Hlth Sci, Sch Med, Diskapi Yildirim Beyazit Training & Res Hosp, Dept Endocrinol & Metab, Ankara, Turkey., [Demirbas, Berrin] TOBB Univ, Sch Med, Dept Endocrinol & Metab, Ankara, Turkey., [Ertek, Sibel] Private Mem Hosp, Dept Endocrinol & Metab, Ankara, Turkey., [Altay, Mustafa; Dagdeviren, Murat] Univ Hlth Sci, Sch Med, Kecioren Training & Res Hosp, Dept Endocrinol & Metab, Ankara, Turkey., [Abedi, Amir Hassein] Erciyes Univ, Sch Med, Dept Endocrinol & Metab, Kayseri, Turkey., [Cetinkalp, Sevki; Ozisik, Hatice] Ege Univ, Sch Med, Dept Endocrinol & Metab, Izmir, Turkey., [Yener, Serkan] Dokuz Eylul Univ, Sch Med, Dept Endocrinol & Metab, Izmir, Turkey., [Guney, Engin; Unubol, Mustafa] Adnan Menderes Univ, Sch Med, Dept Endocrinol & Metab, Aydin, Turkey., [Yaylali, Guzin Fidan; Topsakal, Senay] Pamukkale Univ, Sch Med, Dept Endocrinol & Metab, Denizli, Turkey., [Hekimsoy, Zeliha] Celal Bayar Univ, Sch Med, Dept Endocrinol & Metab, Manisa, Turkey., [Akbaba, Gulhan] Mugla Univ, Sch Med, Dept Endocrinol & Metab, Mugla, Turkey., [Aslan, Ibrahim] Univ Hlth Sci, Antalya Training & Res Hosp, Sch Med, Dept Endocrinol & Metab, Antalya, Turkey., [Balci, Mustafa Kemal; Dalkiran, Sefika] Akdeniz Univ, Sch Med, Dept Endocrinol & Metab, Antalya, Turkey., [Akbay, Esen] Mersin Univ, Sch Med, Dept Endocrinol & Metab, Mersin, Turkey., [Gul, Kamile] Kahramanmaras Sutcu Imam Univ, Sch Med, Dept Endocrinol & Metab, Kahramanmaras, Turkey., [Agbaht, Kemal] Private Defne Hosp, Dept Endocrinol & Metab, Antalya, Turkey., [Yilmaz, Muge Ozsan] Mustafa Kemal Univ, Sch Med, Dept Endocrinol & Metab, Antakya, Turkey., [Bozkirli, Emre] Baskent Univ, Adana Training Hosp, Dept Endocrinol & Metab, Ankara, Turkey., [Tetiker, B. Tamer; Cetinkaya Altuntas, Seher] Cukurova Univ, Sch Med, Dept Endocrinol & Metab, Adana, Turkey., [Atmaca, Aysegul; Durmus, Elif Tutku] 19 Mayis Univ, Sch Med, Dept Endocrinol & Metab, Samsun, Turkey., [Mete, Turkan] Univ Hlth Sci, Sch Med, Samsun Training & Res Hosp, Dept Endocrinol & Metab, Samsun, Turkey., [Dikbas, Oguz] Giresun Univ, Sch Med, Dept Endocrinol & Metab, Giresun, Turkey., [Akin, Safak] Recep Tayyip Erdogan Univ, Sch Med, Dept Endocrinol & Metab, Rize, Turkey., [Nuhoglu, Irfan; Ersoz, Halil Onder] Karadeniz Tech Univ, Sch Med, Dept Endocrinol & Metab, Trabzon, Turkey., [Bayraktaroglu, Taner] Bulent Ecevit Univ, Sch Med, Dept Endocrinol & Metab, Zonguldak, Turkey., [Sisman, Pinar] Kars Harakani State Hosp, Dept Endocrinol & Metab, Kars, Turkey., [Sahin, Ibrahim; Cetin, Sedat] Inonu Univ, Sch Med, Dept Endocrinol & Metab, Malatya, Turkey., [Capoglu, Ilyas; Akbas, Emin Murat] Erzincan Univ, Sch Med, Dept Endocrinol & Metab, Erzincan, Turkey., [Ucler, Rifki] Yuzuncu Yil Univ, Sch Med, Dept Endocrinol & Metab, Van, Turkey., [Eren, Mehmet Ali] Harran Univ, Sch Med, Dept Endocrinol & Metab, Sanliurfa, Turkey., [Tuzcu, Alpaslan Kemal; Pekkolay, Zafer] Dicle Univ, Sch Med, Dept Endocrinol & Metab, Diyarbakir, Turkey., [Ozkaya, Mesut] Univ Hlth Sci, Sch Med, Gaziantep Ersin Arslan Res & Training Hosp, Gaziantep, Turkey., [Araz, Mustafa] Gaziantep Univ, Sch Med, Dept Endocrinol & Metab, Gaziantep, Turkey., [Salman, Serpil] Liv Hosp Ulus, Dept Endocrinol & Metab, Istanbul, Turkey., [Dizdar, Oguzhan Sitki] Kayseri Educ & Res Hosp, Dept Internal Med, Kayseri, Turkey., [Gurkan, Eren] Mustafa Kemal Univ, Dept Endocrinol & Metab, Antakya, Turkey., [Kargili Carlioglu, Ayse] Erzurum Reg Educ & Res Hosp, Dept Endocrinol & Metab, Erzurum, Turkey.

International audience; CONTEXT: Untreated acromegaly is associated with increased morbidity and mortality due to malignant, cardiovascular, and cerebrovascular disorders. Effective treatment of acromegaly reduces excess mortality, but its impact on cardiovascular risk factors and metabolic parameters are poorly documented.AIM: We analyzed changes in cardiovascular risk factors and metabolic parameters in patients receiving various treatment modalities.PATIENTS AND METHODS: We retrospectively studied 96 patients with acromegaly, both at diagnosis and after IGF-I normalization following surgery alone (n = 51) or medical therapy with first generation somatostatin analogues (SSA, n = 23), or pegvisomant (n = 22). Duration of follow-up was 77 (42-161) months, 75 (42-112) months, and 62 (31-93) months, in patients treated with surgery alone, SSA, and pegvisomant, respectively. In all the cases except four, patients treated medically had underwent previous unsuccessful surgery.RESULTS: IGF-I normalization was associated with increased body weight, decreased systolic blood pressure (SBP) in hypertensive patients, decreased fasting plasma glucose (FPG) and HOMA-IR and HOMA-B levels, increased HDL cholesterol (HDLc); whereas, LDL cholesterol (LDLc) was not significantly different. Plasma PCSK9 levels were unchanged in patients with available values. Cardiovascular and metabolic changes varied with the treatment modality: surgery, but not pegvisomant, had a beneficial effect on SBP; FPG decreased after surgery but increased after SSA; the decline in HOMA-IR was only significant after surgery; pegvisomant significantly increased LDLc and total cholesterol; whereas SA increased HDLc and had no effect on LDLc levels.CONCLUSION: Treatments used to normalize IGF-I levels in patients with acromegaly could have differential effects on cardiovascular risk factors and metabolic parameters.

Background: Obesity is known as one of the major causes of epidemiologic diseases worldwide; therefore, the introduction of treatment strategies by medical professionals, such as the use of various medicines and exercise programs to reduce fat or prevent obesity, is on the rise. Recently, researchers have shown special interest in assessing the effect of lipolytic adenosine and vitamin D deficiency, as well as the effect of exercise, on decreasing body fat percentage. Objective: This study has been designed to examine the effect of adenosine and vitamin D3 injections, in conjunction with high-intensity interval training and isocaloric moderate-intensity training, on the metabolic parameters of obesity induced by a high-fat diet. Methods: This is an experimental study using 92 Wistar rats. At 6 weeks of age, the rats' weights will be recorded, after which they will have 1 week to adapt to their new environment before being divided into 12 groups. The rats will participate in a 2-stage experimental intervention, including a 13-week fattening diet phase followed by a 12-week exercise training phase consisting of an exercise program and the injection of adenosine and vitamin D3. Groups 1 and 2 will have a normal diet, and the other groups will have a diet of 40% fat, with free access to food and water up to the second half of the second stage of the study (end of the sixth week of training). After termination of the interventions, tissue collection and molecular assessments (blood for biochemical, tissues for gene expression analyses, and anthropometrical indexes) will be performed. Results: The project was initiated in April 2017 and completed in December 2017. Data analysis is under way, and the first results are expected to be submitted for publication in November 2018. Conclusions: We hypothesize that weight loss–induced molecular changes and upregulation will be observed in line with an increase in lipolysis and beta oxidation in muscle and fat tissue as a result of performing isocaloric training in drug-receiving rats and groups on a high-fat diet. International Registered Report Identifier (IRRID): RR1-10.2196/10753

Objectives: This study investigated the effect of French maritime pine bark extract (PBE) supplementation on metabolic parameters, vascular cell adhesion molecule 1 (VCAM-1), urinary albumin-to-creatinine ratio (UACR), and anthropometric indexes in patients with type 2 diabetes (T2DM) and microalbuminuria. Design: This randomized, double-blind, placebo-controlled clinical trial was conducted on 46 patients with T2DM and the evidence of microalbuminuria aged 30–65 years. Setting: Patients were recruited from the endocrinology clinic of Sina hospital (Tabriz, Iran) from March 2018 to April 2019. Interventions: The subjects were randomly assigned to receive two capsules/day each containing 50mg of PBE or placebo for eight weeks. Main outcome measures: Glycemic parameters, serum VCAM-1 and lipid profile, UACR, and anthropometric indexes were measured for all patients at baseline and the end of the study. Results: PBE supplementation significantly reduced glycosylated hemoglobin, VCAM-1, total cholesterol, UACR, waist circumference, and waist-to-height ratio compared to the placebo group at the end of the study (all P < 0.05). Changes in fasting blood glucose, insulin, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were not significant between the two groups (all P > 0.05). Conclusions: The study findings demonstrated some favorable effects of PBE supplementation on glycemic control, serum VCAM-1 and total cholesterol levels, and microalbuminuria, as well as abdominal obesity in patients with T2DM.