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Obesity, Metabolic Syndrome and Diabetes Mellitus

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Endocrinology".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 11025

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Special Issue Editors

Dr. Vasile Negrean

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Department 5—Internal Medicine, 4th Medical Clinic, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
Interests: obesity, visceral body fat, diabetes mellitus, complications of diabetes mellitus; metabolic syndrome; dyslipidemia; hypertension; genetic predisposition; cell signaling

Dr. Szu-Tah Chen

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Chang Gung Memorial Hospital, Taipei, Taiwan
Interests: thyroid diseases; diabetes; endocrine diseases

Dr. Teodora Alexescu

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5th Department Internal Medicine, 4th Medical Clinic, University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
Interests: diabetes mellitus; metabolic diseases; metabolic syndrome; nutrition; abdominal obesity

Dr. Adela Viviana Sitar-Tăut

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Internal Medicine Departament, Rehabilitation Cardiology Discipline, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
Interests: cardiology; atrial fibrillation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nowadays, all medical academic community is aware that we are fighting not only the COVID-19 pandemic, but also a pandemic comprised of the metabolic syndrome (MetS) and its components, particularly abdominal obesity, and type 2 Diabetes Mellitus (T2DM). The incidence of these conditions is growing at an alarming pace, creating an important burden on the health systems all over the world.

It is mandatory to find viable solutions to a better management of these metabolic disorders. Current research needs to focus on finding pathways that could be targeted to achieve better control of the progression of these metabolic pathologies.

This Special Issue, "Obesity, Metabolic Syndrome and Diabetes Mellitus", propose to add value to the present knowledge in the field of metabolic disorders. Original research in this field is welcomed, together with well-designed narrative reviews or (preferable) systematic reviews. The topics could expand beyond the proposed keywords if they provide a liaison with the field of the MetS-T2DM. Also, we would like to emphasize that we will consider not only clinical medicine, but equally fundamental research.

We invite you to submit a manuscript for publication in this Special Issue of the journal Medicina.

Dr. Vasile Negrean
Dr. Szu-Tah Chen
Dr. Teodora Alexescu
Dr. Adela Viviana Sitar-Tăut
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

obesity
visceral body fat
diabetes mellitus
complications of diabetes mellitus
metabolic syndrome
dyslipidemia
genetic predisposition
cell signaling

Published Papers (6 papers)

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Research

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11 pages, 827 KiB

Open AccessArticle

Association of Serum Irisin Levels with Body Composition, Metabolic Profile, Leptin, and Adiponectin Levels in Lean and Obese Children

by Kübra Esin, Saime Batirel, Gözde Ülfer, Pakize Yigit and Nevin Sanlier

Medicina 2023, 59(11), 1954; https://doi.org/10.3390/medicina59111954 - 5 Nov 2023

Viewed by 1440

Abstract

Background and Objectives: Irisin is an adipo-myokine with potential metabolic effects in the body, and its association with childhood obesity is still controversial. This study aimed to investigate the relationship between serum irisin levels and anthropometric parameters, body composition, metabolic profiles, leptin, and adiponectin in obese and normal-weight children. Methods: The study sample consisted of a total of 80 children aged 6–10, including 44 obese children (BMI ≥ 97th percentile) and 36 normal-weight children. Anthropometric parameters were measured. Body composition was determined with the use of the Bioelectrical Impedance Analysis (BIA) method. Metabolic profiles, as well as irisin, leptin, and adiponectin levels, were analyzed. Results: Anthropometric parameters and body composition were found to be significantly different between the obese and normal-weight groups (p < 0.05). Fasting blood glucose, insulin, HOMA-IR, and leptin levels were found to be significantly higher in the obese group, while the normal-weight group had significantly higher HDL cholesterol and adiponectin levels (p < 0.05). Serum irisin levels did not differ between the obese and normal-weight groups, or based on sex, vitamin D levels, and insulin resistance status. There was also no statistically significant correlation between serum irisin levels and anthropometric parameters, metabolic profile, leptin, and adiponectin. Conclusions: The study concluded that the obese children who participated in this study had high leptin levels and low adiponectin levels, with no significant difference in the irisin levels between the groups. More comprehensive clinical studies are needed to investigate the relationship between irisin and adipokines in children. Full article

(This article belongs to the Special Issue Obesity, Metabolic Syndrome and Diabetes Mellitus)

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14 pages, 561 KiB

Open AccessArticle

A Mediterranean-Style Diet Improves the Parameters for the Management and Prevention of Type 2 Diabetes Mellitus

by Stefani A. Derrick, Sarah T. Nguyen, Jordan R. Marthens, Leah L. Dambacher, Angelos K. Sikalidis and Scott K. Reaves

Medicina 2023, 59(10), 1882; https://doi.org/10.3390/medicina59101882 - 23 Oct 2023

Cited by 2 | Viewed by 1838

Abstract

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a chronic condition recognized as the inability to maintain glucose homeostasis, typically presenting with insulin resistance and systemic inflammation. With the prevalence of T2DM and major risk factors, such as prediabetes and obesity, increasing each year, the need to address risk factor reduction strategies is crucial. Materials and Methods: Twenty-two men and women, overweight-to-obese adults (BMI mean: 26.1–31.6) (age range mean: 44.6–51.8) with T2DM, indicators of prediabetes, or who were metabolically healthy, participated in Cal Poly’s Nutrition and Exercise in Type 2 Diabetes (CPNET) study. There were no significant differences in terms of age, BMI, or sex distribution among the groups at the baseline. This study’s protocol included following a Mediterranean-style diet, the daily consumption of a high-quality whey protein supplement, and physical activity recommendations for 16 weeks. Body composition data, via dual-energy X-ray absorptiometry (DXA), and fasting blood samples were collected at the baseline and following the intervention. Due to restrictions associated with the outbreak of the COVID-19 pandemic, only 13 of the 22 participants who started this study were able to return for the second data collection to complete this study following the 16-week intervention. Results: The prediabetic and T2DM groups exhibited reductions in their fasting plasma glucose (12.0 mg/dL reduction in the prediabetic group; 19.6 mg/dL reduction in the T2DM group) to that of normal and prediabetic levels, respectively, while the T2DM group also demonstrated improvement in their hemoglobin A1c (reduced from 6.8% to 6.0%) to prediabetic levels. Additionally, the metabolically healthy, overweight group exhibited significant improvements in adiposity, while the obese prediabetic and T2DM groups showed non-significant improvements in all the measured metrics of body composition. No significant changes were observed in the inflammatory biomarkers (p-values ranged from 0.395 to 0.877). Conclusions: Collectively, our results suggest that adherence to a well-balanced, nutritious diet and activity may improve the parameters of glycemic control and provide benefits to body composition that help to manage and prevent the development of T2DM. Our study was able to yield significant findings signifying that the effects of a Mediterranean-style diet are observed even for a more conservative sample size. Full article

(This article belongs to the Special Issue Obesity, Metabolic Syndrome and Diabetes Mellitus)

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24 pages, 556 KiB

Open AccessArticle

Relationship between Behavior and Periodontal Health Self-Perception in Diabetic and Non-Diabetic Patients from Transylvania, Romania—A Self-Report Study, including The Desire to Use a Mobile App for Oral Care Improvements

by Ariadna Georgiana Badea (Paun), Vlad Ioan Bocanet, Iulia Clara Badea, Radu Chifor, Livia Terezia Duma and Cristina Maria Borzan

Medicina 2023, 59(8), 1419; https://doi.org/10.3390/medicina59081419 - 3 Aug 2023

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Abstract

The study aimed to assess self-reported symptoms of periodontal disease (gingival bleeding, tooth mobility and halitosis) among diabetic and non-diabetic patients from Transylvania, Romania. Using statistical analysis methods, correlation between the aforementioned symptoms and diet, oral hygiene habits, stress, physical activity, and BMI (body mass index) were researched. Another secondary objective was to assess the impact of self-reported oral health, aesthetics, and halitosis on their life. Patients’ willingness to use a mobile app for generating awareness of oro-dental complications, improving their knowledge of oro-dental health, and reminding them to visit the dentist based on an awareness-raising function, was also assessed. Methods: The study was based on an original self-administered questionnaire, applied to 182 subjects, in an unselected, randomized manner. A total of 110 questionnaires were applied in two dental offices and 72 questionnaires were applied in a public clinic for diabetic patients from Cluj-Napoca, Romania. Results: Warning signs and symptoms relevant to periodontal disease were identified by respondents, having statistically significant associations with the declared oral health-care habits, including interdental aids, vicious habits (nail biting, bruxism), etc. Some of these periodontal signs could be correlated with a certain lifestyle, such as the perceived stress, smoking status, practicing maintenance sports, and alcohol consumption. A total of 66% of the non-diabetics and 68% of the diabetics of the surveyed subjects consider a software application for generating awareness of oro-dental complications useful, and are willing to pay around EUR 6 for it. Conclusions: Having a medical condition such as diabetes makes patients pay more attention to dental health compared with non-diabetic patients. Patients expressed their desire to use a software application to help them to be aware of their condition and for improving their self-report capabilities, including their oral-health-related status. Full article

(This article belongs to the Special Issue Obesity, Metabolic Syndrome and Diabetes Mellitus)

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17 pages, 1089 KiB

Open AccessArticle

Relationship between Treatment Burden, Health Literacy, and Medication Adherence in Older Adults Coping with Multiple Chronic Conditions

by Dharrshinee Selvakumar, Palanisamy Sivanandy, Pravinkumar Vishwanath Ingle and Kumutha Theivasigamani

Medicina 2023, 59(8), 1401; https://doi.org/10.3390/medicina59081401 - 31 Jul 2023

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Abstract

A prospective study was conducted to investigate the impact of treatment burden and health literacy on medication adherence among older adults with multiple chronic conditions (MCC) and to explore the potential moderating effects of demographic and clinical factors. Face-to-face structured interviews were conducted among older adults aged 60 and above using the Burden of Treatment Questionnaire (TBQ-15), Short Form Health Literacy Questionnaire (HLS-SF12), and Malaysia Medication Adherence Assessment Tool (MyMAAT). This study included 346 older adults aged 60 years and above with two or more chronic conditions (n = 346). Hypertension (30.2%), hyperlipidemia (24.0%), and diabetes (18.0%) were the most reported chronic conditions among participants. The mean score of treatment burden was 53.4 (SD = 28.2), indicating an acceptable burden of treatment. The mean score of health literacy was 16.4 (SD = 12.6), indicating a limited health literacy level among participants; meanwhile, the mean score of medication adherence was 32.6 (SD = 12.3), indicating medication non-adherence among participants. Medication adherence was significantly correlated with treatment burden (r = −0.22, p < 0.0001), health literacy (r = 0.36, p < 0.0001), number of chronic conditions (r = −0.23, p < 0.0001), and age (r = −0.11, p < 0.05). The study findings emphasize that multimorbid older adults with high treatment burdens and low health literacy are more likely to have poor medication adherence. This underscores the importance for clinicians to address these factors in order to improve medication adherence among older adults with multiple chronic conditions (MCC). Full article

(This article belongs to the Special Issue Obesity, Metabolic Syndrome and Diabetes Mellitus)

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10 pages, 1599 KiB

Open AccessArticle

Discriminant Model for Insulin Resistance in Type 2 Diabetic Patients

by Erislandis López-Galán, Rafael Barrio-Deler, Manuel Alejandro Fernández-Fernández, Yaquelin Del Toro-Delgado, Isaac Enrique Peñuela-Puente, Miguel Enrique Sánchez-Hechavarría, Mario Eugenio Muñoz-Bustos and Gustavo Alejandro Muñoz-Bustos

Medicina 2023, 59(5), 839; https://doi.org/10.3390/medicina59050839 - 26 Apr 2023

Viewed by 1589

Abstract

Introduction: Patients with type 2 diabetes mellitus tend to have insulin resistance, a condition that is evaluated using expensive methods that are not easily accessible in routine clinical practice. Objective: To determine the anthropometric, clinical, and metabolic parameters that allow for the discrimination of type 2 diabetic patients who have insulin resistance from those who do not. Methods: A cross-sectional analytical observational study was carried out in 92 type 2 diabetic patients. A discriminant analysis was applied using the SPSS statistical package to establish the characteristics that differentiate type 2 diabetic patients with insulin resistance from those without it. Results: Most of the variables analyzed in this study have a statistically significant association with the HOMA-IR. However, only HDL-c, LDL-c, glycemia, BMI, and tobacco exposure time allow for the discrimination of type 2 diabetic patients who have insulin resistance from those who do not, considering the interaction between them. According to the absolute value of the structure matrix, the variable that contributes most to the discriminant model is HDL-c (−0.69). Conclusions: The association between HDL-c, LDL-c, glycemia, BMI, and tobacco exposure time allows for the discrimination of type 2 diabetic patients who have insulin resistance from those who do not. This constitutes a simple model that can be used in routine clinical practice. Full article

(This article belongs to the Special Issue Obesity, Metabolic Syndrome and Diabetes Mellitus)

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Review

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13 pages, 2752 KiB

Open AccessReview

Antidiabetic Drug Efficacy in Reduction of Mortality during the COVID-19 Pandemic

by Daniel Gonikman and Dmitrijs Kustovs

Medicina 2023, 59(10), 1810; https://doi.org/10.3390/medicina59101810 - 11 Oct 2023

Cited by 1 | Viewed by 1858

Abstract

Background and Objectives: The COVID-19 pandemic caused by the Coronavirus SARS-CoV-2 is a complex challenge for the existing scientific and medical landscape. It is an ongoing public health crisis, with over 245,373,039 confirmed cases globally, including 4,979,421 deaths as of 29 October 2021. Exploring molecular mechanisms correlated with the disease’s severity has demonstrated significant factors of immune compromise, noted in diabetic patients with SARS-CoV-2 infections. Among diabetics, the altered function of the immune system allows for better penetration of the virus into epithelial cells, increased viral binding affinity due to hyperglycemia, reduced T cell function, decreased viral clearance, high risks of cytokine storm, and hyper-inflammatory responses, altogether increasing the susceptibility of these patients to an extreme COVID-19 disease course. Materials and Methods: This research involved a systematic literature search among various databases comprising PubMed and Google Scholar in determining credible studies about the effects of antidiabetic drugs on the high mortality rates among diabetic patients infected with COVID-19. The primary search found 103 results. Duplicated results, non-pertinent articles, and the unavailability of full text were excluded. Finally, we included 74 articles in our review. The inclusion criteria included articles published during 2020–2023, studies that reported a low risk of bias, and articles published in English. Exclusion criteria included studies published in non-peer-reviewed sources, such as conference abstracts, thesis papers, or non-academic publications. Results: Among the studied anti-diabetic drugs, Metformin, the Glucagon-like peptide 1 receptor agonist (GLP-1RA), and Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) have demonstrated decreased mortality rates among diabetic patients infected with COVID-19. Insulin and Dipeptidyl peptidase 4 inhibitors (DPP-4i) have demonstrated increased mortality rates, while Sulfonylureas, Thiazolidinedione (TZD), and Alpha-glucosidase inhibitors (AGI) have demonstrated mortality-neutral results. Full article

(This article belongs to the Special Issue Obesity, Metabolic Syndrome and Diabetes Mellitus)

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