Search Results (2,651)

Osteoporosis is a skeletal disorder characterized by decreased bone strength, which leads to an increased risk of developing fractures. Interestingly, this metabolic disorder is often related to sarcopenia, defined as decreased muscle mass, strength, and function. These two conditions appear to be closely connected, leading to a clinical condition named osteosarcopenia (OS). Aging may explain the link between muscle and bone loss through genetic, mechanical, endocrine, and nutritional factors. Further, aging increases the amount of adipose tissue, often due to sedentary behavior and unbalanced nutritional pattern, leading to a clinical condition defined as osteosarcopenic obesity, characterized by concurrent obesity, sarcopenia, and osteoporosis, where each condition exacerbates the others. Moreover, sarcopenia leads to decreased physical (PA) activity, worsening skeletal homeostasis, and creating a vicious cycle, which increases falls, fracture risk, and disability. This review underscores the importance of a systemic approach, focusing on nutritional therapy integrated with PA and, eventually, pharmacological interventions to efficiently manage (OS). Full article

Background/Objectives: The COVID-19 pandemic and related lockdown measures markedly disrupted children’s lives, raising concerns particularly about their weight. We investigated changes in body mass index (BMI) in children by grade and sex, from pre- to post-COVID-19 lockdown, and BMI recovery post-lockdown. Methods: We retrospectively reviewed the height, weight, and BMI of students from a single elementary school from 2019 to 2023, excluding 2020 (the year of the COVID-19 lockdown). We conducted longitudinal and cross-sectional studies to examine changes in BMI according to grade and BMI status pre-lockdown (2019) and post-lockdown (2021–2023). Results: In the entire student body, the BMI Z-score in 2021, 1 year after the COVID-19 lockdown, had increased significantly compared with that in 2019, 1 year pre-lockdown (p = 0.009). However, longitudinal studies in each grade yielded different results. Students who were in the first grade in 2019 experienced a significant decrease in BMI Z-score post-lockdown (p = 0.003). In contrast, students who were in other grades showed a significant increase in BMI Z-score post-lockdown, with those who were in third grade in 2019 showing the most significant increase (p = 0.027). Conclusions: The degree of BMI increase in children and adolescents due to the COVID-19 lockdown was inconsistent. Changes in obesity status post-lockdown varied depending on age and obesity levels pre-COVID-19 lockdown. Therefore, to manage and prevent obesity-related metabolic diseases in the post-COVID-19 era, diverse approaches and strategies tailored to age and obesity grades during the COVID-19 lockdown will need to be adopted. Full article

Background: Type 1 diabetes (T1D) is an autoimmune disorder characterized by destruction of insulin-producing β-cells. While conventional insulin therapy manages hyperglycemia, it fails to halt autoimmunity. Oral immunotherapy targeting autoantigens like GAD65 offers potential for antigen-specific tolerance; however, its efficacy is limited by gastrointestinal degradation and poor mucosal uptake. Lactococcus lactis (L. lactis), a food-grade delivery vector, enables sustained antigen release and intestinal tract immune modulation, yet the differential transcriptomic mechanisms underlying mucosal versus systemic immune responses remain uncharacterized. Methods: Non-obese diabetic (NOD) mice were randomized into control and GAD65 groups, receiving oral PBS or the GAD65 recombinant L. lactis vaccine, respectively. Fasting blood glucose was monitored weekly. GAD65-specific IgA and IgG, along with immune tolerance-related factors, were quantified using ELISA. Lymphocyte subsets were analyzed by flow cytometry, alongside RNA sequencing and transcriptional profiling. Results: The study demonstrated that the orally administered GAD65-L. lactis vaccine could significantly induce GAD65-specific IgA antibody and TGF-β cytokine and alleviate hyperglycemia and diabetes symptoms in NOD mice. Our study facilitated the induction of GAD65-specific regulatory T cells within both intestinal lamina propria lymphocytes (LPLs) and splenic lymphocytes. Notably, antigen-specific tolerance was mainly observed in intestinal LPLs. Crucially, the immune responses elicited by the vaccine demonstrated significant disparities between intestinal LPLs and splenic lymphocytes, with intestinal LPLs exhibiting unique local immune tolerance transcriptomic profiles. Conclusions: Our findings have enhanced the comprehension of the mechanisms by which oral vaccines influence the interplay between mucosal and systemic immune responses, thereby establishing a foundational framework for the design of oral vaccines. This understanding is instrumental in advancing antigen-specific immune tolerance strategies for autoimmune diseases such as Type 1 Diabetes (T1D). Full article

Resveratrol (RVT) is a plant-derived polyphenol found in traditional medicinal species such as Veratrum grandiflorum and Polygonum cuspidatum, known for their bioactive secondary metabolites. This study evaluates the anti-obesity effects of RVT alone and in combination with orlistat (OLT), a pharmaceutical lipase inhibitor, in a high-fat diet-induced obesity model in rats. Female Sprague-Dawley rats were assigned to receive RVT, OLT, a combination of both, or no treatment, over a four-week period. The combination of RVT and OLT led to a significant reduction in body weight gain and improvement in lipid profiles, including decreased LDL cholesterol. Additionally, the combination ameliorated liver enzyme elevations associated with obesity-related hepatic stress. These findings demonstrate that resveratrol potentiates orlistat’s pharmacological efficacy and highlights the therapeutic potential of bioactive compounds from medicinal plants in metabolic disease management. This study supports further development of plant-based pharmacological agents and synergistic formulations for the treatment of obesity and associated comorbidities. Full article

Metabolic syndrome refers to a group of conditions that commonly occur together, including abdominal obesity, high blood pressure, elevated blood sugar, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL). These factors collectively increase the risk of cardiovascular disease, diabetes, and cognitive impairment. Recent research has identified a connection between metabolic syndrome and cognitive disorders such as mild cognitive impairment and vascular dementia (VaD). Mulberry (Morus alba L.) is a natural source of bioactive compounds with antioxidant, anti-inflammatory, and lipid-regulating properties. This meta-analysis assessed the potential of mulberry extract as an adjunctive treatment for metabolic risk factors linked to vascular dementia. We systematically reviewed randomized controlled trials (RCTs) published up to May 2025 that compared mulberry extract to placebo or standard care in adults with metabolic disorders. Fifteen trials including 1202 participants met the inclusion criteria. The primary outcomes were fasting glucose, fasting insulin, liver enzyme levels, lipid profiles, and inflammatory markers such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP). The pooled results indicated that mulberry supplementation improved blood sugar control and lowered total cholesterol, low-density lipoprotein cholesterol (LDL), triglycerides, fasting blood glucose, glycosylated hemoglobin (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and inflammatory markers. Aspartate aminotransferase (AST) improved, whereas alanine aminotransferase (ALT) showed no significant change. Subgroup analyses revealed that greater benefits were associated with shorter treatment durations and doses below 500 milligrams per day. Furthermore, extracts from different parts of the mulberry plant showed varying effects on lipid and glucose metabolism. None of the included trials directly measured cognitive or neurovascular outcomes, so any potential neurovascular protection is inferred from changes in metabolic and inflammatory markers rather than demonstrated. In summary, these findings suggest that mulberry extract may be a promising complementary approach for managing metabolic risk factors in people at risk for VaD. However, further large-scale and rigorously designed studies are required to confirm its clinical benefits and to identify the most effective preparations. Full article

Metabolic syndrome (MetS)—characterized by dyslipidemia, hypertension, hyperglycemia, and abdominal obesity—is a common, modifiable condition that contributes to functional decline and premature mortality in older adults. The accumulation of MetS components increases the risk of cardiovascular, cerebrovascular, and renal diseases, as well as cognitive impairment and polypharmacy in aging populations. A narrative review was conducted focusing on the management of MetS in adults aged 65 and older. Sources were identified through targeted searches of PubMed and relevant guidelines, with an emphasis on literature discussing geriatric-specific considerations. The review was structured using the Institute for Healthcare Improvement’s (IHI) 4Ms Framework: What Matters, Medication, Mentation, and Mobility. Findings highlight that current MetS guidelines are often extrapolated from younger populations and insufficiently account for geriatric-specific factors such as altered pharmacokinetics, multimorbidity, and social determinants of health. The 4Ms Framework provides a comprehensive lens to adapt these guidelines, supporting individualized treatment plans that consider patient goals, cognitive status, and functional capacity. Incorporating social services and aligning interventions with socioeconomic realities can further bridge disparities in care. The 4Ms framework can help healthcare providers communicate effectively with patients, ensuring treatment plans align with evidence-based practices and the patient’s individual priorities. Treatment of MetS must be tailored to individual patient needs based on presented risk factors, severity of risks, and social determinants of health. Adjusting treatment plans in accordance with the socioeconomic status (SES) of patients will allow for systematic improvement of outcomes. Full article

Background: Fetuin-A, a hepatokine implicated in metabolic regulation, has been associated with both metabolic syndrome and cardiovascular disease. However, its specific role in type 2 diabetes mellitus (T2DM) remains incompletely understood. Objective: This study aimed to investigate the relationship between fetuin-A levels and key components of metabolic syndrome (abdominal obesity, arterial hypertension, hyperglycemia, hypertriglyceridemia and low high-density lipoprotein cholesterol) as well as other cardiovascular risk markers, including metabolic dysfunction-associated fatty liver disease (MAFLD), carotid intima-media thickness (CIMT), and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Methods: A total of 51 patients with T2DM not receiving insulin therapy were enrolled. Participants underwent clinical, biochemical, and imaging evaluations. Hepatic steatosis was assessed via abdominal ultrasonography, and subclinical atherosclerosis was evaluated using CIMT measured with Doppler ultrasonography. Serum fetuin-A was quantified by ELISA. Results: Hepatic steatosis was significantly associated with metabolic syndrome, increased CIMT, and dyslipidemia (elevated total cholesterol, triglycerides, and reduced HDL cholesterol). Although no direct correlation was found between fetuin-A levels and hepatic steatosis, multivariate analysis revealed that fetuin-A concentrations were significantly influenced by total cholesterol and LDL cholesterol levels. Conclusions: Fetuin-A appears to be linked to lipid abnormalities in T2DM and may contribute to cardiovascular risk in this population. These findings support the potential utility of fetuin-A as a biomarker and possible therapeutic target for dyslipidemia management in diabetic patients. Full article

Background/Objectives: Recent shifts in dietary patterns have led to reduced fiber consumption, corresponding with increasing rates of obesity and metabolic disorders. Barley-based cereals with high fiber content, particularly β-glucan, may provide superior metabolic and satiety benefits compared to corn-based alternatives. This study investigated whether barley-based cereals provide superior metabolic and satiety benefits compared to corn-based alternatives in overweight Korean adults. Methods: After selecting the most optimal cereal in the phase 1 study (acute postprandial research), a 6-week randomized controlled trial (RCT) was conducted in phase 2. In the phase 2 trial, overweight adults (n = 30; mean age of 43 ± 10.89 years; 36.7% female) were randomly assigned to consume either barley (n = 15) or corn cereal (n = 15) daily for 6 weeks. Participants consumed approximately 50 g of available carbohydrates (either barley or corn cereal) in 190 mL milk. Outcome measures included anthropometric parameters, fasting blood glucose, homeostasis model assessment of insulin resistance (HOMA-IR), postprandial glucose, subjective satiety, and gut health. Results: After 6 weeks, between-group comparisons revealed significant differences favoring the barley group in body weight (barley: −0.33 kg vs. corn: +0.85 kg; difference: −1.18 kg, p = 0.027), BMI (barley: −0.14 kg/m² vs. corn: +0.03 kg/m²; difference: −0.17 kg/m², p = 0.014), and glycated albumin (barley: −0.78% vs. corn: +0.09%; difference: −0.87%, p = 0.032). Within-group analyses showed that the barley group exhibited significant reductions in percent body fat (−1.03%, p = 0.004), waist circumference (−3.64 cm, p = 0.003), waist-to-hip ratio (−0.02, p = 0.012), glycated albumin (−0.78%, p = 0.029), and LDL cholesterol (−10.57 mg/dL, p = 0.033). Conversely, the corn group showed significant increases in body weight (+0.85 kg, p = 0.026) and percent body fat (+0.84%, p = 0.020), with a significant decrease in HDL cholesterol (−2.84 mg/dL, p = 0.020). Conclusions: Barley-based cereals offer significant metabolic and satiety benefits for overweight adults compared to corn-based alternatives. These findings suggest that barley-based cereals may be an effective dietary intervention for managing obesity and metabolic disorders. Full article

The increasing prevalence of obesity, a chronic disease, necessitates the development and evaluation of evidence-based prevention and intervention strategies tailored to heterogeneous populations. Certain fruits, including papaya and pineapple (Ananas comosus), have been investigated as potential dietary components in obesity management. In the context of obesity and chronic low-grade inflammation, bromelain, a proteolytic enzyme derived from pineapple, is a widely studied phytotherapeutic agent that acts through multiple mechanisms intersecting immune and metabolic pathways. This narrative review summarizes current evidence on the effects of bromelain in obesity, low-grade inflammation, and related metabolic disturbances. Searches of the literature were conducted in Google Scholar, PubMed, and Scopus databases. This review incorporates findings from in vitro, animal, and human studies. We outline the mechanisms and evidence supporting the therapeutic efficacy of bromelain, emphasizing its implications for obesity management in clinical settings. Bromelain has been shown to exert significant anti-inflammatory activity and may modulate adipocyte metabolism, potentially alleviating comorbidities associated with excess adiposity. Although its effects on immune cells are relatively well described, the mechanisms underlying bromelain’s actions on adipocytes remain incompletely understood. Full article

Background/Objectives: Lower urinary tract symptoms (LUTS), such as frequency, urgency, nocturia, and urge incontinence, are commonly linked to overactive bladder (OAB) and benign prostatic hyperplasia (BPH). Oxytocin receptor (OXTR) upregulation has been proposed to enhance bladder and prostate contractility, while obesity is a recognized risk factor for LUTS, OAB, and BPH. This study aimed to investigate whether the OXTR antagonist atosiban attenuates spontaneous and oxytocin-induced contractions in bladder and prostate tissues from obese and non-obese rats. Methods: Bladder and prostate tissues were obtained from obese and non-obese rats and studied in in vitro organ bath preparations. The effects of atosiban (1 µM and 10 µM) on spontaneous contractility and oxytocin-induced responses were examined. Immunohistochemistry was performed to evaluate OXTR expression in the bladder. Results: Atosiban significantly reduced spontaneous contractions in the bladder (p < 0.0001 in obese; p < 0.01 in non-obese) and prostate (p < 0.01 in obese; p < 0.0001 in non-obese). Oxytocin-induced bladder contractions were significantly increased in obese rats but were attenuated by atosiban at 10 µM (p < 0.05), an effect absent in non-obese rats. Immunohistochemical analysis confirmed elevated OXTR expression in both epithelial and stromal compartments of the bladder in obese rats (p < 0.05). Conclusions: These findings indicate that oxytocin contributes to bladder and prostate hypercontractility, particularly in obesity. Targeting OXTR with atosiban may represent a novel therapeutic strategy for the management of LUTS, OAB, and BPH. Full article

Background: The global prevalence of pediatric hypertension is on the rise. Adolescence is a period of high prevalence of childhood hypertension. Obesity and insulin resistance (IR) are important risk factors in the development of hypertension, but their interaction and combined effects on adolescent hypertension remain unclear. Methods: This cross-sectional study utilized data from the China National Nutrition and Health Surveillance of Children and Lactating Mothers (2016–2017). A total of 7031 adolescents aged 12–17 years from five provinces were included. The triglyceride-glucose index (TyG) was used as an indicator of IR. Multivariable logistic regression and generalized linear mixed-effect models were used to assess the interaction and joint effects of IR and obesity (measured by body mass index [BMI] and waist circumference [WC]) on hypertension. Relative excess risk due to interaction (RERI), proportion attributable to interaction (AP), and synergy index (SI) were calculated to evaluate additive interactive effects. Mediation analysis explored the potential mediating role of the TyG in the association between obesity and hypertension. Results: IR and obesity were positively associated with adolescent hypertension (p < 0.001). Interaction analyses revealed a robust synergistic interaction between obesity and IR on hypertension, with the AP being approximately 40% (p < 0.001). TyG significantly mediated the association between obesity and adolescent hypertension (6.30% for high BMI and 8.54% for high WC, both p < 0.001). Conclusions: This study suggests that obesity and IR could synergistically contribute to the prevalence of hypertension in adolescents. For the primary prevention and management of hypertension in adolescents, strategies targeting both factors should be considered. Full article

Background/Objectives: Breast cancer-related lymphedema (BCRL) is more prevalent and severe in women with overweight or obesity. This study evaluated the effect of a comprehensive lifestyle intervention—comprising supervised exercise, a hypocaloric Mediterranean diet, and optional meal replacement—on lymphedema outcomes in this population. Methods: In this pilot randomized controlled trial, 112 women with BCRL and BMI 25–40 kg/m² were assigned to an intervention group—receiving supervised resistance and aerobic training, dietary counseling, and optional high-protein meal replacement—or to a control group with standard advice. The primary outcome was change in affected limb volume at 3 and 6 months. Secondary outcomes included morphofunctional parameters, muscle strength, dietary intake, and serum levels of cytokines (IL-1β, IL-6, IL-10, and TNF-α). Analyses also explored outcomes according to whether participants achieved ≥ 5% weight loss. Results: Ninety-four participants completed the trial (intervention n = 43, control n = 51). At 6 months, women who achieved ≥5% weight loss had greater reductions in affected limb volume (−664.9 ± 362.1 mL vs. −395.6 ± 596.9 mL). The intervention group showed significantly greater improvements in BMI (−1.14 ± 1.22 kg/m²), waist circumference (−3.59 ± 4.6 cm), triceps skinfold (−4.61 ± 3.02 mm), fat mass (−2.38 ± 2.75 kg), extracellular water (−0.58 ± 0.85 L), and quadriceps strength (+7.1 ± 9.7 kg). No significant changes were observed in circulating cytokines. Conclusions: In this pilot randomized controlled trial, a structured dietary and exercise intervention improved morphofunctional outcomes in overweight women with BCRL. Weight loss of ≥5% emerged as a potentially relevant therapeutic target that may inform the design of future studies aimed at optimizing lymphedema management. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a prevalent condition with high morbidity and mortality, often accompanied by comorbidities such as alcohol use disorder (AUD). A thorough understanding of the interaction between COPD and AUD is crucial for improving patient outcomes and addressing management challenges. Objectives: This study analyzed temporal trends, clinical characteristics, and hospital outcomes associated with AUD among adults hospitalized with COPD in Spain between 2016 and 2023. Methods: A population-based cohort study was conducted using the Spanish Hospital Discharge Registry. We included adults aged ≥40 years with a diagnosis of COPD. AUD was identified through ICD-10 codes. Temporal trends in AUD prevalence were evaluated using Joinpoint regression, stratified by sex. We also assessed clinical characteristics including pneumonia, obesity, asthma, obstructive sleep apnea (OSA), supplemental oxygen use, long-term steroid use, and mechanical ventilation. Outcomes analyzed included ICU admission and in-hospital mortality (IHM). Results: Among 2,545,151 COPD hospitalizations, 263,568 (10.35%) had an AUD diagnosis. AUD prevalence rose from 8.66% in 2016 to 12.57% in 2023, with a sharper increase in women. Patients with AUD were younger and had higher rates of tobacco use (84.11% vs. 49.33%; p < 0.001) and psychiatric disorders. Multivariable analysis showed male sex, substance use, psychiatric illness, and external cause admissions were independently associated with AUD. Although overall IHM was lower in AUD patients (7.46% vs. 8.2%; p < 0.001), it increased with age, pneumonia, COVID-19, and higher comorbidity. IHM rose progressively, peaking in 2023 (15.6%). Conclusions: AUD prevalence in COPD hospitalizations increased significantly, especially in women. IHM also rose over time. These results highlight the need for integrated approaches targeting mental health and substance use in COPD management. Full article

Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disease linked to type 2 diabetes (T2D), obesity, and dyslipidaemia, which are all parts of the metabolic syndrome. In 2024, for non-cirrhotic MASH with mild to advanced fibrosis, resmetirom, a selective thyroid hormone receptor-β agonist, became the first FDA-approved treatment for this condition. By increasing β-oxidation and lipid metabolism, it minimises systemic thyroid or cardiac effects while reducing hepatic fat, inflammation, and fibrosis. Resmetirom is being developed for use in combination with lifestyle interventions, such as diet and exercise, to maximize patient benefit. Nevertheless, the lack of congruence between clinical trial populations and real-world payer criteria underscores access obstacles that necessitate policy reform. The successful delivery of screening programs depends on the education of providers from various disciplines and the establishment of uniform screening standards. Future studies should investigate the clinical application of resmetirom in combination with agents that may provide additional benefits, such as GLP-1 receptor agonists, SGLT2 inhibitors, and statins. These results are significant in light of recent long-term safety monitoring of these agents, particularly regarding the thyroid axis. Ensuring equitable uptake will be crucial, as it involves defining fair access through payer endpoints, conducting cost-effectiveness analysis, and considering patient-reported outcomes. Resmetirom represents a breakthrough in MASH management, offering potential metabolic benefits in conjunction with comprehensive clinical and lifestyle approaches. Full article

Background/Objectives: Obesity is a chronic metabolic disorder characterized by the excessive expansion of adipose tissue and impaired energy homeostasis. Natural products, such as plant extracts, are gaining attention as potential anti-obesity agents. This study aimed to evaluate and compare the anti-obesity effects of ginger (Zingiber officinale Roscoe) extract alone and as a mixture with long pepper (Piper longum L.) extract in a mouse model of high-fat diet-induced obesity. Methods: Male ICR mice were fed a high-fat diet to induce obesity and were orally administered ginger extract (60 mg/kg/day) or a 1:1 mixture of ginger and long pepper extracts (30 mg/kg/day each) for 8 weeks. Body weight, fat mass, glucose tolerance, and serum lipid levels were measured. Results: Ginger extract alone significantly reduced body weight gain and visceral and subcutaneous fat accumulation and improved glucose homeostasis and serum lipid profiles compared to the high-fat diet group. These effects were more pronounced than those observed with the mixture group. Ginger extract upregulated lipolytic markers via activation of the protein kinase A (PKA) signaling pathway and increased expression of uncoupling protein 1 (UCP1), indicating browning of white adipose tissue. Conclusions: Ginger extract alone exhibited significant anti-obesity effects compared to the mixture with long pepper extract. These findings suggest that ginger extract may serve as a promising natural agent for the prevention and management of obesity-related metabolic dysfunction. Full article