Search Results (1,264)

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), previously referred to as Non-Alcoholic Fatty Liver Disease (NAFLD), is a prevalent chronic liver condition strongly linked to Type 2 Diabetes Mellitus (T2DM) and obesity. Globally, MASLD is the most common cause of chronic liver disease. The bidirectional relationship between MASLD and T2DM underscores the pivotal role of insulin resistance in disease progression, which contributes to hepatic steatosis, oxidative stress, and inflammation, forming a vicious cycle. MASLD is also associated with heightened risks of cardiovascular and chronic kidney diseases, necessitating comprehensive treatment approaches. While lifestyle interventions and weight loss remain the cornerstone of management, their sustainability is challenging. This review highlights the evolving pharmacological landscape targeting MASLD and its advanced form, Metabolic Dysfunction-Associated Steatohepatitis (MASH). Currently, Resmetirom is the only FDA-approved drug for MASH. Current and investigational therapies, including insulin-sensitizing agents like peroxisome proliferator-activated receptor (PPAR) agonists, glucose-lowering drugs such as sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA), drugs that target intermediary metabolism such as Vitamin E, de novo lipogenesis inhibitors, and emerging agents targeting the gut-liver axis and oxidative stress, are explored. These therapies demonstrate promising effects on hepatic steatosis, inflammation, and fibrosis, providing new avenues to address the multifaceted pathophysiology of MASLD. Full article

Background/Objectives: Significant weight loss, whether through bariatric surgery or medication-assisted approaches, presents unique challenges for body contouring procedures. A thorough preoperative evaluation is essential to optimize outcomes and minimize risks. Methods: A comprehensive literature search was conducted across various databases to identify studies on assessment, nutritional optimization, thromboembolic risk, and surgical planning for post-weight-loss patients, with a particular focus on those undergoing medication-assisted weight loss using Glucagon-like peptide-1 (GLP-1) agonists. Results: A detailed review of medical history, comorbidities, weight loss trajectory, and nutritional status is essential. Common conditions such as diabetes, hypertension, and sleep apnea often improve after weight loss but require ongoing management. Nutritional deficiencies, particularly in vitamins and minerals, necessitate dietary counseling and supplementation. Patients who have undergone significant weight loss are at increased risk of thromboembolic events, particularly after body contouring procedures. Surgical planning should be patient-centered, setting realistic expectations and employing a strategic, staged approach when necessary to optimize outcomes. GLP-1 agonists users require special consideration due to their distinct metabolic and physiological profiles. Conclusions: Optimizing preoperative assessment, nutrition, and thromboprophylaxis is critical for safe and effective body contouring in post-weight-loss patients. With the increasing prevalence of medication-assisted weight loss, surgical strategies must adapt to address the distinct anatomical and physiological features of these patients. Full article

Background/Aim: Child and adolescent obesity is currently one of the most pressing public health challenges. Digital technology-based interventions are becoming increasingly important in supporting weight loss motivation and promoting healthy lifestyles. This review aims to assess the effectiveness of technology tools on the BMI (body mass index) and their impact on health attitudes in children and adolescents. Materials and Methods: The study was conducted according to PRISMA guidelines, analysing studies published between 2011 and 2024 on PubMed, Scopus, Web of Science and Google Scholar databases. Of the 1475 articles identified and analysed, 59 met the inclusion criteria. Studies were assessed based on the type of technology used, the type of intervention, family involvement, the level of personalisation and their impact on BMI and motivation. Results: The systematic review showed that digital technologies—in particular mobile apps, wearables and m-health platforms—can effectively support weight reduction and improved eating habits in children and adolescents. The most beneficial results were observed in interventions that were personalised and included caregiver support. In addition, digital technology was shown to have a positive impact on participants’ psychological well-being. Conclusions: Digital technology-based interventions can be an effective tool in the prevention and treatment of obesity in children and adolescents. However, their success depends on a comprehensive approach that includes psychological, social and cognitive developmental factors. Full article

Glucagon-like peptide-1 (GLP-1) is a hormone secreted from enteroendocrine cells that can promote weight loss and blood glucose improvement. We screened probiotic strains that effectively stimulate GLP-1 secretion from human enteroendocrine cells and then investigated the efficacy of this strain in a high-fat diet (HFD)-induced mouse model of obesity. Lactiplantibacillus plantarum GB104 greatly induced GLP-1 secretion by increasing expression of the proglucagon gene (GCG), but not the proprotein convertase subtilisin/kexin type 1 gene (PCSK1) in the human enteroendocrine cell line NCI-H716. In an HFD-induced mouse model of obesity, GB104 inhibited weight gain and improved blood glucose levels by increasing blood GLP-1 levels. It also tended to attenuate the HFD-induced changes in blood levels of other hormones and suppressed fat accumulation in the liver and adipose tissues. In white adipose tissue, GB104 suppressed inflammation by reducing pro-inflammatory M1 macrophages and increasing anti-inflammatory M2 macrophages and regulatory T cells. Probiotic strains that promote GLP-1 secretion, such as GB104, may serve as a promising candidate for dietary intervention against obesity and metabolic diseases. Full article

Diabetic nephropathy (DN) represents a severe microvascular complication of diabetes mellitus with limited therapeutic options, many of which are accompanied by considerable adverse effects. Opuntia ficus-indica (OFI) fruit, rich in vitamins, dietary fiber, and fatty acids, contains numerous bioactive compounds, including phytosterols, polysaccharides, and flavonoids that demonstrate significant potential in diabetes management. The flavonoid fraction derived from OFI fruit (OFI-F) has exhibited pronounced anti-inflammatory, antioxidant, and gut microbiota modulatory properties. However, the efficacy of OFI-F in ameliorating DN and its underlying mechanisms remain inadequately elucidated. This investigation examined the therapeutic potential of OFI-F in DN and explored its mechanistic pathways. Our findings demonstrate that OFI-F administration significantly attenuated renal injury and intestinal barrier dysfunction in the DN murine model. OFI-F intervention resulted in multiple beneficial outcomes in DN mice, including the mitigation of weight loss, reduction in hyperglycemia, decrease in renal coefficient index, and the attenuation of renal injury. An analysis of gut microbiota composition revealed that OFI-F administration favorably modulated the intestinal microbial community by enhancing the abundance of beneficial bacteria while concomitantly reducing populations of potentially pathogenic bacteria. Additionally, OFI-F treatment promoted the production of short-chain fatty acids (SCFAs), which contributed substantially to renoprotection and inflammatory resolution. Antibiotic intervention studies further confirmed the indispensable role of gut microbiota in mediating the renoprotective effects of OFI-F. In conclusion, this study provides compelling evidence supporting the therapeutic potential of OFI-F in DN management through the concurrent modulation of gut microbiota and renal function, offering a promising nutraceutical approach for alleviating renal injury in DN. Full article

Nutrition plays a crucial role during pregnancy and lactation, influencing maternal and infant health, as well as human milk (HM) composition. The Mediterranean diet (MED) is recognized worldwide as a well-established healthy dietary pattern. This narrative review aims to integrate and summarize observational and interventional studies investigating the association between the MED and outcomes across the mother–milk–infant triad. A literature search was conducted in the Cochrane, Google Scholar, and PubMed databases, and 22 studies that met the eligibility criteria were included into review. The included studies were categorized into maternal outcomes (n = 13), HM composition outcomes (n = 9), and infant outcomes (n = 3). This narrative review suggests that adherence to the MED may be associated with maternal psychological health and well-being, postpartum weight loss, glucose metabolism, and the fatty acid profile of HM. Moreover, the included studies exhibited notable methodological differences that hindered direct comparisons and limited the generalizability of the findings. Future research should adopt an integrated and standardized methodology for assessing MED adherence, HM collection, and infant outcomes, considering the mother–human milk–infant triad. Full article

Synchronous colorectal cancer (SCRC) is characterized by the simultaneous occurrence of two or more primary colorectal malignancies, diagnosed either preoperatively, intraoperatively, or within six months postoperatively. The rare prevalence of SCRC makes it an uncommon scenario among colorectal malignancies. Since the majority of SCRC patients have been reported to have two concurrent malignancies, triple synchronous malignancies are extremely rare. We report the case of a 65-year-old male individual presenting with a history of abdominal pain, anemia, anorexia, and unintentional weight loss. He was diagnosed with synchronous colorectal cancer with three distinct tumors: two located in the splenic flexure and sigmoid colon, respectively, and another in the rectum that caused partial obstruction. This case highlights the importance of intraoperative evaluation and an appropriate choice of surgical intervention in colorectal cancer. The early identification and proper management of multiple colorectal cancers remain essential for better survival rates. Full article

Introduction: Hyperbilirubinemia in newborns can lead to kernicterus, a severe form of neonatal encephalopathy caused by bilirubin toxicity. Despite timely interventions such as exchange transfusion, kernicterus can still develop, especially in high-risk infants. MRI is crucial for detecting early and evolving signs of bilirubin-induced brain damage. Case Report: We report a term newborn who developed severe hyperbilirubinemia and kernicterus despite receiving exchange transfusion. The infant presented on day 3 of life with jaundice, hypotonia, and feeding difficulties and had a bilirubin level of 51 mg/dL. After exchange transfusion, bilirubin levels normalized, but neurotoxicity persisted. Initial MRI at one month showed mild T1 hyperintensity in the hippocampi with no changes in the basal ganglia. At two months, T1 hyperintensities in the hippocampi partially resolved. By six months, MRI revealed T2 hyperintensities in the globus pallidus and hippocampal atrophy, consistent with kernicterus. Magnetic resonance spectroscopy (MRS) showed reduced N-acetylaspartate (NAA) levels, indicating neuronal loss. Discussion: MRI is essential in monitoring bilirubin-induced brain injury. In this case, early MRI findings showed mild hippocampal T1 hyperintensity, which resolved partially. At six months, T2 hyperintensities in the globus pallidus confirmed chronic bilirubin encephalopathy. MRS demonstrated a reduction in N-acetylaspartate, indicative of neuronal loss. Susceptibility-Weighted Imaging (SWI) showed no abnormalities, likely due to the myelination process in neonates. Conclusions: This case highlights the importance of repeated MRI in detecting bilirubin-induced brain damage. Early neuroimaging enables timely interventions and improves long-term neurodevelopmental outcomes in infants with severe hyperbilirubinemia. Full article

Background: Clinical data indicate that at least half of patients with malignancies receive radiotherapy. While radiotherapy effectively kills tumor cells, it is also associated with significant ionizing radiation (IR) damage. Moreover, the increasing emissions of nuclear pollutants raise concerns about the potential exposure of more individuals to the risks associated with IR. The Chinese term for amniotic fluid (AF) is rooted in the Yin–Yang theory of traditional Chinese medicine, where it symbolizes the inception of human life. Chick early AF (ceAF), a natural product, has shown promise in the field of regenerative medicine. There have been no studies investigating the potential efficacy of ceAF in the treatment of IR-induced damage. This study aims to assess the therapeutic potential of ceAF in alleviating IR-induced damage and elucidate its potential molecular mechanism. Methods: In vivo experiments were conducted on 8-week-old male C57BL/6J mice to investigate the effects of ceAF in a radiation injury model induced by whole-body irradiation with X-rays (6 Gy) for 5 min. The ceAF was extracted from chicken embryos aged 7–9 days. Results: We found that the supplementation of ceAF reduces mortality induced by IR, improves exercise capacity in IR mice, and reverses IR-induced skin damage. IR leads to varying degrees of volume atrophy and weight loss in the major internal organs of mice. However, ceAF intervention effectively mitigates IR-induced organ damage, with a notable impact on the spleen. The supplementation of ceAF enhances spleen hematopoietic and immune functions by reducing oxidative stress, alleviating inflammatory responses, and preventing splenic DNA damage from IR exposure, ultimately leading to an overall improvement in health. Conclusions: ceAF effectively alleviates body damage induced by IR, and our findings provide new perspectives and therapeutic strategies for mitigating IR-induced damage. Full article

Background and Objective: Dietary interventions are the first-line treatment for overweight individuals (OW) and individuals with obesity (OB) with high-normal blood pressure (BP) or grade I hypertension, especially when at low-to-moderate cardiovascular risk (CVR). However, current guidelines do not specify the most effective dietary approach for optimising cardiovascular and metabolic outcomes in this population. This study aimed to compare the effects of a low-calorie, high-protein ketogenic diet (KD) vs. a low-calorie, low-sodium, and high-potassium Mediterranean diet (MD) on BP profiles assessed via ambulatory BP monitoring (ABPM), as well as on anthropometric measures, metabolic biomarkers, and body composition evaluated by bioelectrical impedance analysis (BIA). Methods: This prospective observational bicentric pilot study included 26 non-diabetic adult outpatients with central OW status or OB status (body mass index, BMI > 27 kg/m²) and high-normal BP (≥130/85 mmHg) or grade I hypertension (140–160/90–100 mmHg), based on office BP measurements. All participants had low-to-moderate CVR according to the second version of the systemic coronary risk estimation (SCORE2) and were selected and categorized as either KD (n = 15) or MD (n = 11). Comprehensive blood analysis, BIA, and ABPM were conducted at baseline and after three months. Results: At baseline, no significant differences were observed between the groups. Following three months of dietary intervention, both groups exhibited substantial reductions in body weight (KD: 98.6 ± 13.0 to 87.3 ± 13.4 kg; MD: 93.8 ± 17.7 to 86.1 ± 19.3 kg, p < 0.001) and waist circumference. Mean 24 h systolic BP (SBP) and diastolic BP (DBP) significantly declined in both groups (24 h mean SBP decreased from 125.0 ± 11.3 to 116.1 ± 8.5 mmHg (p = 0.003) and 24 h mean DBP decreased from 79.0 ± 8.4 to 73.7 ± 6.4 mmHg (p < 0.001)). Fat-free mass (FFM) increased, whereas fat mass (FM), blood lipid levels, and insulin concentrations decreased significantly. The ΔFM/ΔFFM correlates with ABP improvements. However, no significant between-group differences were detected at follow-up. Conclusions: The KD and the MD mediated weight loss and body composition changes, effectively improving bio-anthropometric and cardiovascular parameters in individuals with OW status or OB status and high BP. Although more extensive studies are warranted to elucidate potential long-term differences, our findings suggest the manner in which these two different popular dietary approaches may equally confer metabolic and cardiovascular benefits, emphasising the importance of weight and FM loss. Full article

Eye diseases (EDs), including glaucoma, diabetic retinopathy, and cataracts, are major contributors to vision loss and reduced quality of life worldwide. These conditions not only affect millions of individuals but also impose a significant burden on global healthcare systems. As the population ages and lifestyle changes increase the prevalence of conditions like diabetes, the incidence of EDs is expected to rise, further straining diagnostic and treatment resources. Timely and accurate diagnosis is critical for effective management and prevention of vision loss, as early intervention can significantly slow disease progression and improve patient outcomes. However, traditional diagnostic methods rely heavily on manual analysis of fundus imaging, which is labor-intensive, time-consuming, and subject to human error. This underscores the urgent need for automated, efficient, and accurate diagnostic systems that can handle the growing demand while maintaining high diagnostic standards. Current approaches, while advancing, still face challenges such as inefficiency, susceptibility to errors, and limited ability to detect subtle retinal asymmetries, which are critical early indicators of disease. Effective solutions must address these issues while ensuring high accuracy, interpretability, and scalability. This research introduces a 2D single-channel convolutional neural network (CNN) based on ResNet101-V2 architecture. The model integrates gradient-weighted class activation mapping (Grad-CAM) to highlight retinal asymmetries linked to EDs, thereby enhancing interpretability and detection precision. Evaluated on retinal Optical Coherence Tomography (OCT) datasets for multiclass classification tasks, the model demonstrated exceptional performance, achieving accuracy rates of 99.90% for four-class tasks and 99.27% for eight-class tasks. By leveraging patterns of retinal symmetry and asymmetry, the proposed model improves early detection and simplifies the diagnostic workflow, offering a promising advancement in the field of automated eye disease diagnosis. Full article

Introduction: Obesity is a global health problem requiring effective interventions to achieve weight loss and maintain it in the long term. A major challenge for clinicians is weight regain (WR), defined as progressive weight gain following successful weight loss. WR is affected by multiple factors, including psychological traits linked to specific brain alterations. Understanding these mechanisms is crucial in developing strategies to prevent WR and to ensure effective weight control. Objectives: This narrative review aims to gather current findings on the psychological and neurobiological determinants of WR and to discuss the interplay between these factors. Methods: A literature search was conducted on PubMed, Medline, and Web of Science for English-language studies published between December 1990 and November 2024. Results: WR is driven by interconnected psychological and neurobiological factors that influence eating behavior and the regulation of body weight. Certain personality traits and emotional patterns are associated with specific changes in brain activity, which together affect vulnerability to WR. Although distinct mechanisms can be identified, the complexity of homeostatic and nonhomeostatic appetite control suggests that no single factor predominates. Conclusions: This review highlights the dynamic interplay between psychological and neurobiological predictors of WR. However, due to the narrative nature of this review, the focus on selected determinants, and the limited quality and size of the available studies, further research is needed to comprehensively understand causality and to improve relapse prevention strategies. Full article

Metabolic syndrome (MetS) is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, and chronic inflammation, significantly increasing the risk of cardiovascular disease and type 2 diabetes. Effective management of MetS is critical, with exercise being a key intervention. This review analyzed the effects of different exercise intensities—low, moderate, and high-intensity interval training (HIIT)—on metabolic health, oxidative stress (OS), inflammation, and cardiovascular function. A search of Medline, PEDro, and EBSCO identified 2251 articles, with 159 studies published between 1999 and 2025 included after screening. Low-intensity exercise improved insulin sensitivity, reduced OS markers (e.g., MDA, 8-OHdG), and enhanced antioxidant enzyme activity. Moderate-intensity exercise showed similar benefits with notable reductions in inflammatory markers (e.g., IL-1β, TNF-α). HIIT promoted fat loss and improved metabolic markers but temporarily increased OS and inflammation. Dietary strategies also play a critical role. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diets are well established, emphasizing nutrient-dense foods like unsaturated fats and fiber to reduce inflammation and manage weight. The ketogenic diet (KD), a high-fat, low-carbohydrate approach, has recently gained attention for its metabolic benefits. KD induces ketosis, improving insulin sensitivity, reducing triglycerides, and enhancing fat oxidation. Studies show KD effectively reduces body weight and glucose levels, though long-term adherence and nutrient deficiencies remain challenges. Intermittent fasting also showed potential benefits, though effects on glucose metabolism were inconsistent. This review underscores the need for tailored approaches combining exercise, diet, and fasting to optimize MetS outcomes, offering integrative strategies for prevention and management. Full article

Objectives: This study aims to elucidate the metabolic differences between obese adolescents categorized into low-weight-loss (LWL) and high-weight-loss (HWL) groups. Methods: The objective of this study is to investigate the metabolic characteristics of obese adolescents, with a focus on the statistically significant individual differences observed in weight loss outcomes after the same dietary and exercise training intervention. A four-week exercise and dietary intervention was administered to the participants. Obese adolescents were categorized into LWL (with a weight loss percentage of 5–10%) and HWL (with a weight loss percentage of >10%) groups on the basis of their weight loss outcomes. Post-intervention changes in body morphology and body composition between the two groups were compared using Analysis of Covariance (ANCOVA), with gender as a covariate. Additionally, metabolic changes were analyzed in depth; differential metabolites between the groups were identified through ANCOVA adjusted for gender, followed by pathway analysis. Results: After the four-week exercise intervention, the body morphology and composition of the obese adolescents showed significant improvements compared with those before the intervention (p < 0.001). For example, weight decreased from 80.65 kg to 72.35 kg, BMI decreased from 30.57 kg/m² to 27.26 kg/m², waist circumference decreased from 103.64 cm to 94.72 cm, and body fat percentage decreased from 32.68% to 28.54%. Prior to the exercise intervention, no significant differences in body morphology and composition were observed between the HWL and LWL groups (p > 0.05). After the intervention, the HWL group demonstrated significant improvements in weight, body mass index, waist circumference, body fat percentage, fat mass, fat-free mass, body water amount, and skeletal muscle mass compared with the LWL group (p < 0.001). After controlling for the levels of pre-intervention metabolites, 27 differential metabolites were identified between the HWL and LWL groups. These metabolites were categorized into fatty acids, amino acids, organic acids, carnitines, indoles, benzoic acids, and carbohydrates. Notably, they were significantly enriched in the eight metabolic pathways involved in amino acid metabolism, fatty acid biosynthesis, and coenzyme A biosynthesis. Conclusions: A four-week exercise intervention enhanced the body morphology and physical fitness of obese adolescents, although the degree of weight loss varied among individuals. Considerable weight reduction was significantly correlated with metabolites involved in lipid, amino acid, organic acid, carbohydrate, and gut microbiota metabolism and with the enrichment of pathways involved in amino acid metabolism, fatty acid biosynthesis, and coenzyme A biosynthesis. These findings indicate that intrinsic metabolic characteristics considerably influence individual responsiveness to exercise-based weight-loss interventions. Full article

The aim of this narrative review is to explore possible connections that might lead to both obesity and asthma; it will explain factors and mechanisms involved in disease pathogenesis, focusing particularly on diet and nutrients, the microbiome, inflammatory and metabolic dysregulation, lung function, the genetics/genomics of obese asthma, risk of exacerbation, atopy, and response to treatment. It highlights the role that obesity plays as a risk factor for and disease modifier of asthma, understanding the evidence supporting lifestyle changes in influencing disease progression. Pathophysiological mechanisms in obesity-related asthma have influences on the course of disease pathology. Due to these factors, the child with obese asthma needs a specific therapeutic approach taking into account the common unresponsiveness to bronchodilators, increased requirements for controller medications, poorer steroid effectiveness, and better response to leukotriene receptor (LTR) inhibitors. Therapeutic strategies centered on prevention are suggested and the development of resources to assist families with weight loss strategies and lifestyle changes is shown to be useful for effective weight control and optimal asthma management. Obese children with asthma generally should receive interventions that encourage daily physical activity, weight loss, and normalization of nutrient levels, and monitoring of common obesity-related sequelae should be considered by healthcare providers managing obese children with difficult to control asthma. Recognizing and identifying an asthmatic patient is not always easy and a detailed medical history of the patient, with particular attention paid to their presenting and past symptoms, and a complete physical examination play pivotal and fundamental roles in determining the final diagnosis. Full article