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BACKGROUND:Worldwide, dengue is an unrelenting economic and health burden. Dengue outbreaks have become increasingly common, which place great strain on health infrastructure and services. Early warning models could allow health systems and vector control programmes to respond more cost-effectively and efficiently. METHODOLOGY/PRINCIPAL FINDINGS:The Shewhart method and Endemic Channel were used to identify alarm variables that may predict dengue outbreaks. Five country datasets were compiled by epidemiological week over the years 2007-2013. These data were split between the years 2007-2011 (historic period) and 2012-2013 (evaluation period). Associations between alarm/ outbreak variables were analysed using logistic regression during the historic period while alarm and outbreak signals were captured during the evaluation period. These signals were combined to form alarm/ outbreak periods, where 2 signals were equal to 1 period. Alarm periods were quantified and used to predict subsequent outbreak periods. Across Mexico and Dominican Republic, an increase in probable cases predicted outbreaks of hospitalised cases with sensitivities and positive predictive values (PPV) of 93%/ 83% and 97%/ 86% respectively, at a lag of 1-12 weeks. An increase in mean temperature ably predicted outbreaks of hospitalised cases in Mexico and Brazil, with sensitivities and PPVs of 79%/ 73% and 81%/ 46% respectively, also at a lag of 1-12 weeks. Mean age was predictive of hospitalised cases at sensitivities and PPVs of 72%/ 74% and 96%/ 45% in Mexico and Malaysia respectively, at a lag of 4-16 weeks. CONCLUSIONS/SIGNIFICANCE:An increase in probable cases was predictive of outbreaks, while meteorological variables, particularly mean temperature, demonstrated predictive potential in some countries, but not all. While it is difficult to define uniform variables applicable in every country context, the use of probable cases and meteorological variables in tailored early warning systems could be used to highlight the occurrence of dengue outbreaks or indicate increased risk of dengue transmission.

Ultrasound images can be utilized as a non-invasive method in the reproductive program. Striped catfish in various gonadal development were examined with a portable Mindray Model Z60Vet using the Convex probe at a frequency of 5 MHz. The results showed that the male gonads of immature striped catfishes were not distinguished from other visceral organs by using an ultrasonic technique. Ultrasound images in ovaries in stages II and III had significant differences. In ovary ‘s group of stage III, the oocyte’s dimensions on the ultrasound images were twice bigger than the group of stage II was. Before the premilitary injection, eggs displayed small, smooth, black dots, and 12h after the definitive dose, egg diameters raised twice and had brighter dots on the ultrasound images.

Tung Nguyen Thanh,1 Sang Trieu Tien,2 Phong Nguyen Van,2 Son Dang Thai,3 Thuc Luong Cong,4 Tuan Dinh Le,5 Son Tien Nguyen,5 Tuan Tran Van,1 Hoang Huy Duong,6 Tien Minh Bui,7 Kien Trung Nguyen7 1Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 2Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 3Institute of Biological and Food Technology, Hanoi Open University, Hanoi, 100000, Vietnam; 4Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 5Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Hanoi, 100000, Vietnam; 6Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam; 7Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, VietnamCorrespondence: Sang Trieu Tien, Department of Biology and Medical Genetics, Vietnam Military Medical University, Hanoi, 100000, Vietnam, Email trieusangk83@yahoo.com.vnBackground: To optimize the multiplex polymerase chain reaction (M-PCR) technique to diagnose microdeletions of azoospermia factors (AZF) on the Y chromosome and initially apply the technique to diagnose male patients with sperm density less than 5× 106 million sperm/mL was assigned to do a test to check for AZF microdeletions on the Y chromosome.Methods: Based on the positive control samples which belong to male subjects who have had 2 healthy children without any assisted reproductive technologies, the M-PCR method was developed to detect simultaneously and accurately AZF microdeletions on 32 male patients with sperm densities below 5× 106 million sperm/mL of semen at the Department of Biology and Medical Genetics – Vietnam Military Medical University.Results: Successful optimization of the M-PCR technique including 7 reactions arranged according to each AZFabc region using 24 STS/gene on the Y chromosome. Initial application to diagnose AZF deletion on 32 azoospermic and oligospermic men reveals that AZFa deletion accounts for 6.25% (2/32); deletion of all 3 regions AZFa,b,c with 18.75% (6/32 cases); The combined deletion rate of AZFb,c is highest, accounting for 56.24% (18/32 patients).Conclusion: Successfully optimized the M-PCR technique in identifying AZF microdeletions using 24 sequence tagged sites (STS)/gene for azoospermic and oligozoospermic men. The M-PCR technique has great potential in the application of AZF deletion diagnosis.Keywords: male infertility, azoospermia factors, AZF, multiplex polymerase chain reaction, M-PCR, sequence tagged sites, STS

Congenital abnormalities of the iliac artery are uncommon and often discovered incidentally during the diagnosis or treatment of peripheral vascular diseases such as abdominal aortic aneurysm (AAA) and peripheral arterial diseases. The endovascular treatment of infrarenal AAA can be complicated by anatomic abnormalities in the iliac arteries, such as the absence of the common iliac artery (CIA) or overly short bilateral common iliac arteries. We present a case of a patient with a ruptured AAA and bilateral absence of the CIA, successfully treated by endovascular intervention combined with preservation of the internal iliac artery using the sandwich technique.

Ha Thi Thu Tran,1,* Yen Hoang Nguyen,1,* Thuy Dinh Vuong,2 Loi Van Bui,3 Hue Thi Doan,1 Ha Thi Thu Le,1 Thien Cong Le,1 Thai Quoc Nguyen,4 Son Ngoc Do,5 Phuong Doan Nguyen,6 Chinh Quoc Luong,5 Tung Son Vu,7 Son Nam Tran,8 Ngoc Bao Doan,9 Long Bao Hoang,10 Tuan Van Nguyen1,11 1Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam; 2Department of Schizophrenia, Vietnam National Institute of Mental Health, Hanoi, Vietnam; 3Department of Stress-Related Disorders, Vietnam National Institute of Mental Health, Hanoi, Vietnam; 4Center of Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam; 5Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Vietnam; 6Outpatient Department, Construction Hospital, Hanoi, Vietnam; 7Department of Mood Disorders, Vietnam National Institute of Mental Health, Hanoi, Vietnam; 8Department of Oncology, Vietnam National Hospital of Traditional Medicine, Hanoi, Vietnam; 9School of Preventive medicine and Public health, Hanoi Medical University, Hanoi, Vietnam; 10Research and Training Management Department, Institute of Gastroenterology and Hepatology, Hanoi, Vietnam; 11Vietnam National Institute of Mental Health, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Ha Thi Thu Tran, Email tran_thuha@hmu.edu.vnObjective: To evaluate the prevalence of post-traumatic stress disorder (PTSD) and other psychological disturbances in the Vietnamese healthcare workers (HCWs) at COVID-19 field hospitals.Methods: A cross-sectional study was conducted using the Impact of Event Scale–Revised (IES-R) to measure PTSD and the Depression Anxiety Stress scale (DASS) to measure other psychological disturbances. The anxiety about COVID-19 was evaluated by the fear of COVID-19 (FOC) scale. A self-developed questionnaire was used to assess work conditions and HCW’s major concerns and preparedness. Ordinal logistic regression was used to identify factors associated with the severity of PTSD. A structural modeling equation (SEM) model was fitted to examine the correlation between PTSD and other psychological disturbances.Results: A total of 542 HCWs participated in this study. The prevalence of PTSD was 21.2%, most cases were mild. In the ordinal logistic regression analysis, a history of mental illness, poor preparedness, working in a condition with poor resources, a greater number of concerns, and greater fear of COVID-19 were independently associated with higher severity of PTSD. The prevalence of depression, anxiety, and stress was 46.8%, 38.3%, and 60.2, respectively. In the SEM model, PTSD and psychological disturbances had a strong correlation (standardized covariance 0.86).Conclusion: The prevalence of PTSD and other psychological disturbances was alarmingly high among HCWs who worked at COVID-19 field hospitals. The reported associated factors can be useful for policymakers and health authorities in the preparation for future pandemics.Keywords: PTSD, COVID-19, healthcare workers, DASS, fear of COVID, psychological disturbances

Summary: Background: GBP510 vaccine contains self-assembling, recombinant nanoparticles displaying SARS-CoV-2 spike receptor-binding domains. We report interim phase 3 immunogenicity results for GBP510 adjuvanted with AS03 (GBP510/AS03) compared with ChAdOx1-S (Vaxzevria, AstraZeneca) in healthy adults aged ≥18 years, up to 6 months after the second dose. Methods: This was a randomised, active-controlled, observer-blinded, parallel group, phase 3 study, conducted at 38 sites across six countries (South Korea, Philippines, Thailand, Vietnam, Ukraine and New Zealand). Cohort 1 (no history of SARS-CoV-2 infection/COVID-19 vaccination) was randomised 2:1 to receive two doses of GBP510/AS03 or ChAdOx1-S (immunogenicity and safety), while Cohort 2 (regardless of baseline serostatus) was randomised 5:1 (safety). Primary objectives were to demonstrate superiority in geometric mean titre (GMT) and non-inferiority in seroconversion rate (SCR; ≥4-fold rise from baseline) of GBP510/AS03 vs. ChAdOx1-S for neutralising antibodies against the ancestral strain by live-virus neutralisation assay. Secondary objectives included assessment of safety and reactogenicity (long-term 6 months cut-off date: 09 August 2022). This study was registered on ClinicalTrials.gov (NCT05007951). Findings: Between 30 August 2021 and 11 January 2022, a total of 4913 participants were screened and 4036 participants (1956 in Cohort 1 and 2080 in Cohort 2) who met eligibility criteria were enrolled and randomised to receive 2 doses of GBP510/AS03 (n = 3039) or ChAdOx1-S (n = 997). Most participants were Southeast Asian (81.5%) and aged 18–64 years (94.7%). The primary objectives assessed in per-protocol set included 877 participants in GBP510/AS03 and 441 in ChAdOx1-S group: at 2 weeks after the second vaccination, the GMT ratio (GBP510/AS03/ChAdOx1-S) in per-protocol set was 2.93 (95% CI 2.63–3.27), demonstrating superiority (95% CI lower limit >1) of GBP510/AS03; the between-group SCR difference of 10.8% (95% CI 7.68–14.32) also satisfied the non-inferiority criterion (95% CI lower limit > −5%). Neutralizing antibody titres sustained higher for the GBP510/AS03 group compared to the ChAdOx1-S group through 6 months after the second vaccination. In Safety analysis (Cohort 1 & 2), the proportion of participants with adverse events (AEs) after any vaccination was higher with GBP510/AS03 vs. ChAdOx1-S for solicited local AEs (56.7% vs. 49.2%), but was similar for solicited systemic AEs (51.2% vs. 53.5%) and unsolicited AEs (13.3% vs. 14.6%) up to 28 days after the second vaccination. No safety concerns were identified during follow-up for 6 months after the second vaccination. Interpretation: Our interim findings suggested that GBP510/AS03 met the superiority criterion for neutralising antibodies and non-inferiority criterion for SCR compared with ChAdOx1-S, and showed a clinically acceptable safety profile. Funding: This work was supported, in whole or in part, by funding from CEPI and the Bill & Melinda Gates Foundation Investments INV-010680 and INV-006462. The Bill & Melinda Gates Foundation supported this project for the generation of IND-enabling data and CEPI supported this clinical study.

Son Tien Nguyen,1,* Tien Bui Minh,2,* Hoa Trung Dinh,3,4 Tuan Dinh Le,1 Nga Phi Thi Nguyen,1 Thi Thanh Hoa Tran,3 Trinh Hien Vu,3 Thuc Luong Cong,5 Lan Ho Thi Nguyen,3 Phuong Tuan Pham,3,4 Tien Viet Tran,6 Kien Xuan Nguyen7 1Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 2Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 3Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam; 4National Hospital of Endocrinology, Ha Noi, Vietnam; 5Cardiovascular Center, Military Hospital 103, Vietnam Medical Military University, Ha Noi, Vietnam; 6Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam; 7Department of Military Medical Command and Organization, Vietnam Medical Military University, Ha Noi, Vietnam*These authors contributed equally to this workCorrespondence: Kien Xuan Nguyen, Department of Military Medical Command and Organization, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi city, Vietnam, Email nguyenxuankien@vmmu.edu.vnIntroduction: Cortisol is proven to play a crucial role in hyperglycemia and fetal development in gestational diabetes mellitus (GDM). This research aims to investigate the relationship between maternal serum cortisol and insulin resistance indices and fetal ultrasound characteristics in women with GDM.Methods: A cross-sectional and descriptive study on 144 GDM in Vietnam from January 2015 to December 2020. Serum cortisol was measured using electrochemiluminescence immunoassay at 8 a.m. on the examination day in the vicinity of the 24th gestational week. Fetal ultrasound was performed by an experienced person who was blind to the study.Results: The mean cortisol level in the GDM group was 627.04 nmol/L. Serum cortisol levels positively correlated with abdominal circumference (AC), fasting plasma glucose (FPG), insulin, triglycerides, HOMA2-IR, and Mathew indices (with r of 0.18, 0.22, 0.18, 0.17, 0.18, and 0.22, respectively). Serum cortisol levels negatively correlated with QUICKI and McAuley indices (with r of − 0.19 and − 0.21), respectively. In a univariate linear regression, maternal serum cortisol positively correlated with fetal AC, head circumference (HC), and biparietal diameter (BPD) (with r of 0.21; 0.23; and 0.25, respectively). In a multivariate linear regression analysis, cortisol positively correlated with fetal AC, HC, and BPD after adjusting to maternal McAuley index.Conclusion: Serum cortisol levels in GDM correlated with fasting blood glucose, triglycerides, and insulin resistance. Besides, serum cortisol levels in GDM positively correlated with fetal development.Keywords: gestational diabetes mellitus, serum cortisol, insulin resistance indices, fetal ultrasound parameters

Nga Phi Thi Nguyen,1,2,* Thuc Luong Cong,3,4,* Thi Thanh Hoa Tran,5 Binh Nhu Do,6 Son Tien Nguyen,1,2 Binh Thanh Vu,7,* Lan Ho Thi Nguyen,8 Manh Van Ngo,9 Hoa Trung Dinh,10 Hoang Duong Huy,11 Nghia Xuan Vu,12 Kien Nguyen Trung,13 Duong Ngoc Vu,14 Nghia The Pham,14 Tuan Dinh Le2,15,* 1Department of Endocrinology, Military Hospital 103, Hanoi, Vietnam; 2Department of Rheumatology and Endocrinology, Vietnam Military Medical University, Hanoi, Vietnam; 3Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam; 4Department of Cardiology, Vietnam Military Medical University, Hanoi, Vietnam; 5Emergency Resuscitation Department, National Hospital of Endocrinology, Hanoi, Vietnam; 6Division of Military Science, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 7Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of General Internal Medicine, National Hospital of Endocrinology, Hanoi, Vietnam; 9Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 10Department of Requested Treatment, National Hospital of Endocrinology, Hanoi, Vietnam; 11Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 12Department of Blood Transfusion, 108 Military Central Hospital, Hanoi, Vietnam; 13Department of Science Management, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 14Department of Imaging Diagnosis, Hanoi Medical University, Hanoi, Vietnam; 15Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Tuan Dinh Le, Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Tel +84 388166078, Email letuan985@gmail.com Binh Thanh Vu, Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, Vietnam, Tel +84 334588298, Email binhvt@tbump.edu.vnIntroduction: Low albumin levels, high levels of high-sensitivity C-reactive protein (hs-CRP), and high white blood cell count were risk factors for changes in arterial intima-media thickness (IMT). Femoral artery IMT damages were one of the common peripheral artery type 2 diabetes. This study was conducted to determine the association between femoral artery IMT and plasma albumin, hs-CRP levels, and white blood cell count in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Materials and Methods: From January 2015 to May 2020, 306 patients with nT2D were recruited for this cross-sectional descriptive study at Vietnam’s National Endocrinology Hospital. We measured IMT by Doppler ultrasound.Results: There was a statistically significant difference in albumin, hs-CRP levels, hs-CRP-to-albumin ratio, and white blood cell counts between three different IMT groups namely normal IMT, thick IMT, and atherosclerosis (p = 0.003, p = 0.001, p = 0.001 and p = 0.049, respectively). In the multivariate linear regression analysis, white blood cell count, and hs-CRP levels showed a significantly positive correlation to IMT (standardized B and p of 0.17, 0.015 and 0.163, 0.024, respectively), but albumin levels were a significantly negative correlation to IMT (standardized B = – 0.151, p = 0.029). The multivariate logistic regression analysis showed that albumin (OR = 0.79, 95% CI 0.65– 0.90, p = 0.018), hs-CRP (OR = 1.09, 95% CI 1.01– 1.18, p = 0.026), and white blood cell count (OR = 1.36, 95% CI 1.03– 1.81, p = 0.033) had correlation to atherosclerosis of femoral artery.Conclusion: Reduced plasma albumin, elevated hs-CRP, and white blood cell count associated with IMT increased the odds for atherosclerosis of femoral artery among nT2D.Keywords: plasma albumin, high-sensitivity C-reactive protein, white blood cell count, newly diagnosed type 2 diabetes mellitus, intima-media thickness, atherosclerotic plaque, femoral artery

Tuan Dinh Le,1,2,&ast; Nga Phi Thi Nguyen,2 Hoa Thanh Thi Tran,3 Thuc Luong Cong,4,&ast; Lan Ho Thi Nguyen,5 Binh Do Nhu,6 Son Tien Nguyen,2 Manh Van Ngo,7 Hoa Trung Dinh,8 Hien Thi Nguyen,9 Kien Trung Nguyen,10 Duc-Cuong Le7,11,&ast; 1Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 2Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 3National Hospital of Endocrinology, Hanoi, Vietnam; 4Department of Cardiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 5Department of General Internal Medicine, National Hospital of Endocrinology, Ha Noi, Vietnam; 6Division of Military Science, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 7Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam; 9Department of Physiology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 10Department of Science Management, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 11Epidemiology-Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam&ast;These authors contributed equally to this workCorrespondence: Tuan Dinh LeCenter of Emergency, Critical Care Medicine and Clinical Toxicology, Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Ward, Ha Dong District, Ha Noi, VietnamTel +840388166078Email letuan985@gmail.comDuc-Cuong LePostgraduate Training Management Department; Epidemiology-Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, VietnamTel +84 93 8042 668Email cuongldvn@gmail.comPurpose: This study was aimed at the prevalence, cardiovascular risk factors of diabetic peripheral neuropathy (DPN), and the relationship between DPN and fasting glucagon-like peptide-1 (fGLP-1) concentrations in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Methods: A cross-sectional descriptive study was conducted from 2015 to 2020 with a population of 473 nT2D. Screening for DPN was based on the United Kingdom screening test. fGLP-1 was measured by enzyme-linked immunosorbent assay.Results: The prevalence of DPN was 26.6%, in which mild grade was 17.3%, moderate grade was 8.2% and severe grade was 1.1% in total. Age (OR = 1.73, 95% CI 1.12– 2.67, p = 0.012), smoking (OR = 1.64, 95% CI 1.03– 2.62, p = 0.037), poor control HbA1c (OR = 2.66, 95% CI 1.23– 5.76, p = 0.01), 24-h urinary albumin (24hUA) (OR = 2.49, 95% CI 1.26– 4.94, p = 0.007), and diabetic retinopathy (OR = 3.17, 95% CI 1.46– 6.89, p = 0.002) significantly increased the risk for DPN. In multivariate logistic regression analysis, hypertension (OR = 2.96, 95% CI 1.16– 7.55, p = 0.023), triglyceride (OR = 1.50, 95% CI 1.11– 2.03, p = 0.009), albumin (OR = 0.85, 95% CI 0.75– 0.95, p = 0.005), and fGLP-1 (OR = 0.79, 95% CI 0.67– 0.93, p = 0.005) correlated with DPN. The fGLP-1 concentrations were reduced significantly in DPN (p < 0.001). In particular, male patients with DPN had a significantly lower fGLP-1 levels than those without DPN (p < 0.001).Conclusion: The prevalence of DPN among nT2D was 26.6%. Age, smoking, hypertension, HbA1c control, triglyceride, albumin, 24hUA, diabetic retinopathy were the associated risk factors of DPN, and fGLP-1 was negatively correlated with DPN (OR = 0.79, 95% CI 0.67– 0.93, p = 0.005).Keywords: newly diagnosed type 2 diabetes mellitus, diabetic peripheral neuropathy, cardiovascular risk factors, glucagon-like peptide-1 concentrations

ObjectiveWe aimed to investigate the short and long-term metabolic consequences of IGF1R systemic gene deficiency in mice.MethodsUBC-CreERT2, Igf1rfl/fl mutant mice were used to suppress IGF1R signaling in adult tissues by inducing postnatal generalized Igf1r deletion with tamoxifen. Animals were analyzed at two different ages: i) 13-weeks old young mice, and ii) 12-months old middle-aged mice. In addition, the effects of 10 weeks-long high-fat diet (HFD) were investigated in middle-aged mice.ResultsYoung IGF1R-deficient mice were insulin-resistant, with high IGF1, growth hormone (GH) and IGFBP3, as well as low IGFBP2 circulating levels. Males also presented increased triglycerides in liver. In contrast, middle-aged mice did not clearly show all of these alterations, suggesting possible compensatory effects. Middle-aged IGF1R-deficient male mice were able to counteract the negative effects induced by aging and HFD in adiposity, inflammation and glucose metabolism. A metabolic sexual dimorphism dependent on IGF1R was observed, especially in middle-aged mice.ConclusionsThese results demonstrate that IGF1R is involved in metabolic homeostasis, with effects modulated by diet-induced obesity and aging in a sex dependent manner. Thus, IGF1R deficiency in mice is proposed as a useful tool to understand metabolic alterations observed in patients with IGF1R gene deletions.