Background: Persistent hyperglycemia in diabetes is associated with profound changes in lipid and... more Background: Persistent hyperglycemia in diabetes is associated with profound changes in lipid and lipoprotein abnormalities which result in particle distribution within lipoprotein classes. Recently, we have reported the antidiabetic properties of GTF-231 (Gymnemic acid, Trigonelline and Ferulic acid-2:3:1) a phytochemical preparation in experimental type 2 diabetic rats. The present study was aimed to evaluate the effect of GTF-231 on the regulation of lipid homeostasis in T2DM induced rats. Materials and methods: High fat diet fed-low dose STZ induced experimental type 2 diabetes was used as the animal model. GTF at a concentration of 300mg/kg.b.w./rat/day was orally administered for 30 days to experimental type 2 diabetic rats. The alterations in the levels of lipid profile in plasma, hepatic and renal tissues were studied. The activities of HMG CoA reductase was assayed in liver and kidney tissues of control and experimental groups of rats. The levels of lipid metabolizing enzymes such as lipoprotein lipase and lecithin cholesterol acyltransferase in the plasma and hepatic tissues were assayed. Results: Oral administration of GTF-231significantly normalized the altered levels of lipid profile in plasma, hepatic and renal tissues. Likewise, the decreased levels of HDL-c and increased levels of LDL-c and VLDL-c in plasma of diabetic rats were normalized upon treatment with GTF. Additionally,GTF-231 treatment significantly decreased the activity HMG-CoA reductase in the liver and kidney tissues. Decreased activities of lipid metabolizing enzymes such as lipoprotein lipase and lecithin cholesterol acyltransferase in the plasma and hepatic tissues were normalized upon oral treatment with GTF-231. Conclusion: The data obtained are claimed to display synergistic, efficacious and agonistic/antagonistic actions of GTF-231 and the mixture of species in the phytochemical preparation shows better therapeutic effects at a relatively less concentration than either species on its own and the ameliorative potential of GTF-231 in diabetic dyslipidemia was comparable with metformin (200 mg/kg.b.w.).
Introduction: Abdominal visceral fat accumulation can cause insulin resistance in type 2 diabetic... more Introduction: Abdominal visceral fat accumulation can cause insulin resistance in type 2 diabetic patients. We investigated the association between serum fatty acid levels and the visceral fat area (VFA). Materials and methods: In this retrospective study we evaluated relationship between the serum levels of 24 fatty acids and the abdominal VFA measured by computed tomography in 32 patients with type 2 diabetes who had been hospitalized. Results: Of the 24 fatty acids evaluated, the serum palmitoleic acid (C16:1 n-7) level had a moderate positive correlation (r = 0.565) with VFA while the serum arachidic acid (C:20:0) level had a very weak negative correlation (r =-0.351);no significant correlations with the VFA were found for the remaining 22 fatty acids. On the other hand, we discovered 5 significant correlations in 18 estimated activity indices of elongases and desaturases, which were calculated with ratios of corresponding fatty acid concentrations. The palmitoleic acid (C16:1 n-7) /palmitic acid (C16:0) (r = 0.719, stearoyl-CoA-desaturase (SCD)-1 (16)) index and the oleic acid (C18:1 n-9) / stearic acid (C18:0) (r = 0.534, SCD-1(18) index had moderate to strong correlations with the VFA, whereas stearic acid (C18:0) /palmitic acid (C16:0) (r =-0.495, elongase of very long chain fatty acids (Elovl) 6 index exhibited a significant negative correlation. Conclusions: The serum palmitoleic acid (C16:1 n-7) level and some estimated activity indices significantly correlated with the VFA in the type 2 diabetic patients. SCD-1 indices and an Elovl6 index were reciprocally associated with the VFA. The SCD-1(16) index, which showed the strongest correlation with the VFA along with the negative association of the Elovl6 index, might be useful in estimating the VFA.
Sedentary behaviour contributes to adverse physical health outcomes in youth. Although evidence f... more Sedentary behaviour contributes to adverse physical health outcomes in youth. Although evidence for the relationship between sedentary behaviour and mental health outcomes is emerging, little is known regarding risk of psychological distress and low self-esteem. The purpose of this study was to investigate the association of sedentary behaviour with psychological distress and self-esteem in a well-characterised young adult population after controlling for a wide range of potential confounders. We adopted a cross-sectional study design. A sample of 352 participants, 208(59.1%) females and 144(40.9%) males responded to a survey. Participants were recruited from University Tunku Abdul Rahman, Malaysia. Sedentary behaviour of the participants was determined by Sedentary Behaviour Questionnaire. Kessler Psychological Distress Scale and Rosenberg Self-Esteem Scale were used to measure psychological distress and global self-esteem respectively. Analysis of sedentary behaviour demonstrated that participants have high sedentary times. The highest sedentary behaviour engaged by the participants was doing paperwork or computer work, followed by sitting, listening to music and sitting and talk on a phone. Participants spent least time playing musical instruments. Multi regression analysis was performed to determine the level of significance. Sedentary behaviour showed a statistically significant association with psychological distress and self-esteem. Sedentary behaviour can lead to mental health problems in young adults. These findings have a number of important implications for policy and practice. They highlight the need to ensure that young people have appropriate and timely access to evidence based services and interventions across the continuum. Further high-quality longitudinal or interventional research is needed to confirm findings and determine the direction of these relationships.
Background: Hyperinsuliunemia is a condition with excess levels of circulating insulin in the blo... more Background: Hyperinsuliunemia is a condition with excess levels of circulating insulin in the blood among non-diabetics. Hyperinsuliunemia may increase breast cancer developing probability. Purpose: to investigate the role of hyperinsuliunemia in early recurrence in breast cancer by estrogen receptor (ER), progesterone receptor (PR) and human epider-mal growth factor receptor 2 (HER2). Methods: 50 patients with invasive breast cancer in stage II and III in age range 17-65 years, involved in this study and classified into five subtypes of ER, PR and HER2, and followed prospectively for 2 years from beginning treatment based on insulin serum levels. Results: In newly diagnosed patients the mean concentrations and standard deviation were (17.11 ± 10.17), while the insulin levels in the patients after chemo-therapy treatment were (26.06 ± 15.69), when the tow means were compared by t. test the blood concentration of insulin was high significantly in patients as control (p > 0.001). Regarding hormone receptors and HER2, the insulin levels in ER− PR−HER2− and ER− PR−HER2+ increased significantly after chemotherapy (p = 0.005 and 0.047) respectively. 10 of triple negative breast cancer patients suffered recurrence. Conclusion: Hyperinsuliunemia and weight change after chemotherapy may consider as risk factors for breast cancer recurrence among patients with triple-negative breast cancer.
Obesity is a global health problem in recent years. Adipose tissue was known as a storage tissue ... more Obesity is a global health problem in recent years. Adipose tissue was known as a storage tissue increasing with rise of the body mass index the indicator of obesity. The endocrine functions of adipose tissue might contribute to obesity, diabetes mellitus, cancer and infertility. Many environmental chemicals affect actions of hormones so these chemicals have been defined as endocrine-disrupting chemicals(EDCs) or endocrine disruptors. With the increase in production of EDCs in the world parallels the global obesity prevalence increases. The reported rise in obesity of children under 2 years of age is also suggestive of alterations during development. In early life EDCs exposure can influence epigenetic programming of obesity. These pollutants can pass from mother to fetus via placenta and breast feeding. Some obesogens are found in nature such as phytoestrogens and the others are mostly synthetic chemicals. These chemicals commonly found in pesticides /herbicides, industrial and household products, plastics detergents and personal care products. These substances are defined persistant organic pollutant (POPs) and they accumulate in adipose tissue. Common EDSs are Tributyltin (TBT), 4-Nonylphenol used in industry, persistent organochlorines (POPs) used in agriculture industry, diethylstilboestrol (DES) as a pharmaceutical, bisphenol A (BPA) and phthalates used in plastics, parabens as preservatives, phytoestrogens in edible plants, polybrominated diphenylethers (PBDEs) as flame retardants. We searched current literature with the key words: obesogens, POPs, endocrine disruptors in pubmed and filtered the results with articles in recent 5 years. This mini reviewprovides current experience about association between obesity and endocrine disrupting chemicals.
Type-2 diabetes and Alzheimer's disease are very serious diseases and the former has been suggest... more Type-2 diabetes and Alzheimer's disease are very serious diseases and the former has been suggested to be one of the causes of the latter. Low glycemic index foods inhibit rapid increases in blood glucose and insulin secretion after meals. In this study, we investigated the palatability of boiled rice and inhibition of an abrupt increase in blood glucose level (BGL) and amyloid β peptide production after eating blend of ordinary unpolished rice, " Koshihikari " and anthocyanin-rich black-rice, " Okunomurasaki " unpolished rice cooked after a high-pressure treatment (HPT KO). " Okunomurasaki " showed a high antioxidant capacity and high inhibitory activity against β-secretase even after HPT and cooking. A randomized, single-blind, crossover-designed study was conducted using 15 subjects with a normal BGL. BGLs at 90 and 120 min after ingesting the cooked HPT KO were significantly lower than that for cooked Koshihikari polished rice (p < 0.05). Furthermore, the increase in the amyloid β40 peptide in the blood 120 min after eating HPT KO tended to be lower than that of cooked Koshihikari polished rice. It would be necessary to conduct a long-term test using the present HPT KO in terms of inhibitory activity against the abrupt increase of BGL and amyloid β peptide production for the probability to prevent type-2 diabetes and Alzheimer's disease .
Purpose: The aim of the study was to investigate the sonographic characteristics of the varices o... more Purpose: The aim of the study was to investigate the sonographic characteristics of the varices of pancreas in portal hypertension. Methods: We retrospectively reviewed the sonographic findings, case records and other diagnostic procedures of 11 patients with clinical features of portal hypertension of different etiology, all having sonographical changes suggesting presence of the pancreatic varices. Size, echogenicity, margins, location and type of vascularity were analyzed. All patients underwent subsequent upper gas-trointestinal endoscopy. Results: Gray-scale sonography demonstrated either anechoic oval lesions or tortuous tubular structures located in different parts of pancreas. The vascular nature of the structures was proven by detection of blood flow on color Doppler and power Doppler sonography and categorized as venous by means of pulsed Doppler sonography. CT revealed pancreatic varices in 9 patients. Of the 11 subjects with upper gastrointestinal endoscopy performed, 9 had esophageal varices confirmed. Conclusions: Varices of pancreas are detectable on Doppler sonography in patients with portal hypertension.
Myocardial infarction (MI)-prone Watanabe hereditary hyperlipidemic (WHHLMI) rabbits were reporte... more Myocardial infarction (MI)-prone Watanabe hereditary hyperlipidemic (WHHLMI) rabbits were reported to spontaneously but slowly develop MI, associated with enhanced coronary atherosclerosis and metabolic syndrome features. Our aim was to accelerate these processes by exposing the rabbits to a high-fat diet (HFD) that was previously shown to induce insulin resistance and cardiac injury in rabbits. HFD feeding for one year was indeed associated with development of obesity (37% increases in body weight, as compared to 3.7% for control standard-fat diet, SFD). On HFD, liver weight and hepatic triglyceride content were significantly higher as compared to SFD, with mild steatosis. Glucose and insulin levels were not markedly different on SFD or HFD, however after 1 year of diet treatment, HFD-fed animals were more glucose intolerant as compared to SFD-fed rabbits. On SFD, the rabbits developed marked thoracic aorta stenosis and calcification of atherosclerotic lesions, which were not aggravated by HFD feeding. Cardiac function analysis by MRI and transthoracic echocardiography did not reveal significant differences between SFD-and HFD-fed rabbits. Thus, the metabolic and cardiac phenotype of WHHLMI rabbits was not aggravated by HFD feeding for one year, and the rabbits did not spontaneously develop diabetes or myocardial infarction.
Aims: To evaluate metabolic and anthropometric changes achieved and maintained by diabetic patien... more Aims: To evaluate metabolic and anthropometric changes achieved and maintained by diabetic patients (pts) in a structured weight loss (WL) program vs usual care in an endocrine clinic (UCG). Materials and Methods: This retrospective comparison study examined 38 diabetic pts with BMI >25 undergoing the active weight loss phase of WL determined by patient goal weight and then followed for 6 months in weight maintenance phase (WM). Multiple endpoints were assessed at baseline including BMI and hemoglobin A1c (A1c). Endpoints were reassessed at 6 months in WM. The usual care group (UCG) was obtained through chart review of 26 diabetic pts with BMI > 25 in an endocrine specialty clinic who completed an education program including lifestyle counseling by a certified diabetic educator. Data were analyzed using ANCOVA and protected LSD, adjusting for age, gender, and baseline weight. Results: Patients showed a change in BMI at 6 months of-6.8 ± 0 (bsl 44 ± 8.4) and-0.7 ± 1.1 (bsl 35 ± 6.2) for HMR® pts and UCG, respectively (p < 0.05). HMR® pts had 13.4% ± 3 % WL vs 7.9% ± 4% in UCG p = 0.34). 6 month A1c was similar in HMR pts (7.5% ± 2; bsl 8.3 ± 1.9) and UCG (7.5% ± 2.3; bsl 9.8 ± 1.8). HMR® pts had a reduction of total medication usage of 28%, with at least one medication discontinued in 80% of pts, while the UCG had only 23% of pts with discontinuation of at least one medication (p < 0.05). Conclusions: Compared to CDE-led diabetic education emphasizing lifestyle change, pts in an intensive WL program utilizing weekly coaching, meal replacements, and exercise, had a significant decrease in BMI and achieved a similar A1c with reduction in medication requirements.
Diabetes is one of the most devastating diseases in the world. Its prevention is very important i... more Diabetes is one of the most devastating diseases in the world. Its prevention is very important in addition to the development of the curing technology. We started the cooperative research on low Glycemic Index (GI) rice to prevent diabetes. High-amy-lose rice is promising to prevent diabetes because its GI is lower than low-amylose one. Since Hoku243 presents fewer short-branched glucans and more long chains in the amylopectin starch, its starch is resistant to gelatinization and the boiled rice grains are non-sticky and brittle. The prevention of abrupt increases in postprandial blood glucose level (BGL) by feeding Sprague-Dawley (SD) rats with Hoku243 (produced by high pressure treatment (HPT) after soaking in unsalted rice koji miso) was investigated.
There is debate about the additive effects of exercise in conjunction with diet to treat obesity,... more There is debate about the additive effects of exercise in conjunction with diet to treat obesity, and not much is known about the differential effects of strength versus aerobic training. This randomized controlled trial examined the effects of diet plus strength training, diet plus aerobic training, or diet only on metabolic risk factors associated with obesity. Eighty-one overweight and obese participants completed the 8-week intervention. All participants received an energy-restrictive formula diet with an energy content based on 70% of measured resting metabolic rate (RMR). Participants assigned to an exercise group trained 3 days/week under supervision. Anthropometrics and fasting hormones were assessed pre-and post-intervention. Mean weight loss (8.5 ± 4.3kg SD) did not differ between groups nor did reductions in BMI or body fat, although the diet plus strength training group showed marginally greater lean mass retention. There were significant improvements in the values and number of metabolic syndrome risk factors, and decreases in insulin concentrations and insulin resistance, which did not vary between groups. For men, testosterone increased significantly more in the diet plus aerobic training as compared to the other groups. As compared to diet alone, the addition of strength or aerobic training did not improve changes in BMI, body fat, or metabolic risk factors although the diet plus strength training group showed a trend toward preservation of lean mass, and the diet plus aerobic group in men resulted in increased testosterone. Citation: Geliebter A., et al. Obesity-related hormones and metabolic risk factors: a randomized trial of diet plus either strength or aerobic training versus diet alone in overweight participants (2014) J Diabetes Obes 1(1): 1-7.
Obesity is frequently present in women with polycystic ovary syndrome (PCOS). It aggravates the a... more Obesity is frequently present in women with polycystic ovary syndrome (PCOS). It aggravates the adverse features of the syndrome and increases the metabolic risk in this population. Weight management by life style intervention often remains unsatisfactory and non-sustainable. In the present mini review, we revised limited studies addressing the potential use of agents mediating through glucagon-like peptide (GLP)-1 in PCOS. We reported that short-term intervention with long acting GLP-1 analogue liraglutide is associated with consistent BMI decrease in treatment naive obese women with PCOS and in those who had been previously poor responders to metformin and life style modification. Metformin, a well-established therapy used in PCOS with high metabolic risk, was recognized as a mechanistically well-suited combination with li-raglutide. Short-term intervention with liraglutide also improved eating behavior in obese PCOS. Furthermore, we discussed the potential association of genetic variability of GLP-1 receptor and inter-individual differences in response to liraglutide regarding weight reduction. In addition, we challenged the original concept related to the enhancement of GLP-1 mediated action through phosphordiesterase 4 (PDE 4) inhibitions as a new potential therapeutic target in obesity-related population. We concluded that GLP-1 mediated agents are promising treatment strategies in the management of obese PCOS. However, larger sample size studies with longer durations of treatment may be required to examine potential benefits of these medications in decreasing metabolic risk and improving reproductive out come in obese PCOS.
Diabetes Mellitus (DM), Chronic Kidney Disease (CKD), and Coronary Heart Disease (CHD) are in pra... more Diabetes Mellitus (DM), Chronic Kidney Disease (CKD), and Coronary Heart Disease (CHD) are in practice a complex medical status which are closely associated and generally coexist. This article focuses the diabetes risk factors of the CKD patients, and examines the association between DM, CKD and CHD, based on the data set in Apollo Hospitals, Managiri, Tamil nadu, India. The risk factors of DM, and its association with CKD and CHD are discussed for the awareness of the healthy individuals, diabetes, kidney, cardiac patients, and medical practitioners.
The involvement of gut microbiota in type 2 diabetes has been recognized[1,2]. Several Clostridiu... more The involvement of gut microbiota in type 2 diabetes has been recognized[1,2]. Several Clostridium or lactobacilli species are reportedly enriched in type 2 diabetes[1,2]. A study by Forslund et al, showed that gut microbes mediate the therapeutic effects of
metformin through certain types of short-chain fatty acid production[3]. Gut microbiota may therefore influence insulin sensitivity. Serum metformin levels of type 2 diabetes patients are positively correlated with Escherichia abundance, whereas they are negative correlation with Intestinibacter abundance[3].
Serotonin (5-hydroxytryptamine, 5-HT) is mainly synthesized, stored, and released from enterochromaffin cells within mucosal epithelia of the gut[4]. Gut microbes regulate 5-HT levels in the colon and blood. Spore-forming bacteria (Sp) from the mouse and human microbiota promote 5-HT biosynthesis from colonic enterochromaffin cells, which supply 5-HT to the mucosa, lumen, and circulating platelets[4]. The microbiota-dependent changes in gut 5-HT impact gastrointestinal motility and platelet function[4].
5-HT1B and 5-HT4 receptors, which are distributed in the enteric nervous system and smooth muscle in the gut, may be involved in the gut-mediated glucose homeostasis[5,6]. Pharmacologic stimulation of serotonin 5-HT1B or 5-HT4 receptors increases plasma active glucagon-like-peptide-1 levels independently of feeding and improves glucose tolerance under the dipeptidyl peptidase-4 inhibition in mice[5,6]. Although it remains unclear whether gut microbiota influence insulin secretion, the gut microviota-5-HT axis may be a novel therapeutic target for type 2 diabetes in future.
Obesity and the associated diseases such as type 2 diabetes are the leading causes of human morbi... more Obesity and the associated diseases such as type 2 diabetes are the leading causes of human morbidity and mortality but the biological mechanism of obesity is not clearly understood[1]. The patient often struggles to maintain a more active lifestyle and a healthy diet. Here we suggest that mindfulness should be explored as an adjunct therapy for this disease. The rationale for this suggestion follows.
The prevalence of obesity and overweight in most population is increasing alarmingly. This rise i... more The prevalence of obesity and overweight in most population is increasing alarmingly. This rise is associated with economic development, increasing urbanization, change in dietary and other lifestyle patterns and also reduced physical activity. Last studies showed that type 2 diabetes incidence rise with increasing body mass index (BMI). This paper evaluated the prevalence of overweight and obesity among diabetic patients. A total of 518 consecutive central-based patients (198 males and 320 females) with type 2 diabetes (T2DM) were investigated in this prospective cross-sectional study. The overall prevalence of overweight and obesity (BMI > 25 kg/m²) was 76%. The mean of BMI in women was 26.66 ± 3.98 and in men was 28.70 ± 4.36. The prevalence of overweight and obesity were 48% and 28%, respectively. This paper indicated a high prevalence of overweight and obesity in diabetic patients in Yazd (central province of Iran).
Epicardial fat is true visceral fat deposited around sub epicardial coronary vessels; it has been... more Epicardial fat is true visceral fat deposited around sub epicardial coronary vessels; it has been implicated in the development of coronary atherosclerosis. Epicardial fat has been also associated with insulin resistance. Tran’s thoracic echocardiography provides a reliable measurement of epicardial fat thickness.
Objective: To evaluate the association between epicardial fat thickness with metabolic syndrome and anthropometric parameters of adiposity.
Methods: We assessed 70 patients who underwent echocardiography; the epicardial fat thickness on the free wall of the right ventricle was measured at end-diastole from the parasternal long-axis views of 3 cardiac cycles with Aloka Alfa 6 equipment (Japan), by 2 cardiologists who were unaware of the clinical data. Metabolic syndrome was defined according with the International Diabetes Federation criteria.
The association between epicardial fat thicknesses with metabolic syndrome was evaluated with the fisher exact test, whereas its correlation with body mass index, and waist circumference was evaluated with the Pearson coefficient.
Results: We found a significant association between epicardial fat thickness and metabolic syndrome (p = 0.0076), we also found a significant correlation between epicardial fat and body mass index (r = 0.51, p = 0.00001) and with waist circumference (r = 0.472, p = 0.0004).
Conclusion: Epicardial fat thickness is associated with metabolic syndrome and anthropometric parameters related with adiposity, and may contribute to the cardiovascular risk of these patients.
An end-expiratory oxygen (FEO2) concentration > 90% is desirable prior to tracheal intubation. We... more An end-expiratory oxygen (FEO2) concentration > 90% is desirable prior to tracheal intubation. We hypothesized that the time required for pre oxygenation to achieve an FEO2 of 90% was related to patient Body Mass Index (BMI). Seventy- seven consenting patients undergoing a rapid sequence induction were enrolled. After the anesthesia rebreathing circuit was filled with 100% oxygen for 4 min, these unpremeditated patients were instructed to breathe normally following application of a tight-fitting face mask with oxygen flowing at 10 L min-1. End-tidal oxygen and carbon dioxide values were recorded during the pre oxygenation period. Induction of anesthesia was performed when the FEO2 reached 90% or after 5 min of pre oxygenation in a standardized fashion. The times to achieve an FEO2 of 90% were 152 ± 57, 136 ± 62 and 136 ± 70 sec in the normal, overweight and obese subgroups, respectively. A total of 7 patients failed to achieve an FEO2 90% after 5 min of preoxygenation. Four patients also experienced a decrease in SpO2 < 95% during the apneic period prior to tracheal intubation (3 in the obese group and 1 in the overweight group). The mean BMI (± SD) of the patients who failed to achieve a FEO2 of 90% was 40 ± 9 kg/m². The time required to achieve an FEO2 of 90% during preoxygenation period was unrelated to the patient’s BMI. However, morbidly obese patients were more likely to experience a fall in their SpO2 to < 95% during the induction period.
Background: Liposuction can remove a substantial amount of body fat. We investigated the effects ... more Background: Liposuction can remove a substantial amount of body fat. We investigated the effects of liposuction of large volumes of fat on anthropometrics, body composition (BIA), metabolic hormones, and psychological measures in overweight/obese women. To our knowledge, this is the first study to examine both physiological and psychological changes following liposuction of large volumes of fat in humans.
Method: Nine premenopausal healthy overweight/obese women (age = 35.9 ± 7.1 SD, weight = 84.4 kg ± 13.6, BMI = 29.9 kg/m² ± 2.9) underwent liposuction, removing 3.92 kg ± 1.04 SD of fat. Following an overnight fast, height, weight, waist, and hip circumferences were measured at baseline (one week pre-surgery) and post-surgery (wk 1,4,12). Blood samples were drawn for fasting concentrations of glucose, insulin, leptin, and ghrelin. The Body Shape Questionnaire (BSQ), Body Dysmorphic Disorder (BDD) Examination Self-Report (BDDE-SR), and Zung Self-Rating Depression Scale (ZDS) were administered.
Results: Body weight, BMI, waist circumference, and body fat consistently decreased over time (p < .05). Glucose did not change significantly, but insulin decreased from wk 1 to wk 12 (p < .05). Leptin decreased from baseline to wk 1 (p = .01); ghrelin increased but not significantly. Changes in body fat and waist circumference (baseline to wk 1) correlated positively with changes in insulin during that period, and correlated inversely with changes in ghrelin (p < .05). BSQ scores decreased significantly over time (p = .004), but scores for BDDE-SR (p = .10) and ZDS (p = .24) did not change significantly.
Conclusion: Liposuction led to significant decreases in body weight and fat, waist circumference, and leptin levels. Changes in body fat and waist circumference correlated with concurrent changes in the adipose-related hormones, insulin and ghrelin (baseline to wk 1), and body shape perception improved. Thus, besides the obvious cosmetic effects, liposuction led to several positive body composition, hormonal, and psychological changes.
Association between type 2 diabetes (T2DM) and compositional changes in the gut micro biota is st... more Association between type 2 diabetes (T2DM) and compositional changes in the gut micro biota is stablished, however little is known about the dysbiosis in early stages of Prediabetes (preDM). The purpose of this investigation is to elucidate the characteristics of the gut micro biome in preDM and T2DM, compared to Non-Diabetic (nonDM) subjects. Forty nine subjects were recruited for this study, 15 nonDM, 20 preDM and 14 T2DM. Bacterial community composition and diversity were investigated in fecal DNA samples using Illumina sequencing of the V4 region within the 16S rRNA gene. The five most abundant phyla identified were: Bacteroidetes, Firmicutes, Proteobacteria, Verrucomicrobia, and Actinobacteria. Class Chloracido bacteria was increased in preDM compared to T2DM (p = 0.04). An unknown genus from family Pseudonocardiaceae was significantly present in preDM group compared to the others (p = 0.04). Genus Collinsella, and an unknown genus belonging to family Enterobacteriaceae were both found to be significantly increased in T2DM compared to the other groups (Collinsella, and p = 0.03, Enterobacteriaceae genus p = 0.02). PERMANOVA and Mantel tests performed did not reveal a relationship between overall composition and diagnosis group or HbA1C level. This study identified dysbiosis associated with both preDM and T2DM, specifically at the class and genus levels suggesting that earlier treatment in preDM could possibly have an impact on the intestinal micro flora transitioning to T2DM.
Background: Persistent hyperglycemia in diabetes is associated with profound changes in lipid and... more Background: Persistent hyperglycemia in diabetes is associated with profound changes in lipid and lipoprotein abnormalities which result in particle distribution within lipoprotein classes. Recently, we have reported the antidiabetic properties of GTF-231 (Gymnemic acid, Trigonelline and Ferulic acid-2:3:1) a phytochemical preparation in experimental type 2 diabetic rats. The present study was aimed to evaluate the effect of GTF-231 on the regulation of lipid homeostasis in T2DM induced rats. Materials and methods: High fat diet fed-low dose STZ induced experimental type 2 diabetes was used as the animal model. GTF at a concentration of 300mg/kg.b.w./rat/day was orally administered for 30 days to experimental type 2 diabetic rats. The alterations in the levels of lipid profile in plasma, hepatic and renal tissues were studied. The activities of HMG CoA reductase was assayed in liver and kidney tissues of control and experimental groups of rats. The levels of lipid metabolizing enzymes such as lipoprotein lipase and lecithin cholesterol acyltransferase in the plasma and hepatic tissues were assayed. Results: Oral administration of GTF-231significantly normalized the altered levels of lipid profile in plasma, hepatic and renal tissues. Likewise, the decreased levels of HDL-c and increased levels of LDL-c and VLDL-c in plasma of diabetic rats were normalized upon treatment with GTF. Additionally,GTF-231 treatment significantly decreased the activity HMG-CoA reductase in the liver and kidney tissues. Decreased activities of lipid metabolizing enzymes such as lipoprotein lipase and lecithin cholesterol acyltransferase in the plasma and hepatic tissues were normalized upon oral treatment with GTF-231. Conclusion: The data obtained are claimed to display synergistic, efficacious and agonistic/antagonistic actions of GTF-231 and the mixture of species in the phytochemical preparation shows better therapeutic effects at a relatively less concentration than either species on its own and the ameliorative potential of GTF-231 in diabetic dyslipidemia was comparable with metformin (200 mg/kg.b.w.).
Introduction: Abdominal visceral fat accumulation can cause insulin resistance in type 2 diabetic... more Introduction: Abdominal visceral fat accumulation can cause insulin resistance in type 2 diabetic patients. We investigated the association between serum fatty acid levels and the visceral fat area (VFA). Materials and methods: In this retrospective study we evaluated relationship between the serum levels of 24 fatty acids and the abdominal VFA measured by computed tomography in 32 patients with type 2 diabetes who had been hospitalized. Results: Of the 24 fatty acids evaluated, the serum palmitoleic acid (C16:1 n-7) level had a moderate positive correlation (r = 0.565) with VFA while the serum arachidic acid (C:20:0) level had a very weak negative correlation (r =-0.351);no significant correlations with the VFA were found for the remaining 22 fatty acids. On the other hand, we discovered 5 significant correlations in 18 estimated activity indices of elongases and desaturases, which were calculated with ratios of corresponding fatty acid concentrations. The palmitoleic acid (C16:1 n-7) /palmitic acid (C16:0) (r = 0.719, stearoyl-CoA-desaturase (SCD)-1 (16)) index and the oleic acid (C18:1 n-9) / stearic acid (C18:0) (r = 0.534, SCD-1(18) index had moderate to strong correlations with the VFA, whereas stearic acid (C18:0) /palmitic acid (C16:0) (r =-0.495, elongase of very long chain fatty acids (Elovl) 6 index exhibited a significant negative correlation. Conclusions: The serum palmitoleic acid (C16:1 n-7) level and some estimated activity indices significantly correlated with the VFA in the type 2 diabetic patients. SCD-1 indices and an Elovl6 index were reciprocally associated with the VFA. The SCD-1(16) index, which showed the strongest correlation with the VFA along with the negative association of the Elovl6 index, might be useful in estimating the VFA.
Sedentary behaviour contributes to adverse physical health outcomes in youth. Although evidence f... more Sedentary behaviour contributes to adverse physical health outcomes in youth. Although evidence for the relationship between sedentary behaviour and mental health outcomes is emerging, little is known regarding risk of psychological distress and low self-esteem. The purpose of this study was to investigate the association of sedentary behaviour with psychological distress and self-esteem in a well-characterised young adult population after controlling for a wide range of potential confounders. We adopted a cross-sectional study design. A sample of 352 participants, 208(59.1%) females and 144(40.9%) males responded to a survey. Participants were recruited from University Tunku Abdul Rahman, Malaysia. Sedentary behaviour of the participants was determined by Sedentary Behaviour Questionnaire. Kessler Psychological Distress Scale and Rosenberg Self-Esteem Scale were used to measure psychological distress and global self-esteem respectively. Analysis of sedentary behaviour demonstrated that participants have high sedentary times. The highest sedentary behaviour engaged by the participants was doing paperwork or computer work, followed by sitting, listening to music and sitting and talk on a phone. Participants spent least time playing musical instruments. Multi regression analysis was performed to determine the level of significance. Sedentary behaviour showed a statistically significant association with psychological distress and self-esteem. Sedentary behaviour can lead to mental health problems in young adults. These findings have a number of important implications for policy and practice. They highlight the need to ensure that young people have appropriate and timely access to evidence based services and interventions across the continuum. Further high-quality longitudinal or interventional research is needed to confirm findings and determine the direction of these relationships.
Background: Hyperinsuliunemia is a condition with excess levels of circulating insulin in the blo... more Background: Hyperinsuliunemia is a condition with excess levels of circulating insulin in the blood among non-diabetics. Hyperinsuliunemia may increase breast cancer developing probability. Purpose: to investigate the role of hyperinsuliunemia in early recurrence in breast cancer by estrogen receptor (ER), progesterone receptor (PR) and human epider-mal growth factor receptor 2 (HER2). Methods: 50 patients with invasive breast cancer in stage II and III in age range 17-65 years, involved in this study and classified into five subtypes of ER, PR and HER2, and followed prospectively for 2 years from beginning treatment based on insulin serum levels. Results: In newly diagnosed patients the mean concentrations and standard deviation were (17.11 ± 10.17), while the insulin levels in the patients after chemo-therapy treatment were (26.06 ± 15.69), when the tow means were compared by t. test the blood concentration of insulin was high significantly in patients as control (p > 0.001). Regarding hormone receptors and HER2, the insulin levels in ER− PR−HER2− and ER− PR−HER2+ increased significantly after chemotherapy (p = 0.005 and 0.047) respectively. 10 of triple negative breast cancer patients suffered recurrence. Conclusion: Hyperinsuliunemia and weight change after chemotherapy may consider as risk factors for breast cancer recurrence among patients with triple-negative breast cancer.
Obesity is a global health problem in recent years. Adipose tissue was known as a storage tissue ... more Obesity is a global health problem in recent years. Adipose tissue was known as a storage tissue increasing with rise of the body mass index the indicator of obesity. The endocrine functions of adipose tissue might contribute to obesity, diabetes mellitus, cancer and infertility. Many environmental chemicals affect actions of hormones so these chemicals have been defined as endocrine-disrupting chemicals(EDCs) or endocrine disruptors. With the increase in production of EDCs in the world parallels the global obesity prevalence increases. The reported rise in obesity of children under 2 years of age is also suggestive of alterations during development. In early life EDCs exposure can influence epigenetic programming of obesity. These pollutants can pass from mother to fetus via placenta and breast feeding. Some obesogens are found in nature such as phytoestrogens and the others are mostly synthetic chemicals. These chemicals commonly found in pesticides /herbicides, industrial and household products, plastics detergents and personal care products. These substances are defined persistant organic pollutant (POPs) and they accumulate in adipose tissue. Common EDSs are Tributyltin (TBT), 4-Nonylphenol used in industry, persistent organochlorines (POPs) used in agriculture industry, diethylstilboestrol (DES) as a pharmaceutical, bisphenol A (BPA) and phthalates used in plastics, parabens as preservatives, phytoestrogens in edible plants, polybrominated diphenylethers (PBDEs) as flame retardants. We searched current literature with the key words: obesogens, POPs, endocrine disruptors in pubmed and filtered the results with articles in recent 5 years. This mini reviewprovides current experience about association between obesity and endocrine disrupting chemicals.
Type-2 diabetes and Alzheimer's disease are very serious diseases and the former has been suggest... more Type-2 diabetes and Alzheimer's disease are very serious diseases and the former has been suggested to be one of the causes of the latter. Low glycemic index foods inhibit rapid increases in blood glucose and insulin secretion after meals. In this study, we investigated the palatability of boiled rice and inhibition of an abrupt increase in blood glucose level (BGL) and amyloid β peptide production after eating blend of ordinary unpolished rice, " Koshihikari " and anthocyanin-rich black-rice, " Okunomurasaki " unpolished rice cooked after a high-pressure treatment (HPT KO). " Okunomurasaki " showed a high antioxidant capacity and high inhibitory activity against β-secretase even after HPT and cooking. A randomized, single-blind, crossover-designed study was conducted using 15 subjects with a normal BGL. BGLs at 90 and 120 min after ingesting the cooked HPT KO were significantly lower than that for cooked Koshihikari polished rice (p < 0.05). Furthermore, the increase in the amyloid β40 peptide in the blood 120 min after eating HPT KO tended to be lower than that of cooked Koshihikari polished rice. It would be necessary to conduct a long-term test using the present HPT KO in terms of inhibitory activity against the abrupt increase of BGL and amyloid β peptide production for the probability to prevent type-2 diabetes and Alzheimer's disease .
Purpose: The aim of the study was to investigate the sonographic characteristics of the varices o... more Purpose: The aim of the study was to investigate the sonographic characteristics of the varices of pancreas in portal hypertension. Methods: We retrospectively reviewed the sonographic findings, case records and other diagnostic procedures of 11 patients with clinical features of portal hypertension of different etiology, all having sonographical changes suggesting presence of the pancreatic varices. Size, echogenicity, margins, location and type of vascularity were analyzed. All patients underwent subsequent upper gas-trointestinal endoscopy. Results: Gray-scale sonography demonstrated either anechoic oval lesions or tortuous tubular structures located in different parts of pancreas. The vascular nature of the structures was proven by detection of blood flow on color Doppler and power Doppler sonography and categorized as venous by means of pulsed Doppler sonography. CT revealed pancreatic varices in 9 patients. Of the 11 subjects with upper gastrointestinal endoscopy performed, 9 had esophageal varices confirmed. Conclusions: Varices of pancreas are detectable on Doppler sonography in patients with portal hypertension.
Myocardial infarction (MI)-prone Watanabe hereditary hyperlipidemic (WHHLMI) rabbits were reporte... more Myocardial infarction (MI)-prone Watanabe hereditary hyperlipidemic (WHHLMI) rabbits were reported to spontaneously but slowly develop MI, associated with enhanced coronary atherosclerosis and metabolic syndrome features. Our aim was to accelerate these processes by exposing the rabbits to a high-fat diet (HFD) that was previously shown to induce insulin resistance and cardiac injury in rabbits. HFD feeding for one year was indeed associated with development of obesity (37% increases in body weight, as compared to 3.7% for control standard-fat diet, SFD). On HFD, liver weight and hepatic triglyceride content were significantly higher as compared to SFD, with mild steatosis. Glucose and insulin levels were not markedly different on SFD or HFD, however after 1 year of diet treatment, HFD-fed animals were more glucose intolerant as compared to SFD-fed rabbits. On SFD, the rabbits developed marked thoracic aorta stenosis and calcification of atherosclerotic lesions, which were not aggravated by HFD feeding. Cardiac function analysis by MRI and transthoracic echocardiography did not reveal significant differences between SFD-and HFD-fed rabbits. Thus, the metabolic and cardiac phenotype of WHHLMI rabbits was not aggravated by HFD feeding for one year, and the rabbits did not spontaneously develop diabetes or myocardial infarction.
Aims: To evaluate metabolic and anthropometric changes achieved and maintained by diabetic patien... more Aims: To evaluate metabolic and anthropometric changes achieved and maintained by diabetic patients (pts) in a structured weight loss (WL) program vs usual care in an endocrine clinic (UCG). Materials and Methods: This retrospective comparison study examined 38 diabetic pts with BMI >25 undergoing the active weight loss phase of WL determined by patient goal weight and then followed for 6 months in weight maintenance phase (WM). Multiple endpoints were assessed at baseline including BMI and hemoglobin A1c (A1c). Endpoints were reassessed at 6 months in WM. The usual care group (UCG) was obtained through chart review of 26 diabetic pts with BMI > 25 in an endocrine specialty clinic who completed an education program including lifestyle counseling by a certified diabetic educator. Data were analyzed using ANCOVA and protected LSD, adjusting for age, gender, and baseline weight. Results: Patients showed a change in BMI at 6 months of-6.8 ± 0 (bsl 44 ± 8.4) and-0.7 ± 1.1 (bsl 35 ± 6.2) for HMR® pts and UCG, respectively (p < 0.05). HMR® pts had 13.4% ± 3 % WL vs 7.9% ± 4% in UCG p = 0.34). 6 month A1c was similar in HMR pts (7.5% ± 2; bsl 8.3 ± 1.9) and UCG (7.5% ± 2.3; bsl 9.8 ± 1.8). HMR® pts had a reduction of total medication usage of 28%, with at least one medication discontinued in 80% of pts, while the UCG had only 23% of pts with discontinuation of at least one medication (p < 0.05). Conclusions: Compared to CDE-led diabetic education emphasizing lifestyle change, pts in an intensive WL program utilizing weekly coaching, meal replacements, and exercise, had a significant decrease in BMI and achieved a similar A1c with reduction in medication requirements.
Diabetes is one of the most devastating diseases in the world. Its prevention is very important i... more Diabetes is one of the most devastating diseases in the world. Its prevention is very important in addition to the development of the curing technology. We started the cooperative research on low Glycemic Index (GI) rice to prevent diabetes. High-amy-lose rice is promising to prevent diabetes because its GI is lower than low-amylose one. Since Hoku243 presents fewer short-branched glucans and more long chains in the amylopectin starch, its starch is resistant to gelatinization and the boiled rice grains are non-sticky and brittle. The prevention of abrupt increases in postprandial blood glucose level (BGL) by feeding Sprague-Dawley (SD) rats with Hoku243 (produced by high pressure treatment (HPT) after soaking in unsalted rice koji miso) was investigated.
There is debate about the additive effects of exercise in conjunction with diet to treat obesity,... more There is debate about the additive effects of exercise in conjunction with diet to treat obesity, and not much is known about the differential effects of strength versus aerobic training. This randomized controlled trial examined the effects of diet plus strength training, diet plus aerobic training, or diet only on metabolic risk factors associated with obesity. Eighty-one overweight and obese participants completed the 8-week intervention. All participants received an energy-restrictive formula diet with an energy content based on 70% of measured resting metabolic rate (RMR). Participants assigned to an exercise group trained 3 days/week under supervision. Anthropometrics and fasting hormones were assessed pre-and post-intervention. Mean weight loss (8.5 ± 4.3kg SD) did not differ between groups nor did reductions in BMI or body fat, although the diet plus strength training group showed marginally greater lean mass retention. There were significant improvements in the values and number of metabolic syndrome risk factors, and decreases in insulin concentrations and insulin resistance, which did not vary between groups. For men, testosterone increased significantly more in the diet plus aerobic training as compared to the other groups. As compared to diet alone, the addition of strength or aerobic training did not improve changes in BMI, body fat, or metabolic risk factors although the diet plus strength training group showed a trend toward preservation of lean mass, and the diet plus aerobic group in men resulted in increased testosterone. Citation: Geliebter A., et al. Obesity-related hormones and metabolic risk factors: a randomized trial of diet plus either strength or aerobic training versus diet alone in overweight participants (2014) J Diabetes Obes 1(1): 1-7.
Obesity is frequently present in women with polycystic ovary syndrome (PCOS). It aggravates the a... more Obesity is frequently present in women with polycystic ovary syndrome (PCOS). It aggravates the adverse features of the syndrome and increases the metabolic risk in this population. Weight management by life style intervention often remains unsatisfactory and non-sustainable. In the present mini review, we revised limited studies addressing the potential use of agents mediating through glucagon-like peptide (GLP)-1 in PCOS. We reported that short-term intervention with long acting GLP-1 analogue liraglutide is associated with consistent BMI decrease in treatment naive obese women with PCOS and in those who had been previously poor responders to metformin and life style modification. Metformin, a well-established therapy used in PCOS with high metabolic risk, was recognized as a mechanistically well-suited combination with li-raglutide. Short-term intervention with liraglutide also improved eating behavior in obese PCOS. Furthermore, we discussed the potential association of genetic variability of GLP-1 receptor and inter-individual differences in response to liraglutide regarding weight reduction. In addition, we challenged the original concept related to the enhancement of GLP-1 mediated action through phosphordiesterase 4 (PDE 4) inhibitions as a new potential therapeutic target in obesity-related population. We concluded that GLP-1 mediated agents are promising treatment strategies in the management of obese PCOS. However, larger sample size studies with longer durations of treatment may be required to examine potential benefits of these medications in decreasing metabolic risk and improving reproductive out come in obese PCOS.
Diabetes Mellitus (DM), Chronic Kidney Disease (CKD), and Coronary Heart Disease (CHD) are in pra... more Diabetes Mellitus (DM), Chronic Kidney Disease (CKD), and Coronary Heart Disease (CHD) are in practice a complex medical status which are closely associated and generally coexist. This article focuses the diabetes risk factors of the CKD patients, and examines the association between DM, CKD and CHD, based on the data set in Apollo Hospitals, Managiri, Tamil nadu, India. The risk factors of DM, and its association with CKD and CHD are discussed for the awareness of the healthy individuals, diabetes, kidney, cardiac patients, and medical practitioners.
The involvement of gut microbiota in type 2 diabetes has been recognized[1,2]. Several Clostridiu... more The involvement of gut microbiota in type 2 diabetes has been recognized[1,2]. Several Clostridium or lactobacilli species are reportedly enriched in type 2 diabetes[1,2]. A study by Forslund et al, showed that gut microbes mediate the therapeutic effects of
metformin through certain types of short-chain fatty acid production[3]. Gut microbiota may therefore influence insulin sensitivity. Serum metformin levels of type 2 diabetes patients are positively correlated with Escherichia abundance, whereas they are negative correlation with Intestinibacter abundance[3].
Serotonin (5-hydroxytryptamine, 5-HT) is mainly synthesized, stored, and released from enterochromaffin cells within mucosal epithelia of the gut[4]. Gut microbes regulate 5-HT levels in the colon and blood. Spore-forming bacteria (Sp) from the mouse and human microbiota promote 5-HT biosynthesis from colonic enterochromaffin cells, which supply 5-HT to the mucosa, lumen, and circulating platelets[4]. The microbiota-dependent changes in gut 5-HT impact gastrointestinal motility and platelet function[4].
5-HT1B and 5-HT4 receptors, which are distributed in the enteric nervous system and smooth muscle in the gut, may be involved in the gut-mediated glucose homeostasis[5,6]. Pharmacologic stimulation of serotonin 5-HT1B or 5-HT4 receptors increases plasma active glucagon-like-peptide-1 levels independently of feeding and improves glucose tolerance under the dipeptidyl peptidase-4 inhibition in mice[5,6]. Although it remains unclear whether gut microbiota influence insulin secretion, the gut microviota-5-HT axis may be a novel therapeutic target for type 2 diabetes in future.
Obesity and the associated diseases such as type 2 diabetes are the leading causes of human morbi... more Obesity and the associated diseases such as type 2 diabetes are the leading causes of human morbidity and mortality but the biological mechanism of obesity is not clearly understood[1]. The patient often struggles to maintain a more active lifestyle and a healthy diet. Here we suggest that mindfulness should be explored as an adjunct therapy for this disease. The rationale for this suggestion follows.
The prevalence of obesity and overweight in most population is increasing alarmingly. This rise i... more The prevalence of obesity and overweight in most population is increasing alarmingly. This rise is associated with economic development, increasing urbanization, change in dietary and other lifestyle patterns and also reduced physical activity. Last studies showed that type 2 diabetes incidence rise with increasing body mass index (BMI). This paper evaluated the prevalence of overweight and obesity among diabetic patients. A total of 518 consecutive central-based patients (198 males and 320 females) with type 2 diabetes (T2DM) were investigated in this prospective cross-sectional study. The overall prevalence of overweight and obesity (BMI > 25 kg/m²) was 76%. The mean of BMI in women was 26.66 ± 3.98 and in men was 28.70 ± 4.36. The prevalence of overweight and obesity were 48% and 28%, respectively. This paper indicated a high prevalence of overweight and obesity in diabetic patients in Yazd (central province of Iran).
Epicardial fat is true visceral fat deposited around sub epicardial coronary vessels; it has been... more Epicardial fat is true visceral fat deposited around sub epicardial coronary vessels; it has been implicated in the development of coronary atherosclerosis. Epicardial fat has been also associated with insulin resistance. Tran’s thoracic echocardiography provides a reliable measurement of epicardial fat thickness.
Objective: To evaluate the association between epicardial fat thickness with metabolic syndrome and anthropometric parameters of adiposity.
Methods: We assessed 70 patients who underwent echocardiography; the epicardial fat thickness on the free wall of the right ventricle was measured at end-diastole from the parasternal long-axis views of 3 cardiac cycles with Aloka Alfa 6 equipment (Japan), by 2 cardiologists who were unaware of the clinical data. Metabolic syndrome was defined according with the International Diabetes Federation criteria.
The association between epicardial fat thicknesses with metabolic syndrome was evaluated with the fisher exact test, whereas its correlation with body mass index, and waist circumference was evaluated with the Pearson coefficient.
Results: We found a significant association between epicardial fat thickness and metabolic syndrome (p = 0.0076), we also found a significant correlation between epicardial fat and body mass index (r = 0.51, p = 0.00001) and with waist circumference (r = 0.472, p = 0.0004).
Conclusion: Epicardial fat thickness is associated with metabolic syndrome and anthropometric parameters related with adiposity, and may contribute to the cardiovascular risk of these patients.
An end-expiratory oxygen (FEO2) concentration > 90% is desirable prior to tracheal intubation. We... more An end-expiratory oxygen (FEO2) concentration > 90% is desirable prior to tracheal intubation. We hypothesized that the time required for pre oxygenation to achieve an FEO2 of 90% was related to patient Body Mass Index (BMI). Seventy- seven consenting patients undergoing a rapid sequence induction were enrolled. After the anesthesia rebreathing circuit was filled with 100% oxygen for 4 min, these unpremeditated patients were instructed to breathe normally following application of a tight-fitting face mask with oxygen flowing at 10 L min-1. End-tidal oxygen and carbon dioxide values were recorded during the pre oxygenation period. Induction of anesthesia was performed when the FEO2 reached 90% or after 5 min of pre oxygenation in a standardized fashion. The times to achieve an FEO2 of 90% were 152 ± 57, 136 ± 62 and 136 ± 70 sec in the normal, overweight and obese subgroups, respectively. A total of 7 patients failed to achieve an FEO2 90% after 5 min of preoxygenation. Four patients also experienced a decrease in SpO2 < 95% during the apneic period prior to tracheal intubation (3 in the obese group and 1 in the overweight group). The mean BMI (± SD) of the patients who failed to achieve a FEO2 of 90% was 40 ± 9 kg/m². The time required to achieve an FEO2 of 90% during preoxygenation period was unrelated to the patient’s BMI. However, morbidly obese patients were more likely to experience a fall in their SpO2 to < 95% during the induction period.
Background: Liposuction can remove a substantial amount of body fat. We investigated the effects ... more Background: Liposuction can remove a substantial amount of body fat. We investigated the effects of liposuction of large volumes of fat on anthropometrics, body composition (BIA), metabolic hormones, and psychological measures in overweight/obese women. To our knowledge, this is the first study to examine both physiological and psychological changes following liposuction of large volumes of fat in humans.
Method: Nine premenopausal healthy overweight/obese women (age = 35.9 ± 7.1 SD, weight = 84.4 kg ± 13.6, BMI = 29.9 kg/m² ± 2.9) underwent liposuction, removing 3.92 kg ± 1.04 SD of fat. Following an overnight fast, height, weight, waist, and hip circumferences were measured at baseline (one week pre-surgery) and post-surgery (wk 1,4,12). Blood samples were drawn for fasting concentrations of glucose, insulin, leptin, and ghrelin. The Body Shape Questionnaire (BSQ), Body Dysmorphic Disorder (BDD) Examination Self-Report (BDDE-SR), and Zung Self-Rating Depression Scale (ZDS) were administered.
Results: Body weight, BMI, waist circumference, and body fat consistently decreased over time (p < .05). Glucose did not change significantly, but insulin decreased from wk 1 to wk 12 (p < .05). Leptin decreased from baseline to wk 1 (p = .01); ghrelin increased but not significantly. Changes in body fat and waist circumference (baseline to wk 1) correlated positively with changes in insulin during that period, and correlated inversely with changes in ghrelin (p < .05). BSQ scores decreased significantly over time (p = .004), but scores for BDDE-SR (p = .10) and ZDS (p = .24) did not change significantly.
Conclusion: Liposuction led to significant decreases in body weight and fat, waist circumference, and leptin levels. Changes in body fat and waist circumference correlated with concurrent changes in the adipose-related hormones, insulin and ghrelin (baseline to wk 1), and body shape perception improved. Thus, besides the obvious cosmetic effects, liposuction led to several positive body composition, hormonal, and psychological changes.
Association between type 2 diabetes (T2DM) and compositional changes in the gut micro biota is st... more Association between type 2 diabetes (T2DM) and compositional changes in the gut micro biota is stablished, however little is known about the dysbiosis in early stages of Prediabetes (preDM). The purpose of this investigation is to elucidate the characteristics of the gut micro biome in preDM and T2DM, compared to Non-Diabetic (nonDM) subjects. Forty nine subjects were recruited for this study, 15 nonDM, 20 preDM and 14 T2DM. Bacterial community composition and diversity were investigated in fecal DNA samples using Illumina sequencing of the V4 region within the 16S rRNA gene. The five most abundant phyla identified were: Bacteroidetes, Firmicutes, Proteobacteria, Verrucomicrobia, and Actinobacteria. Class Chloracido bacteria was increased in preDM compared to T2DM (p = 0.04). An unknown genus from family Pseudonocardiaceae was significantly present in preDM group compared to the others (p = 0.04). Genus Collinsella, and an unknown genus belonging to family Enterobacteriaceae were both found to be significantly increased in T2DM compared to the other groups (Collinsella, and p = 0.03, Enterobacteriaceae genus p = 0.02). PERMANOVA and Mantel tests performed did not reveal a relationship between overall composition and diagnosis group or HbA1C level. This study identified dysbiosis associated with both preDM and T2DM, specifically at the class and genus levels suggesting that earlier treatment in preDM could possibly have an impact on the intestinal micro flora transitioning to T2DM.
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metformin through certain types of short-chain fatty acid production[3]. Gut microbiota may therefore influence insulin sensitivity. Serum metformin levels of type 2 diabetes patients are positively correlated with Escherichia abundance, whereas they are negative correlation with Intestinibacter abundance[3].
Serotonin (5-hydroxytryptamine, 5-HT) is mainly synthesized, stored, and released from enterochromaffin cells within mucosal epithelia of the gut[4]. Gut microbes regulate 5-HT levels in the colon and blood. Spore-forming bacteria (Sp) from the mouse and human microbiota promote 5-HT biosynthesis from colonic enterochromaffin cells, which supply 5-HT to the mucosa, lumen, and circulating platelets[4]. The microbiota-dependent changes in gut 5-HT impact gastrointestinal motility and platelet function[4].
5-HT1B and 5-HT4 receptors, which are distributed in the enteric nervous system and smooth muscle in the gut, may be involved in the gut-mediated glucose homeostasis[5,6]. Pharmacologic stimulation of serotonin 5-HT1B or 5-HT4 receptors increases plasma active glucagon-like-peptide-1 levels independently of feeding and improves glucose tolerance under the dipeptidyl peptidase-4 inhibition in mice[5,6]. Although it remains unclear whether gut microbiota influence insulin secretion, the gut microviota-5-HT axis may be a novel therapeutic target for type 2 diabetes in future.
Objective: To evaluate the association between epicardial fat thickness with metabolic syndrome and anthropometric parameters of adiposity.
Methods: We assessed 70 patients who underwent echocardiography; the epicardial fat thickness on the free wall of the right ventricle was measured at end-diastole from the parasternal long-axis views of 3 cardiac cycles with Aloka Alfa 6 equipment (Japan), by 2 cardiologists who were unaware of the clinical data. Metabolic syndrome was defined according with the International Diabetes Federation criteria.
The association between epicardial fat thicknesses with metabolic syndrome was evaluated with the fisher exact test, whereas its correlation with body mass index, and waist circumference was evaluated with the Pearson coefficient.
Results: We found a significant association between epicardial fat thickness and metabolic syndrome (p = 0.0076), we also found a significant correlation between epicardial fat and body mass index (r = 0.51, p = 0.00001) and with waist circumference (r = 0.472, p = 0.0004).
Conclusion: Epicardial fat thickness is associated with metabolic syndrome and anthropometric parameters related with adiposity, and may contribute to the cardiovascular risk of these patients.
Method: Nine premenopausal healthy overweight/obese women (age = 35.9 ± 7.1 SD, weight = 84.4 kg ± 13.6, BMI = 29.9 kg/m² ± 2.9) underwent liposuction, removing 3.92 kg ± 1.04 SD of fat. Following an overnight fast, height, weight, waist, and hip circumferences were measured at baseline (one week pre-surgery) and post-surgery (wk 1,4,12). Blood samples were drawn for fasting concentrations of glucose, insulin, leptin, and ghrelin. The Body Shape Questionnaire (BSQ), Body Dysmorphic Disorder (BDD) Examination Self-Report (BDDE-SR), and Zung Self-Rating Depression Scale (ZDS) were administered.
Results: Body weight, BMI, waist circumference, and body fat consistently decreased over time (p < .05). Glucose did not change significantly, but insulin decreased from wk 1 to wk 12 (p < .05). Leptin decreased from baseline to wk 1 (p = .01); ghrelin increased but not significantly. Changes in body fat and waist circumference (baseline to wk 1) correlated positively with changes in insulin during that period, and correlated inversely with changes in ghrelin (p < .05). BSQ scores decreased significantly over time (p = .004), but scores for BDDE-SR (p = .10) and ZDS (p = .24) did not change significantly.
Conclusion: Liposuction led to significant decreases in body weight and fat, waist circumference, and leptin levels. Changes in body fat and waist circumference correlated with concurrent changes in the adipose-related hormones, insulin and ghrelin (baseline to wk 1), and body shape perception improved. Thus, besides the obvious cosmetic effects, liposuction led to several positive body composition, hormonal, and psychological changes.
metformin through certain types of short-chain fatty acid production[3]. Gut microbiota may therefore influence insulin sensitivity. Serum metformin levels of type 2 diabetes patients are positively correlated with Escherichia abundance, whereas they are negative correlation with Intestinibacter abundance[3].
Serotonin (5-hydroxytryptamine, 5-HT) is mainly synthesized, stored, and released from enterochromaffin cells within mucosal epithelia of the gut[4]. Gut microbes regulate 5-HT levels in the colon and blood. Spore-forming bacteria (Sp) from the mouse and human microbiota promote 5-HT biosynthesis from colonic enterochromaffin cells, which supply 5-HT to the mucosa, lumen, and circulating platelets[4]. The microbiota-dependent changes in gut 5-HT impact gastrointestinal motility and platelet function[4].
5-HT1B and 5-HT4 receptors, which are distributed in the enteric nervous system and smooth muscle in the gut, may be involved in the gut-mediated glucose homeostasis[5,6]. Pharmacologic stimulation of serotonin 5-HT1B or 5-HT4 receptors increases plasma active glucagon-like-peptide-1 levels independently of feeding and improves glucose tolerance under the dipeptidyl peptidase-4 inhibition in mice[5,6]. Although it remains unclear whether gut microbiota influence insulin secretion, the gut microviota-5-HT axis may be a novel therapeutic target for type 2 diabetes in future.
Objective: To evaluate the association between epicardial fat thickness with metabolic syndrome and anthropometric parameters of adiposity.
Methods: We assessed 70 patients who underwent echocardiography; the epicardial fat thickness on the free wall of the right ventricle was measured at end-diastole from the parasternal long-axis views of 3 cardiac cycles with Aloka Alfa 6 equipment (Japan), by 2 cardiologists who were unaware of the clinical data. Metabolic syndrome was defined according with the International Diabetes Federation criteria.
The association between epicardial fat thicknesses with metabolic syndrome was evaluated with the fisher exact test, whereas its correlation with body mass index, and waist circumference was evaluated with the Pearson coefficient.
Results: We found a significant association between epicardial fat thickness and metabolic syndrome (p = 0.0076), we also found a significant correlation between epicardial fat and body mass index (r = 0.51, p = 0.00001) and with waist circumference (r = 0.472, p = 0.0004).
Conclusion: Epicardial fat thickness is associated with metabolic syndrome and anthropometric parameters related with adiposity, and may contribute to the cardiovascular risk of these patients.
Method: Nine premenopausal healthy overweight/obese women (age = 35.9 ± 7.1 SD, weight = 84.4 kg ± 13.6, BMI = 29.9 kg/m² ± 2.9) underwent liposuction, removing 3.92 kg ± 1.04 SD of fat. Following an overnight fast, height, weight, waist, and hip circumferences were measured at baseline (one week pre-surgery) and post-surgery (wk 1,4,12). Blood samples were drawn for fasting concentrations of glucose, insulin, leptin, and ghrelin. The Body Shape Questionnaire (BSQ), Body Dysmorphic Disorder (BDD) Examination Self-Report (BDDE-SR), and Zung Self-Rating Depression Scale (ZDS) were administered.
Results: Body weight, BMI, waist circumference, and body fat consistently decreased over time (p < .05). Glucose did not change significantly, but insulin decreased from wk 1 to wk 12 (p < .05). Leptin decreased from baseline to wk 1 (p = .01); ghrelin increased but not significantly. Changes in body fat and waist circumference (baseline to wk 1) correlated positively with changes in insulin during that period, and correlated inversely with changes in ghrelin (p < .05). BSQ scores decreased significantly over time (p = .004), but scores for BDDE-SR (p = .10) and ZDS (p = .24) did not change significantly.
Conclusion: Liposuction led to significant decreases in body weight and fat, waist circumference, and leptin levels. Changes in body fat and waist circumference correlated with concurrent changes in the adipose-related hormones, insulin and ghrelin (baseline to wk 1), and body shape perception improved. Thus, besides the obvious cosmetic effects, liposuction led to several positive body composition, hormonal, and psychological changes.