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Research on enhancing the production of lipids, particularly polyunsaturated fatty acids that are considered important for health, has focused on improvement of metabolism as well as heterologous expression of biosynthetic genes in the oleaginous fungus Aspergillus oryzae. To date, the productivity and production yield of free fatty acids have been enhanced by 10-fold to 90-fold via improvements in metabolism and optimization of culture conditions. Moreover, the productivity of ester-type fatty acids present in triacylglycerols could be enhanced via metabolic improvement. Culturing A. oryzae in a liquid medium supplemented with non-ionic surfactants could also lead to the effective release of free fatty acids from the cells. The current review highlights the advancements made in this field so far and discusses the future outlook for research on lipid production using A. oryzae. I hope the contents are useful for researchers in this field to consider the strategy of increasing production of various valuable metabolites as well as lipids in A. oryzae. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery induces significant weight loss, increases insulin sensitivity, and improves dyslipidemia. As one of the most widely performed bariatric surgeries, laparoscopic sleeve gastrectomy (LSG) is thought to improve the metabolic profile along with weight loss. The objective of this study was to evaluate longitudinal changes in the serum metabolite levels after LSG and elucidate the underlying mechanisms of metabolic improvement. Methods: Clinical metabolic parameters and serum samples were collected preoperatively and at 1, 3, and 6 months postoperatively from nine patients with obesity undergoing LSG. Serum metabolites were measured using a non-targeted metabolic liquid chromatography–mass spectrometry method. Results: During the 1, 3, and 6 months postoperative follow-up, the body mass index, HOMA-IR, and liver fat content showed a gradual descending trend. A total of 328 serum metabolites were detected, and 38 were differentially expressed. The up-regulated metabolites were mainly enriched in ketone body metabolism, alpha-linolenic acid and linoleic acid metabolism, pantothenate and CoA biosynthesis, glycerolipid metabolism, and fructose and mannose degradation, while the down-regulated metabolites were closely related to caffeine metabolism, oxidation of branched-chain fatty acids, glutamate metabolism, and homocysteine degradation. Notably, nine metabolites (oxoglutarate, 2-ketobutyric acid, succinic acid semialdehyde, phthalic acid, pantetheine, eicosapentaenoate, 3-hydroxybutanoate, oxamic acid, and dihydroxyfumarate) showed persistent differential expression at 1, 3, and 6 months follow-up. Some were found to be significantly associated with weight loss, insulin resistance improvement, and liver fat content reduction. Conclusions: This finding may provide a new perspective for revealing novel biomarkers and mechanisms of metabolic improvement in obesity and related comorbidities.

The causes for failure of metabolic improvement and inadequate weight loss after metabolic surgery (MS) in Chinese patients with type 2 diabetes (T2D) have not been fully elucidated. The effect of insulin resistance (IR) on the outcome of T2D, hypertension, hyperlipidemia, and obesity after MS in Chinese patients with T2D and a body mass index (BMI) of 25–32.5 kg/m2 warrants further study. Patients with T2D and a BMI of 25–32.5 kg/m2 who underwent MS between July 2019 and June 2021 were included. University hospital, China. IR levels were evaluated with the glucose disposal rate (GDR). Improvement of T2D, hypertension, and hyperlipidemia was assessed with the composite triple endpoint (CTEP), and weight loss was assessed with the percent of total weight loss (%TWL). Partial correlation analysis, binary logistic regression analysis, multiple linear regression analysis, receiver operating characteristic curve (ROC) analysis, and subgroup analysis were used to analyze the relationship between the CTEP, %TWL at 1 year postoperative, and GDR preoperative. This study analyzed the data of 51 patients with T2D and a BMI of 25–32.5 kg/m2 (30 men and 21 women) with a mean preoperative GDR of 3.72 ± 1.48 mg/kg/min. Partial correlation coefficients between CTEP, %TWL, and GDR were.303 (P =.041) and.449 (P =.001), respectively. The preoperative GDR was significantly positively correlated with CTEP (OR = 1.610, P =.024) and %TWL (β = 1.38, P =.003). The preoperative GDR predicted cutoff values of 4.36 and 5.35 mg/kg/min for CTEP attainment and %TWL ≥ 20%, respectively. IR levels predicted metabolic improvement and weight loss 1 year after MS in Chinese patients with T2D and a BMI of 25–32.5 kg/m2. • Insulin resistance levels were evaluated by calculating GDR with the HEC. • Insulin secretion was measured using the OGTT model. • GDR predicted metabolic improvement and weight loss one year after MS in Chinese T2D patients with a BMI of 25-32.5 kg/m2. [ABSTRACT FROM AUTHOR]

Abstract Background and aim The role of dietary protein and glycemic index on insulin resistance (based on TyG index) within a nutritional program for weight loss and weight maintenance was examined. Methods This study analyzed 744 adults with overweight/obesity within the DIOGenes project. Patients who lost at least 8% of their initial weight (0–8 weeks) after a low-calorie diet (LCD) were randomly assigned to one of five ad libitum diets designed for weight maintenance (8–34 weeks): high/low protein (HP/LP) and high/low glycemic index (HGI/LGI), plus a control. The complete nutritional program (0–34 weeks) included both LCD plus the randomized diets intervention. The TyG index was tested as marker of body mass composition and insulin resistance. Results In comparison with the LP/HGI diet, the HP/LGI diet induced a greater BMI loss (p

Background and aim: The role of dietary protein and glycemic index on insulin resistance (based on TyG index) within a nutritional program for weight loss and weight maintenance was examined. Methods: This study analyzed 744 adults with overweight/obesity within the DIOGenes project. Patients who lost at least 8% of their initial weight (0–8 weeks) after a low-calorie diet (LCD) were randomly assigned to one of five ad libitum diets designed for weight maintenance (8–34 weeks): high/low protein (HP/LP) and high/low glycemic index (HGI/LGI), plus a control. The complete nutritional program (0–34 weeks) included both LCD plus the randomized diets intervention. The TyG index was tested as marker of body mass composition and insulin resistance. Results: In comparison with the LP/HGI diet, the HP/LGI diet induced a greater BMI loss (p < 0.05). ∆TyG was positively associated with resistance to BMI loss (β = 0.343, p = 0.042) during the weight maintenance stage. In patients who followed the HP/LGI diet, TyG (after LCD) correlated with greater BMI loss in the 8–34 weeks period (r = −0.256; p < 0.05) and during the 0–34 weeks intervention (r = −0.222, p < 0.05) periods. ΔTyG1 value was associated with ΔBMI2 (β = 0.932; p = 0.045) concerning the HP/LGI diet. Conclusions: A HP/LGI diet is beneficial not only for weight maintenance after a LCD, but is also related to IR amelioration as assessed by TyG index changes. Registration Clinical Trials NCT00390637. [ABSTRACT FROM AUTHOR]

Background Visceral obesity is associated with diabetogenic and atherogenic abnormalities, including insulin resistance and increased risk for cardiometabolic diseases and mortality. Rodent lipectomy studies have demonstrated a causal link between visceral fat and insulin resistance, yet human omentectomy studies have failed to replicate this metabolic benefit, perhaps owing to the inability to target the mesentery. Objectives We aimed to demonstrate that safe and effective removal of mesenteric fat could be achieved in obese insulin-resistant baboons using tissue liquefaction technology. Setting Southwest National Primate Research Center, San Antonio, Texas. Methods Tissue liquefaction technology has been developed to enable mesenteric visceral lipectomy (MVL) to be safely performed without disturbing the integrity of surrounding nerves and vessels in the mesentary. After an initial MVL optimization study (n = 3), we then performed MVL (n = 4) or sham surgery (n = 2) in a cohort of insulin-resistant baboons, and the metabolic phenotype was assessed via hyperinsulinemic-euglycemic clamps at baseline and 6 weeks later. Results MVL led to a 75% improvement in glucose disposal at 6-weeks follow-up ( P = .01). Moreover, despite removing only an average of 430 g of mesenteric fat (~1% of total body mass), MVL led to a 14.4% reduction in total weight ( P = .001). Thus, these data demonstrate that mesenteric fat can be safely targeted for removal by tissue liquefaction technology in a nonhuman primate, leading to substantial metabolic improvements, including reversal of insulin resistance and weight loss. Conclusions These data provide the first demonstration of successful adipose tissue removal from the mesentery in a mammal. Importantly, we have demonstrated that when MVL is performed in obese, insulin-resistant baboons, insulin resistance is reversed, and significant weight loss occurs. Therefore, trials performing MVL in humans with abdominal obesity and related metabolic sequelae should be explored as a potential clinical tool to ameliorate insulin resistance and treat type 2 diabetes. [ABSTRACT FROM AUTHOR]

Purpose of Review: Metabolic and bariatric surgery (MBS) is considered to be the most effective treatment for obesity. Not only due to the significant weight reduction but also because of the many health benefits associated with it. In the last 5 years, several studies have suggested that epigenetic modifications could be involved in the mechanisms underlying the response to bariatric surgery. In this review, we will compile the different studies (2012-2017) concerning the effect of this surgical procedure on DNA methylation patterns (the most studied epigenetic marker) and its association with metabolic improvement. This is an emerging area, and currently, there are not many studies in the literature. The aim is to show what has been done so far and what the future direction in this emerging area might be. Recent Findings: Recent findings have shown how metabolic and bariatric surgery modifies the DNA methylation profile of the specific genes associated with the pathophysiology of the disease. The studies were performed in morbidly obese subjects, mainly in women, with the aim of reducing weight and improving the obesity-associated comorbidities. DNA methylation has been measured both in specific tissue and in peripheral blood samples. In general, studies about site-specific DNA methylation have shown a change in the methylation profile after surgery, whereas the studies analyzing global DNA methylation are not so conclusive. Summary: Summing up, metabolic and bariatric surgery can modify the DNA methylation profile of different genes and contributes to the metabolic health benefits that are often seen after metabolic and bariatric surgery. Although there are still many issues to be resolved, the capacity to revert the DNA methylation profile of specific sites opens a window for searching for target markers to treat obesity-related comorbidities. [ABSTRACT FROM AUTHOR]

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Background and Aim: Obesity is one of the greatest public health concerns worldwide. Weight loss surgeries have been increased in recent decades due to the world's epidemic of obesity. The aim of this prospective study is investigating metabolic factors of morbid obese patients following Roux-en-Y gastric bypass surgery. Methods: This was a nonrandomized prospective cohort study conducted from 2010 to 2013 on 60 consecutive patients who had body mass index (BMI) of more than 40 kg/m and met the surgical indication criteria of bariatric surgery. Upon discharge, patients were followed in outpatient clinic of Qaem Hospital, Mashhad, Iran, each 3 months for 12 months. Measurement of anthropometric and metabolic indices was done in each postoperative visit. Results: Mean BMI reduction was 15.26 ± 3.45 kg/m in the patients with an average value of 28.84 ± 3.94 (range from 22 to 40 kg/m), which was significantly lower than the base value ( p < 0.001). After a 12-month follow up, patients had lower low-density lipoprotein, triglycerides, and total cholesterol ( p < 0.001 for all the variables), while achieving a greater high-density lipoprotein ( p = 0.004). An improvement was seen in all of hypertensive patients after a 3-month follow up and blood pressure remained within normal limit in further follow ups. Complete remission was observed in all the patients with obstructive sleep apnea. Conclusion: It appears reasonable that multidisciplinary treatment including surgical alternatives should be concerned for all morbidly obese patients, considering high rate of failure of conservative medical therapy in this setting. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports a 5-year follow-up from a study aimed at evaluating whether an intervention which focused on patients’ personal understanding of their illness was more effective than conventional diabetes care with regard to metabolic control among patients with type 2 diabetes mellitus (DM2). The study was conducted within Swedish primary health care and included 102 patients (mean age 63 years). At clinic level they were randomised into control or intervention groups. The intervention directed at patients consisted of ten two-hour group sessions over 9 months, focusing on patients’ own needs and questions. The mean HbA1c at baseline was 5.71% (S.D. 0.76) in the intervention group and 5.78% (S.D. 0.71) in the control group. At the 5-year follow-up, the mean HbA1c in the intervention group still was 5.71% (S.D. 0.85) while among the controls it had increased to 7.08% (S.D. 1.71). The adjusted difference was 1.37 (p <0.0001). Treatment upgrade, BMI, total cholesterol, HDL, LDL and triglycerides at baseline did not influence the difference in HbA1c. These findings indicate that group sessions in patients with DM2 focusing on patients’ personal understanding of their illness are more effective than conventional diabetes care with regard to metabolic control. [Copyright &y& Elsevier]

Abstract: The aim of this study was to evaluate, whether an educational intervention, focusing on patients’ personal understanding of their illness, was more effective than care given according to national guidelines for diabetes care. Methods: An intervention group (n = 44), with type 2 diabetes was compared with a control group (n = 60), with HbA1c as the primary outcome. The intervention included ten group sessions addressing themes related to the patients’ personal understanding of their illness. The diabetes nurses involved were educated in theories about illness/wellness experiences and participated in group sessions where various caring strategies related to the patients’ individual needs and understanding were reflected upon. Results: At 1-year follow-up the intervention group showed lower HbA1c levels (mean difference 0.94%; P &#60; 0.001), lower triglycerides (mean difference 0.52mmol/l; P = 0.002) and higher high-density lipoprotein (mean difference 0.15mmol/l; P = 0.029) and treatment satisfaction than did the control group. The differences remained when adjusting for age, gender, body mass index or changed treatment during the intervention period. Within the intervention group, BMI and treatment satisfaction were also improved. Conclusion: The intervention, which focused on patients’ personal understanding of illness, was found to be effective in terms of metabolic control and treatment satisfaction. [Copyright &y& Elsevier]