RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: In traditional Persian medicine (TPM), people often use herbal infusions as a dosage form to treat diseases related to hyperglycemia, known as 'dam-kardeh'. Traditionally, herbal preparations of Eryngium bungei Boiss. (E. b), Tragopogon buphthalmoides (DC.) Boiss. (T. b), Salvia hydrangea DC. ex Benth. (S. h), and Juniperus polycarpos K. Koch. (J. p) are used to manage diabetes in Iran. However, there is no evidence of their effectiveness in controlling glucose levels and their mechanisms remain unclear. AIM OF THE STUDY: This study aimed to investigate whether traditional doses of plant infusions can have hypoglycemic and/or anti-hyperglycemic effects during fasting and/or postprandial states and establish the basis for future research on their potential mechanisms of action. MATERIALS AND METHODS: The effects of traditional doses of herbal extracts on blood glucose levels in STZ-NA-induced hyperglycemic rats were investigated in 2-h acute tests during fasting and postprandial states (with a glucose load). In addition, the potential inhibitory effect in vitro of enzymes involved in relevant pathways, such as gluconeogenesis (fructose-1,6-bisphosphatase, FBPase and glucose-6-phosphatase, G6Pase), carbohydrate breakdown (intestinal α-glucosidases), and insulin sensitivity (protein tyrosine phosphatase 1B, PTP-1B) was evaluated. Acute toxicity tests were carried out and HPLC-SQ-TOF was used to analyze the chemical profiles of the plant extracts. RESULTS: In the fasting state, T. b, S. h, and E. b were as effective as glibenclamide in lowering blood glucose levels in hyperglycemic rats. Moreover, all three suppressed G6Pase and FBPase enzymatic activity by 90-97% and 80-91%, respectively. On the other hand, significant postprandial hypoglycemic efficacy was observed for E. b, S. h, and T. b. Based on the AUC values, T. b caused a reduction comparable to the therapeutic efficacy of repaglinide. When investigating the possible mechanisms of action involved in this activity, E. b, S. h, and T. b showed significant inhibition of PTP-1B in vitro (>70%). Finally, all plant extracts showed no signs of acute toxicity. Several compounds that may contribute to biological activities were identified, including phenolic acids and flavonoid glycosides. CONCLUSIONS: The present study supports the traditional use of T. b, E. b and S. h for the control of diabetes in the fasting and postprandial state. Moreover, these plants were found to be rich in bioactive compounds with hypoglycemic and antihyperglycemic activities. On the other hand, J. p, showed a modest effect only in the fasting state and after 90 min. Further studies are needed to expand these results by analyzing the chemical composition and using complementary experimental models.

Asunto(s)

Glucemia , Diabetes Mellitus Experimental , Ayuno , Hipoglucemiantes , Extractos Vegetales , Periodo Posprandial , Animales , Hipoglucemiantes/farmacología , Extractos Vegetales/farmacología , Extractos Vegetales/administración & dosificación , Extractos Vegetales/química , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Experimental/sangre , Masculino , Irán , Ratas , Medicina Persa , Ratas Wistar , Hiperglucemia/tratamiento farmacológico , Plantas Medicinales/química , Estreptozocina , Juniperus/química

RESUMEN

Subjects who have ischemia with non-obstructive coronary arteries (INOCA) experience angina pectoris with evidence of myocardial ischemia but without coronary stenosis. Few studies have investigated factors associated with its survival, especially insulin resistance. In this study, subjects with angina pectoris, without known diabetes mellites (DM), and with non-invasive tests showing myocardial ischemia were admitted for coronary angiography (CAG). Those whose CAG did not reveal stenosis and agreed to receive an oral glucose tolerance test (OGTT) 2 weeks after hospital discharge were enrolled for analysis. All-cause mortality was recorded, which served as the outcome of the study. A total of 587 subjects with INOCA, without known DM, and with OGTT data were analyzed. After OGTT and HbA1c tests, 86 subjects (14.7%) were newly diagnosed with DM and 59.8% had pre-DM. The median duration of follow-up was 7.03 years. Thirty-nine subjects died during the follow-up period. The incidence rate of mortality was 9.9 /1000 person-year. Those who died had a higher fasting glucose (101 ± 17 vs. 94 ± 13 mg/dl, p = 0.003) but a lower estimated glomerular filtration rate (eGFR) (54 ± 22 vs. 87 ± 30 ml/min, p < 0.001). In the Cox survival analysis, a higher fasting glucose (hazard ratio 1.053, p = 0.007) was associated with worse mortality for INOCA without DM (N = 501). On the contrary, a higher eGFR (hazard ratio 0.967, p = 0.012) was protective of better survival for non-diabetic INOCA (N = 501). In conclusion, for non-diabetic INOCA, higher fasting glucose was associated with worse mortality and higher eGFR was protective for better survival.

Asunto(s)

Glucemia , Ayuno , Prueba de Tolerancia a la Glucosa , Humanos , Masculino , Femenino , Glucemia/análisis , Glucemia/metabolismo , Persona de Mediana Edad , Ayuno/sangre , Anciano , Isquemia Miocárdica/mortalidad , Isquemia Miocárdica/sangre , Angiografía Coronaria , Vasos Coronarios/patología , Vasos Coronarios/metabolismo , Tasa de Filtración Glomerular , Diabetes Mellitus/mortalidad , Resistencia a la Insulina

RESUMEN

BACKGROUND: Glycemic control is crucial in peritoneal dialysis (PD) patients with diabetes. Although fasting blood glucose (FBG) is the most commonly used index to measure blood glucose levels, there is currently no evidence supporting the association between FBG level and mortality risk in PD patients. METHODS: A total of 3548 diabetic PD patients between 2002 and 2018 were enrolled from the National Health Insurance Service database of Korea. We investigated the association between FBG levels and the risk of all-cause and cause-specific mortality. RESULTS: Patients with FBG levels 80-99 mg/dL exhibited the highest survival rates, whereas those with FBG levels ≥180 mg/dL had the lowest survival rates. Compared with FBG levels 80-99 mg/dL, the adjusted hazard ratios and 95% confidence interval for all-cause mortality significantly increased as follows: 1.02 (0.87-1.21), 1.41 (1.17-1.70), 1.44 (1.18-2.75), and 2.05 (1.73-2.42) for patients with FBG 100-124 mg/dL, FBG 125-149 mg/dL, FBG 150-179 mg/dL, and FBG ≥180 mg/dL, respectively. The risk for all-cause mortality also showed an increasing pattern in patients with FBG levels <80 mg/L. The risk of cardiovascular death significantly increased as FBG levels exceeded 125 mg/dL. However, the risk of infection-related and malignancy-related deaths did not show a significant increase with increasing FBG levels. CONCLUSION: There was an increase in the risk of all-cause mortality as FBG levels exceeded 125 mg/dL in PD patients with diabetes, and the risk of cardiovascular death showed a strong correlation with FBG levels compared with other causes of death.

Asunto(s)

Glucemia , Causas de Muerte , Ayuno , Diálisis Peritoneal , Humanos , Masculino , Femenino , Diálisis Peritoneal/mortalidad , Persona de Mediana Edad , Glucemia/análisis , Ayuno/sangre , República de Corea/epidemiología , Anciano , Factores de Riesgo , Adulto , Tasa de Supervivencia , Fallo Renal Crónico/mortalidad , Fallo Renal Crónico/sangre , Fallo Renal Crónico/terapia , Diabetes Mellitus/mortalidad , Diabetes Mellitus/sangre

RESUMEN

In the study of obesity and diabetes, mice are widely used for experimental research, and fasting is a common procedure used to reset metabolism in mouse models. The fasting duration for experimental mice varies greatly in nutritional and metabolic studies, ranging from 2 to 48 h. This study aims to assess the optimal fasting duration for mice fed low- and high-fat diets over a short period of time. C57BL/6J mice were fed a low-fat diet (LFD) or high-fat diet (HFD) and fasted for 4, 6, 8, 10, 12, or 24 h. The effects of different conditions after fasting on the metabolic level of mice were explored, and the data were collected for analysis. Our data indicate that fasting has inconsistent effects on mice fed a low-fat or high-fat diet. To compare the metabolic differences between mice in different dietary levels and thereby secure better scientific data, mice should fast for 6 h in animal experiments. Fasting for 6 h is also recommended when comparing glucose tolerance with insulin tolerance.

Asunto(s)

Dieta Alta en Grasa , Ayuno , Ratones Endogámicos C57BL , Animales , Dieta Alta en Grasa/efectos adversos , Ratones , Masculino , Glucemia/metabolismo , Dieta con Restricción de Grasas , Resistencia a la Insulina , Factores de Tiempo , Insulina/metabolismo , Insulina/sangre , Prueba de Tolerancia a la Glucosa , Obesidad/metabolismo

RESUMEN

Ramadan fasting is widely acknowledged for its positive impacts on health, yet it also presents inherent risks, prompting a need for comprehensive exploration into its metabolic implications and its effects on diabetes. This study introduces a novel methodology called systematic literature network analysis (SLNA), which merges bibliometric analysis with systematic literature review (SLR). The aim of this study was to examine the global research landscape concerning Ramadan fasting, metabolism, and diabetes. Through the systematic search strategy, 206 relevant documents were analyzed. Through co-occurrence analysis mapping, the study uncovered four distinct cluster groups, revealing intricate relationships and evolving trends within the field. Moreover, the trajectory of research publications on Ramadan fasting from 2001 to 2023 was tracked, highlighting a growing interest in this domain. The bibliometric analysis emphasized a consensus regarding the beneficial effects of Ramadan fasting on individual health, particularly in improving lipid profiles, managing body weight, regulating glucose levels, and nutrient intake. However, significant variations in research focus were observed across predominantly Muslim countries, with notable exceptions like Indonesia and Brunei Darussalam absent among the top contributors. Furthermore, the analysis shed light on the balanced selection of research subjects by authors, indicating a nuanced approach to exploring the multifaceted aspects of Ramadan fasting, metabolism, and diabetes. These findings offer significant perspectives for researchers aiming to contextualize their studies within the wider conversation on this subject, thereby aiding in a more profound comprehension of the intricate relationship between fasting, metabolic functions, and the management of diabetes.

Asunto(s)

Diabetes Mellitus , Ayuno , Islamismo , Humanos , Ayuno/metabolismo , Diabetes Mellitus/metabolismo , Diabetes Mellitus/epidemiología , Bibliometría

RESUMEN

AIMS: Extended fasting-postprandial switch intermitting time has been shown to affect Alzheimer's disease (AD). Few studies have investigated the cerebral perfusion response to fasting-postprandial metabolic switching (FMS) in AD patients. We aimed to evaluate the cerebral perfusion response to FMS in AD patients. METHODS: In total, 30 AD patients, 32 mild cognitive impairment (MCI) patients, and 30 healthy control individuals (HCs) were included in the quantification of cerebral perfusion via cerebral blood flow (CBF). The cerebral perfusion response to FMS was defined as the difference (ΔCBF) between fasting and postprandial CBF. RESULTS: Patients with AD had a regional negative ΔCBF in the anterior temporal lobe, part of the occipital lobe and the parietal lobe under FMS stimulation, whereas HCs had no significant ΔCBF. The AD patients had lower ΔCBF values in the right anterior temporal lobe than the MCI patients and HCs. ΔCBF in the anterior temporal lobe was negatively correlated with cognitive severity and cognitive reserve factors in AD patients. CONCLUSIONS: AD patients exhibited a poor ability to maintain cerebral perfusion homeostasis under FMS stimulation. The anterior temporal lobe is a distinct area that responds to FMS in AD patients and negatively correlates with cognitive function.

Asunto(s)

Enfermedad de Alzheimer , Circulación Cerebrovascular , Disfunción Cognitiva , Ayuno , Periodo Posprandial , Humanos , Masculino , Femenino , Enfermedad de Alzheimer/metabolismo , Enfermedad de Alzheimer/diagnóstico por imagen , Enfermedad de Alzheimer/fisiopatología , Anciano , Circulación Cerebrovascular/fisiología , Periodo Posprandial/fisiología , Disfunción Cognitiva/metabolismo , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/diagnóstico por imagen , Persona de Mediana Edad , Anciano de 80 o más Años , Neuroimagen/métodos , Encéfalo/metabolismo , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Encéfalo/irrigación sanguínea , Imagen por Resonancia Magnética

RESUMEN

The global COVID-19 pandemic has disrupted daily routines and heightened stress levels worldwide, impacting various aspects of health, including sleep. This cross-sectional study conducted in Iran aimed to investigate the impact of Ramadan Intermittent Fasting (RIF) during the pandemic on sleep disturbances and associated risk factors in adults aged ≥ 18 years. Data was collected from Iranian participants observing RIF. A structured electronic questionnaire, translated into Persian, gathered information on sociodemographics, dietary habits, sleep parameters, physical activity, and more. The study assessed sleep quality, duration, and disturbances and conducted a thorough analysis to identify risk factors associated with sleep disruptions. The study revealed that 48% of the participants experienced sleep disturbances during RIF, with 21% reporting poor sleep quality and 46% having unusual sleep duration. Various factors were associated with an elevated risk of sleep disruptions, including body mass index, place of residence, income levels, cohabitation status, family history of obesity, hypertension, diabetes, heart disease, personal history of obesity, weight fluctuations, Shisha smoking, and unemployment. The results highlight the critical importance of health promotion strategies tailored to cultural contexts. This study advocates for enhanced health education initiatives focusing on sleep hygiene and stress management, especially during periods of significant lifestyle alterations like Ramadan amid a global pandemic. Such initiatives are vital in mitigating sleep disturbances and promoting overall well-being in populations facing unique health challenges.

Asunto(s)

COVID-19 , Ayuno , Islamismo , Humanos , COVID-19/epidemiología , Estudios Transversales , Masculino , Irán/epidemiología , Femenino , Adulto , Factores de Riesgo , Persona de Mediana Edad , Trastornos del Sueño-Vigilia/epidemiología , SARS-CoV-2 , Calidad del Sueño , Adulto Joven , Pandemias , Pueblos de Medio Oriente

RESUMEN

This study aimed to evaluate the impact of time-restricted eating (TRE) on neuro-physiological parameters, objective and subjective sleep, pulmonary capacity, and postural balance among women with excess body weight. METHODS: Thirty-one participants were assigned to either a TRE group (n = 15, 28.74 ± 9.25 years, 88.32 ± 13.38 kg, and 32.71 ± 5.15 kg/m2), engaging in ad libitum 16 h fasting over a 12-week period, or a control group (CG, n = 16, 36.25 ± 11.52 years, 90.88 ± 19.01 kg, and 33.66 ± 6.18 kg/m2). The assessment of heart rate variability (HRV), spirometric parameters (forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/ FVC ratio, objective and subjective sleep assessments employing actigraphy and the Epworth Sleepiness Scale, and postural balance using the Y balance test (YBT) were conducted before and after the intervention. RESULTS: No significant negative effects of TRE were observed for HRV and objective sleep parameters. Only the TRE group improved FEV1 in both sitting (p < 0.0005) and supine positions (p = 0.001). Furthermore, the TRE group showed improvement in postural balance performance compared to the CG in anterior (p = 0.03), postero-medial (p = 0.04), and postero-lateral directions (p = 0.003). CONCLUSION: This study highlights TRE as a feasible and safe dietary intervention with significant improvements in postural balance and pulmonary function, without any negative impact on HRV or objective sleep assessments among overweight or obese women.

Asunto(s)

Frecuencia Cardíaca , Obesidad , Sobrepeso , Equilibrio Postural , Sueño , Humanos , Femenino , Adulto , Sobrepeso/fisiopatología , Obesidad/fisiopatología , Equilibrio Postural/fisiología , Sueño/fisiología , Frecuencia Cardíaca/fisiología , Capacidad Vital , Pulmón/fisiopatología , Pulmón/fisiología , Ayuno , Volumen Espiratorio Forzado , Adulto Joven , Persona de Mediana Edad

RESUMEN

BACKGROUND: Exercise and dietary interventions are essential for maintaining weight and reducing fat accumulation. With the growing popularity of various dietary strategies, evidence suggests that combining exercise with dietary interventions offers greater benefits than either approach alone. Consequently, this combined strategy has become a preferred method for many individuals aiming to maintain health. Calorie restriction, 5/2 intermittent fasting, time-restricted feeding, and the ketogenic diet are among the most popular dietary interventions today. Aerobic exercise, resistance training, and mixed exercise are the most widely practiced forms of physical activity. Exploring the best combinations of these approaches to determine which yields the most effective results is both meaningful and valuable. Despite this trend, a comparative analysis of the effects of different exercise and diet combinations is lacking. This study uses network meta-analysis to evaluate the impact of various combined interventions on body composition and to compare their efficacy. METHODS: We systematically reviewed literature from database inception through May 2024, searching PubMed, Web of Science, Embase, and the Cochrane Library. The study was registered in PROSPERO under the title: "Effects of Exercise Combined with Different Dietary Interventions on Body Composition: A Systematic Review and Network Meta-Analysis" (identifier: CRD42024542184). Studies were meticulously selected based on specific inclusion and exclusion criteria (The included studies must be randomized controlled trials involving healthy adults aged 18 to 65 years. Articles were rigorously screened according to the specified inclusion and exclusion criteria.), and their risk of bias was assessed using the Cochrane risk of bias tool. Data were aggregated and analyzed using network meta-analysis, with intervention efficacy ranked by Surface Under the Cumulative Ranking (SUCRA) curves. RESULTS: The network meta-analysis included 78 randomized controlled trials with 5219 participants, comparing the effects of four combined interventions: exercise with calorie restriction (CR+EX), exercise with time-restricted eating (TRF+EX), exercise with 5/2 intermittent fasting (5/2F+EX), and exercise with a ketogenic diet (KD+EX) on body composition. Intervention efficacy ranking was as follows: (1) Weight Reduction: CR+EX > KD+EX > TRF+EX > 5/2F+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.94 (-3.64, 9.52); 2.37 (-0.40, 5.15); 1.80 (-1.75, 5.34)). (2) BMI: CR+EX > KD+EX > 5/2F+EX > TRF+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 1.95 (-0.49, 4.39); 2.20 (1.08, 3.32); 1.23 (-0.26, 2.71)). (3) Body Fat Percentage: CR+EX > 5/2F+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.66 (-1.56, 6.89); 2.84 (0.56, 5.13); 3.14 (0.52, 5.75).). (4) Lean Body Mass in Male: CR+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of TRF+EX and KD+EX are -1.60 (-6.98, 3.78); -2.76 (-7.93, 2.40)). (5) Lean Body Mass in Female: TRF+EX > CR+EX > 5/2F+EX > KD+EX (Relative to TRF+EX, the effect sizes of CR+EX, 5/2F+EX and KD+EX are -0.52 (-2.58, 1.55); -1.83 (-4.71, 1.04); -2.46 (-5.69,0.76).). CONCLUSION: Calorie restriction combined with exercise emerged as the most effective strategy for reducing weight and fat percentage while maintaining lean body mass. For women, combining exercise with time-restricted eating proved optimal for preserving muscle mass. While combining exercise with a ketogenic diet effectively reduces weight, it is comparatively less effective at decreasing fat percentage and preserving lean body mass. Hence, the ketogenic diet combined with exercise is considered suboptimal.

Asunto(s)

Composición Corporal , Restricción Calórica , Dieta Cetogénica , Ejercicio Físico , Metaanálisis en Red , Humanos , Ejercicio Físico/fisiología , Restricción Calórica/métodos , Dieta Cetogénica/métodos , Adulto , Entrenamiento de Fuerza , Femenino , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Ayuno , Adulto Joven , Adolescente , Anciano , Dieta/métodos

RESUMEN

Lifestyle management of obesity includes nutritional therapy, physical activity, and several intermittent fasting therapies. Effective nutrition therapies include optimized low-fat diets, high-quality ketogenic diets, and energy-restricted diets. Adherence to dietary change remains the most substantial barrier to success; therefore, patients engaging in lifestyle changes require intensive support and resources. Physical activity is shown to have benefits to body composition and disease risk beyond the effects on weight loss. Patients should be guided toward a regimen that is appropriate for their capacity for movement. Multiple intermittent fasting strategies have now been shown to cause substantial weight loss and metabolic health improvement.

Asunto(s)

Ejercicio Físico , Estilo de Vida , Obesidad , Pérdida de Peso , Humanos , Obesidad/terapia , Ejercicio Físico/fisiología , Dieta Cetogénica/métodos , Ayuno , Dieta con Restricción de Grasas/métodos

RESUMEN

OBJECTIVE: To determine the presence of microplastics in the stomach, and the relationship between pathological changes in stomach tissue and microplastics. STUDY DESIGN: An analytical study. Place and Duration of the Study: Department of Internal Medicine, Sorgun State Hospital, Yozgat, Turkiye, from December 2022 to November 2023. METHODOLOGY: Fasting gastric fluid sampling and endoscopic sampling including mucosal and submucosal layers from the antrum were performed. The pH values of the gastric fluids were recorded. Samples were analysed gradually by adding iron solution, hydrogen peroxide, and sodium chloride (NaCl) in a beaker at 75 degrees for 30 minutes. Biopsy materials obtained from antrum were examined histopathologically and reported according to the Sydney classification. The relationship between gastric biopsy results and the presence of microplastic was evaluated using Chi-square test. The significance level was taken as p <0.005. RESULTS: The study included 61 individuals. The presence of microplastics was detected in 17 (27.86%) gastric fluid samples obtained from the individuals. A significant correlation was found between increased activity and inflammation in antrum biopsy and the presence of microplastic (χ2 = 8.55 p = 0.014; χ2 = 25.75, p = 0.001). The relationship between atrophy, metaplasia, and Helicobacter pylori in gastric tissue and the presence of microplastic was statistically insignificant (p >0.05). CONCLUSION: Microplastics were detected in gastric fasting fluid. These materials can cause histopathologic changes and inflammation in the gastric antrum. KEY WORDS: H. pylori, Intestinal metaplasia, Inflammation, Microplastic, Plastic, Sydney classification.

Asunto(s)

Ayuno , Microplásticos , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Microplásticos/análisis , Jugo Gástrico/química , Mucosa Gástrica/patología , Biopsia , Estómago/patología , Helicobacter pylori/aislamiento & purificación , Antro Pilórico/patología , Metaplasia/patología , Turquía , Anciano

RESUMEN

Gestational diabetes mellitus (GDM) adversely affects offspring glucose homeostasis and risk of developing obesity. Here, we examined the association between glycemia in pregnant women with overweight or obesity without GDM and offspring metabolic health. Maternal fasting glucose concentrations and glucose 2-h after an oral glucose tolerance test (OGTT) were measured in 208 women with a pre-pregnancy body mass index (BMI) of 28-45 kg/m2 without GDM. Offspring outcomes were collected at birth, 3, and 5 years of age. Linear mixed models with time as fixed factor and subject ID as random effects were used for analysis. No associations were found between maternal fasting or 2-h glucose concentrations with offspring glucose and insulin concentrations from birth to 5 years of age. However, maternal fasting glucose in GW 28 and 36, and 2-h OGTT glucose in GW 28 were positively associated with C-peptide concentration at birth. Maternal fasting glucose concentrations in GW 28 and 36 were positively associated with weight-for-length, and maternal fasting glucose in GW 36 was associated with BMI z-score at birth. In summary, blood glucose in pregnant women with overweight or obesity is positively associated with offspring C-peptide concentration, weight-for-length, and BMI z-score at birth, even in the absence of GDM.

Asunto(s)

Glucemia , Índice de Masa Corporal , Prueba de Tolerancia a la Glucosa , Homeostasis , Obesidad , Sobrepeso , Humanos , Femenino , Embarazo , Adulto , Glucemia/metabolismo , Obesidad/metabolismo , Obesidad/sangre , Sobrepeso/metabolismo , Sobrepeso/sangre , Diabetes Gestacional/metabolismo , Diabetes Gestacional/sangre , Recién Nacido , Preescolar , Insulina/sangre , Insulina/metabolismo , Péptido C/sangre , Ayuno/sangre , Complicaciones del Embarazo/metabolismo , Complicaciones del Embarazo/sangre

RESUMEN

BACKGROUND: A persistent redox state and excessive reactive species involved in carbohydrate and lipid metabolism lead to oxidative damage in the liver, however, how fasting plasma concentrations of lipids and glucose are associated with fasting blood levels of alanine transaminase (ALT) and aspartate transaminase (AST) remains to be evaluated in large-scale population. METHODS: A cross-sectional study with 182,971 residents aged 18 to 92 years; multidimensional stratified analyses including quantile linear regression analysis and sex stratification were adopted to improve the quality of the evidence. RESULTS: The associations between the concentrations of non-HDL-C and triglyceride and ALT levels were positive, stronger in males in each quantile of ALT levels and the coefficients expanded with increasing ALT levels at slopes of 3.610 and 5.678 in males and 2.977 and 5.165 in females, respectively. The associations between the HDL-C concentrations and ALT levels were negative, also stronger in males in each quantile and the coefficients expanded with increasing ALT levels at slopes of -7.839 in females and - 5.797 in males. The associations between glucose concentrations and ALT levels were positive, but stronger in females in each quantile and the coefficients expanded with increasing ALT levels at slopes of 1.736 in males and 2.177 in females, respectively. Similar pattern consist of relatively weaker coefficients and slops were observed between concentrations of non-HDL-C, triglyceride and glucose and AST levels. The associations between albumin concentration and concentrations of blood lipids and glucose were relatively steady across all quantiles. CONCLUSIONS: The dose dependent effect between blood concentrations of lipids and glucose and liver function changes suggests that excessive carbohydrate and lipid metabolism may cause subclinical liver damage. Long term sustained primary and secondary inflammatory factors produced in the liver might be transmitted to adjacent organs, such as the heart, kidneys, and lungs, to cause and/or exacerbate pathological changes in these visceral organs.

Asunto(s)

Alanina Transaminasa , Aspartato Aminotransferasas , Glucemia , Ayuno , Triglicéridos , Humanos , Masculino , Femenino , Persona de Mediana Edad , Alanina Transaminasa/sangre , Adulto , Glucemia/metabolismo , Ayuno/sangre , Anciano , Adolescente , Triglicéridos/sangre , Estudios Transversales , Anciano de 80 o más Años , Aspartato Aminotransferasas/sangre , Adulto Joven , Lípidos/sangre , HDL-Colesterol/sangre

RESUMEN

BACKGROUND: Cardiovascular disease represents a significant risk factor for mortality in individuals with type 2 diabetes mellitus (T2DM). High-density lipoprotein (HDL) is believed to play a crucial role in maintaining cardiovascular health through its multifaceted atheroprotective effects and its capacity to enhance glycemic control. The impact of dietary interventions and intermittent fasting (IF) on HDL functionality remains uncertain. The objective of this study was to assess the effects of dietary interventions and IF as a strategy to safely improve glycemic control and reduce body weight on functional parameters of HDL in individuals with T2DM. METHODS: Before the 12-week intervention, all participants (n = 41) of the INTERFAST-2 study were standardized to a uniform basal insulin regimen and randomized to an IF or non-IF group. Additionally, all participants were advised to adhere to dietary recommendations that promoted healthy eating patterns. The IF group (n = 19) followed an alternate-day fasting routine, reducing their calorie intake by 75% on fasting days. The participants' glucose levels were continuously monitored. Other parameters were measured following the intervention: Lipoprotein composition and subclass distribution were measured by nuclear magnetic resonance spectroscopy. HDL cholesterol efflux capacity, paraoxonase 1 (PON1) activity, lecithin cholesterol acyltransferase (LCAT) activity, and cholesterol ester transfer protein (CETP) activity were assessed using cell-based assays and commercially available kits. Apolipoprotein M (apoM) levels were determined by ELISA. RESULTS: Following the 12-week intervention, the IF regimen significantly elevated serum apoM levels (p = 0.0144), whereas no increase was observed in the non-IF group (p = 0.9801). ApoM levels correlated with weight loss and fasting glucose levels in the IF group. Both groups exhibited a robust enhancement in HDL cholesterol efflux capacity (p < 0.0001, p = 0.0006) after 12 weeks. Notably, only the non-IF group exhibited significantly elevated activity of PON1 (p = 0.0455) and LCAT (p = 0.0117) following the 12-week intervention. In contrast, the changes observed in the IF group did not reach statistical significance. CONCLUSIONS: A balanced diet combined with meticulous insulin management improves multiple metrics of HDL function. While additional IF increases apoM levels, it does not further enhance other aspects of HDL functionality. TRIAL REGISTRATION: The study was registered at the German Clinical Trial Register (DRKS) on 3 September 2019 under the number DRKS00018070.

Asunto(s)

Biomarcadores , Glucemia , Diabetes Mellitus Tipo 2 , Ayuno , Obesidad , Fosfatidilcolina-Esterol O-Aciltransferasa , Humanos , Masculino , Persona de Mediana Edad , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Ayuno/sangre , Fosfatidilcolina-Esterol O-Aciltransferasa/sangre , Resultado del Tratamiento , Obesidad/sangre , Obesidad/diagnóstico , Obesidad/dietoterapia , Obesidad/fisiopatología , Obesidad/terapia , Glucemia/metabolismo , Factores de Tiempo , Biomarcadores/sangre , Restricción Calórica , Arildialquilfosfatasa/sangre , HDL-Colesterol/sangre , Proteínas de Transferencia de Ésteres de Colesterol/sangre , Pérdida de Peso , Anciano , Adulto , Dieta Saludable , Hipoglucemiantes/uso terapéutico , Insulina/sangre , Ayuno Intermitente

RESUMEN

BACKGROUND: This study aimed to investigate the effects of hemoglobin A1c (HbA1c), fasting blood glucose (FBG), 2-hours postprandial blood glucose (2hPBG), and fasting insulin (FINS) levels on pregnancy outcomes and their predictive value in patients with gestational diabetes mellitus (GDM). METHODS: A total of 109 pregnant women with GDM (GDM group) were included and assayed for serum FBG, 2hPBG, HbA1c, and FINS levels. The incidence of adverse pregnancy outcomes was recorded. GDM patients were divided into the poor pregnancy outcome group and the favorable pregnancy outcome group and analyzed for HbA1c, FBG, 2hPBG, and FINS. The predictive value of serum index combined detection on GDM pregnancy outcome was assessed, and the effect of serum indices on pregnancy outcome was evaluated in GDM patients with logistic regression. RESULTS: In the GDM group, there were 8 cases of premature membranes breaking (7.34%), 6 cases of premature delivery (5.50%), 3 cases of hyperamniotic fluid (2.75%), 2 cases of neonatal asphyxia (1.83%), 5 cases of fetal growth restriction (4.59%), and 3 cases of low-birth-weight infants (2.75%). The total incidence of adverse preg-nancy outcomes was 24.77% (27/109). HbA1c, FBG, 2hPBG, and FINS in the poor pregnancy outcome group were higher than those in the favorable pregnancy outcome group. The AUC value of blood biochemical indicators combined detection in predicting pregnancy outcome in GDM patients was higher than of HbA1c, FBG, 2hPBG, and FINS alone detection. HbA1c ≥ 6.94%, FBG ≥ 7.18 mmol/L, 2hPBG ≥ 9.36 mmol/L, and FINS ≥ 13.07 U/L were the risk factors affecting pregnancy outcomes in GDM patients. CONCLUSIONS: The changes of HbA1c, FBG, 2hPBG, and FINS levels in GDM patients are associated with adverse pregnancy outcomes, and the combined detection of serum indicators has predictive value for pregnancy outcomes in GDM patients.

Asunto(s)

Glucemia , Diabetes Gestacional , Hemoglobina Glucada , Valor Predictivo de las Pruebas , Resultado del Embarazo , Humanos , Embarazo , Femenino , Diabetes Gestacional/sangre , Diabetes Gestacional/diagnóstico , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , Resultado del Embarazo/epidemiología , Adulto , Glucemia/análisis , Glucemia/metabolismo , Insulina/sangre , Ayuno/sangre

RESUMEN

PURPOSE: Traditional fasting causes considerable discomfort without added assurance of security, whereas oral carbohydrate beverage offers an alternative to improve medical experience. This study aims to explore the impact of different types and dosages of oral fluids loading before painless bidirectional endoscopy on the gastric emptying and wellbeing. METHODS: 180 patients arranged for bidirectional endoscopy with intravenous anesthesia were randomized: patients in the control group (Group C) obeyed standard fasting; the 200 mL carbohydrate group (Group P1), 400 mL carbohydrate group (Group P2), 200 mL water group (Group W1) and 400 mL water group (Group W2) respectively consumed 200 mL or 400 mL corresponding clear liquids 2 h before the procedure. Gastric emptying metrics under ultrasound, subjective comfort indexes, periprocedural blood glucose and vital signs were contrasted among the groups. RESULTS: No significant differences were detected in the gastric emptying including CSA (cross-sectional area), GV (gastric volume), cGV (corrected gastric volume) and the three-point grading system among groups, and none had a cGV > 1.5 mL/kg before anesthesia. Participants in Group P2 experienced less preprocedural thirst and mouth dryness, so as the postprocedural thirst, mouth dryness and hunger. Periprocedural blood glucose and MAP had the similar trend in all groups. The occurrence of hypotension, bradycardia, hypoxia, and the required norepinephrine was comparable among the groups. CONCLUSIONS: Oral beverage loading with 200 mL or 400 mL can be safely applicated 2 h before painless bidirectional endoscopy without increasing the gastric volume. 400 mL carbohydrate solution effectively relieves the discomfort and could serve as a consideration. TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry on December 5, 2023 (ChiCTR2300078319).

Asunto(s)

Vaciamiento Gástrico , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Adulto , Ayuno , Dieta de Carga de Carbohidratos , Anciano , Administración Oral

RESUMEN

The hypometabolism induced by fasting has great potential in maintaining health and improving survival in extreme environments, among which thyroid hormone (TH) plays an important role in the adaptation and the formation of new energy metabolism homeostasis during long-term fasting. In the present review, we emphasize the potential of long-term fasting to improve physical health and emergency rescue in extreme environments, introduce the concept and pattern of fasting and its impact on the body's energy metabolism consumption. Prolonged fasting has more application potential in emergency rescue in special environments. The changes of THs caused by fasting, including serum biochemical characteristics, responsiveness of the peripheral and central hypothalamus-pituitary-thyroid (HPT) axis, and differential changes of TH metabolism, are emphasized in particular. It was proposed that the variability between brain and liver tissues in THs uptake, deiodination activation and inactivation is the key regulatory mechanism for the cause of peripheral THs decline and central homeostasis. While hypothalamic tanycytes play a pivotal role in the fine regulation of the HPT negative feedback regulation during long-term fasting. The study progress of tanycytes on thyrotropin-releasing hormone (TRH) release and deiodination is described in detail. In conclusion, the combination of the decrease of TH metabolism in peripheral tissues and stability in the central HPT axis maintains the basal physiological requirement and new energy metabolism homeostasis to adapt to long-term food scarcity. The molecular mechanisms of this localized and differential regulation will be a key research direction for developing measures for hypometabolic applications in extreme environment.

Asunto(s)

Metabolismo Energético , Ayuno , Hormonas Tiroideas , Humanos , Ayuno/metabolismo , Ayuno/fisiología , Hormonas Tiroideas/metabolismo , Animales , Metabolismo Energético/fisiología , Sistema Hipotálamo-Hipofisario/metabolismo , Sistema Hipotálamo-Hipofisario/fisiología , Glándula Tiroides/metabolismo , Glándula Tiroides/fisiología , Homeostasis

RESUMEN

Transitions between the fed and fasted state are common in mammals. The liver orchestrates adaptive responses to feeding/fasting by transcriptionally regulating metabolic pathways of energy usage and storage. Transcriptional and enhancer dynamics following cessation of fasting (refeeding) have not been explored. We examined the transcriptional and chromatin events occurring upon refeeding in mice, including kinetic behavior and molecular drivers. We found that the refeeding response is temporally organized with the early response focused on ramping up protein translation while the later stages of refeeding drive a bifurcated lipid synthesis program. While both the cholesterol biosynthesis and lipogenesis pathways were inhibited during fasting, most cholesterol biosynthesis genes returned to their basal levels upon refeeding while most lipogenesis genes markedly overshoot above pre-fasting levels. Gene knockout, enhancer dynamics, and ChIP-seq analyses revealed that lipogenic gene overshoot is dictated by LXRα. These findings from unbiased analyses unravel the mechanism behind the long-known phenomenon of refeeding fat overshoot.

Asunto(s)

Elementos de Facilitación Genéticos , Ayuno , Receptores X del Hígado , Hígado , Animales , Masculino , Ratones , Colesterol/metabolismo , Elementos de Facilitación Genéticos/genética , Ayuno/metabolismo , Regulación de la Expresión Génica , Lipogénesis , Hígado/metabolismo , Receptores X del Hígado/metabolismo , Receptores X del Hígado/genética , Ratones Endogámicos C57BL , Ratones Noqueados

RESUMEN

As the population ages, promoting healthy aging through targeted interventions becomes increasingly crucial. Growing evidence suggests that dietary interventions can significantly impact this process by modulating fundamental molecular pathways. This review focuses on the potential of targeted dietary strategies in promoting healthy aging and the mechanisms by which specific nutrients and dietary patterns influence key pathways involved in cellular repair, inflammation, and metabolic regulation. Caloric restriction, intermittent fasting, the Mediterranean diet, as well as the ketogenic diet showed promising effects on promoting healthy aging, possibly by modulating mTORC1 AMPK, an insulin signaling pathway. By understanding the intricate interplay between diet and molecular pathways, we can develop personalized dietary strategies that not only prevent age-related diseases, but also promote overall health and well-being throughout the aging process.

Asunto(s)

Restricción Calórica , Dieta Cetogénica , Dieta Mediterránea , Ayuno , Envejecimiento Saludable , Humanos , Restricción Calórica/métodos , Envejecimiento Saludable/fisiología , Transducción de Señal , Envejecimiento/fisiología , Ayuno Intermitente

RESUMEN

Men generally favor carbohydrate metabolism, while women lean towards lipid metabolism, resulting in significant sex-based differences in energy oxidation across various metabolic states such as fasting and feeding. These differences are influenced by body composition and inherent metabolic fluxes, including increased lipolysis rates in women. However, understanding how sex influences organ-specific metabolism and systemic manifestations remains incomplete. To address these gaps, we developed a sex-specific, whole-body metabolic model for feeding and fasting scenarios in healthy young adults. Our model integrates organ metabolism with whole-body responses to mixed meals, particularly high-carbohydrate and high-fat meals. Our predictions suggest that differences in liver and adipose tissue nutrient storage and oxidation patterns drive systemic metabolic disparities. We propose that sex differences in fasting hepatic glucose output may result from the different handling of free fatty acids, glycerol, and glycogen. We identified a metabolic pathway, possibly more prevalent in female livers, redirecting lipids towards carbohydrate metabolism to support hepatic glucose production. This mechanism is facilitated by the TG-FFA cycle between adipose tissue and the liver. Incorporating sex-specific data into multi-scale frameworks offers insights into how sex modulates human metabolism.

Asunto(s)

Ayuno , Hígado , Modelos Biológicos , Humanos , Femenino , Masculino , Ayuno/metabolismo , Hígado/metabolismo , Metabolismo de los Lípidos/fisiología , Tejido Adiposo/metabolismo , Glucosa/metabolismo , Adulto , Caracteres Sexuales , Metabolismo Energético/fisiología , Metabolismo de los Hidratos de Carbono/fisiología