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Journal of Family Medicine and Primary... May 2024Polycystic ovary syndrome (PCOS) is a heterogeneous disorder and various phenotypes have been described. While most women with PCOS are obese, women who are lean also...
BACKGROUND
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder and various phenotypes have been described. While most women with PCOS are obese, women who are lean also suffer from PCOS. Metabolic derangements often accompany this syndrome. Family physicians, being the first point of contact in the healthcare system, play a vital role in the early diagnosis and management of this condition through diet and lifestyle modifications. The present study was conducted at the Diet and Lifestyle Diseases Management Division of a Family Medicine Clinic.
METHODS
We conducted a retrospective analysis of the correlation between body mass index (BMI) and metabolic parameters in women diagnosed with PCOS. The case records of women with PCOS, diagnosed as per modified Rotterdam criteria and who attended the outpatient clinic from January 2020 to December 2022, were chosen. Data on BMI and metabolic parameters were retrieved and statistically analyzed.
RESULTS
Upon analysis of 51 case records, 25.49% of women were in the lean group and 74.51% were overweight or obese. Triglycerides/HDL ratio (1.91 ± 0.47 vs 3.97 ± 5.89) and Vitamin D levels (Median 14.12 vs 16.10 ng/ml) were abnormal in both the obese and the lean women groups. However, there was no significant difference between the groups. Other metabolic parameters were within normal ranges.
CONCLUSION
The present study indicates that metabolic derangements are associated with PCOS, irrespective of BMI. More robust studies in larger population samples are needed to elucidate the role of metabolic derangements and mainly insulin resistance in the pathophysiology of PCOS and its different phenotypes.
PubMed: 38948599
DOI: 10.4103/jfmpc.jfmpc_1425_23 -
Journal of Family Medicine and Primary... May 2024Cancer chemotherapy remains an area of concern, as many of the therapies are uncomfortable involving side effects and unpleasant experiences. These factors could further... (Review)
Review
Cancer chemotherapy remains an area of concern, as many of the therapies are uncomfortable involving side effects and unpleasant experiences. These factors could further reduce patient's quality of life, and even endanger their life. Many therapeutic strategies have been tried to reduce the unpleasant side effects and increase the treatment effectiveness; however, none have shown to have promising effects. One of the main hindrances to cancer therapy is the escape strategies by tumor cells to the immune attack. Promoting inflammation in the tumor microenvironment is the cornerstone and key therapeutic target in cancer chemotherapy. High-salt diet (HSD) intake, though it has deleterious effects on human health by promoting chronic inflammation, is found to be advantageous in the tumor microenvironment. Studies identified HSD favors an increased abundance of species in the tumor environment due to gut barrier alteration, which, in turn, promotes inflammation and favors improved response to cancer chemotherapy. A review of the literature was carried out to find out the effects of an HSD on health and diseases, with special mention of its effect on cancer chemotherapy. Studies emphasized HSD would block the myeloid-derived suppressor cells which will enhance the tumor immunity. Exploration of the precise mechanism of simple HSD regime/ingestion of specific bacterial species as probiotics will be effective and essential to formulate the game-changing cancer chemotherapy. With the modern era of healthcare moving toward precision medicine where the physician can choose the treatment option suitable for the individual, HSD regime/ingestion of specific bacterial species can be considered.
PubMed: 38948582
DOI: 10.4103/jfmpc.jfmpc_1574_23 -
Journal of Family Medicine and Primary... May 2024Variety and adequacy of intake of food are required to meet the nutritional needs of the children. Due to poverty/illiteracy, poor families depend on a single food group...
INTRODUCTION
Variety and adequacy of intake of food are required to meet the nutritional needs of the children. Due to poverty/illiteracy, poor families depend on a single food group that is, cereals. Due to the pandemic also, the nutrition of the growing children is affected.
OBJECTIVE
To know the effect of quantity and quality of diet on the nutritional status of under-five children.
METHODOLOGY
This study had 270 children aged between 1 and 4 years registered at Anganwadi as study participants. Information on sociodemographic variables, quantity of calories and proteins consumed, quality of diet, and anthropometry of children was collected. Percentages and paired -tests were used to find the difference between nutritional status and diet at different intervals, which was found to be statistically significant ( < 0.05).
RESULTS
In our study, we found that as the quantity and quality of diet improved nutritional status, especially weight for age, body mass index (BMI) for age Z score also improved. There was a significant difference between calories consumed at the baseline, 6 months and 1 year with < 0.05. Protein intake was significant between baseline and six months with < 0.005.
CONCLUSION
Our study found a high percentage of undernutrition and wasting in the under-five population when diet was not sufficient in quality and quantity. As the quality and quantity of diet improved nutritional status also improved.
PubMed: 38948567
DOI: 10.4103/jfmpc.jfmpc_1743_23 -
Journal of Family Medicine and Primary... May 2024Cardiovascular diseases (CVDs) have many risk factors; few can be modified through health education. Traditional patient counselling methods fail to impact health...
INTRODUCTION
Cardiovascular diseases (CVDs) have many risk factors; few can be modified through health education. Traditional patient counselling methods fail to impact health behaviours to prevent or reduce the risk of CVDs.
OBJECTIVES
This study was conducted to estimate the effect of various risk communication methods on CVD risk reduction and medication adherence.
DESIGN
An open-label superiority randomised control trial was conducted where 159 patients were randomised into three groups: Communication of 10-year Framingham CVD risk score, heart age, and routine care. Follow-up was done 3 months after recruitment. The primary outcome was a difference in excess 10-year Framingham CVD risk score in the end-line compared to baseline. The status of modifiable behavioural risk factors at baseline was expressed as 'yes' and 'no', and follow-up was defined as 'action', 'positive maintenance', 'negative maintenance', and 'defaulter'. The trial was registered with the Clinical Trials Registry India (CTRI NO. CTRI/2020/10/028614).
SETTING
The study setting was screening outpatient department (OPD), General Medicine OPD, and Cardiology OPD of a tertiary care hospital in Central India.
PARTICIPANTS
Participants aged >30 years, residing in Bhopal for more than 6 months, diagnosed with hypertension or diabetes mellitus or both, and having any of the four CVD behavioural risk factors: tobacco use, alcohol use, physical inactivity, or unhealthy diet.
RESULTS
Median excess 10-year Framingham CVD risk scores were 0.945% (CI: 1.275-4.297), -0.850% (-3.932-2.075), and -1.300% (-5.100-0.900) (10-year Framingham CVD risk score vs Heart age vs Routine care) and 0.000% (-3.125-5.925), -1.600% (-3.760-1.475), and -1.400% (-6.600-5.900) before and after intervention, respectively ( > 0.05). Positive maintenance was higher in both intervention groups concerning all modifiable behaviours, with a higher proportion reported in the 10-year Framingham risk score. The action phase was reported higher in intervention groups for medication adherence, addiction, and dietary changes.
CONCLUSION
Systematic risk communication methods reduced the probability of contracting CVD in the future, though this finding was statistically insignificant.
PubMed: 38948564
DOI: 10.4103/jfmpc.jfmpc_1557_23 -
Frontiers in Endocrinology 2024Obesity impairs bone marrow (BM) glucose metabolism. Adult BM constitutes mostly of adipocytes that respond to changes in energy metabolism by modulating their...
OBJECTIVES
Obesity impairs bone marrow (BM) glucose metabolism. Adult BM constitutes mostly of adipocytes that respond to changes in energy metabolism by modulating their morphology and number. Here we evaluated whether diet or exercise intervention could improve the high-fat diet (HFD) associated impairment in BM glucose uptake (BMGU) and whether this associates with the morphology of BM adipocytes (BMAds) in rats.
METHODS
Eight-week-old male Sprague-Dawley rats were fed either HFD or chow diet for 24 weeks. Additionally after 12 weeks, HFD-fed rats switched either to chow diet, voluntary intermittent running exercise, or both for another 12 weeks. BMAd morphology was assessed by perilipin-1 immunofluorescence staining in formalin-fixed paraffin-embedded tibial sections. Insulin-stimulated sternal and humeral BMGU were measured using [F]FDG-PET/CT. Tibial microarchitecture and mineral density were measured with microCT.
RESULTS
HFD rats had significantly higher whole-body fat percentage compared to the chow group (17% vs 13%, respectively; = 0.004) and larger median size of BMAds in the proximal tibia (815 µm vs 592 µm, respectively; = 0.03) but not in the distal tibia. Switch to chow diet combined with running exercise normalized whole-body fat percentage ( < 0.001) but not the BMAd size. At 32 weeks of age, there was no significant difference in insulin-stimulated BMGU between the study groups. However, BMGU was significantly higher in sternum compared to humerus ( < 0.001) and higher in 8-week-old compared to 32-week-old rats ( < 0.001). BMAd size in proximal tibia correlated positively with whole-body fat percentage (r = 0.48, = 0.005) and negatively with humeral BMGU (r = -0.63, = 0.02). HFD significantly reduced trabecular number ( < 0.001) compared to the chow group. Switch to chow diet reversed this as the trabecular number was significantly higher ( = 0.008) than in the HFD group.
CONCLUSION
In this study we showed that insulin-stimulated BMGU is age- and site-dependent. BMGU was not affected by the study interventions. HFD increased whole-body fat percentage and the size of BMAds in proximal tibia. Switching from HFD to a chow diet and running exercise improved glucose homeostasis and normalized the HFD-induced increase in body fat but not the hypertrophy of BMAds.
Topics: Animals; Male; Rats, Sprague-Dawley; Rats; Adiposity; Diet, High-Fat; Physical Conditioning, Animal; Bone Marrow; Glucose; Obesity; Adipocytes
PubMed: 38948514
DOI: 10.3389/fendo.2024.1422869 -
World Journal of Hepatology Jun 2024Nonalcoholic fatty liver disease (NAFLD) is a liver condition that is prevalent worldwide and associated with significant health risks and economic burdens. As it has...
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is a liver condition that is prevalent worldwide and associated with significant health risks and economic burdens. As it has been linked to insulin resistance (IR), this study aimed to perform a bibliometric analysis and visually represent the scientific literature on IR and NAFLD.
AIM
To map the research landscape to underscore critical areas of focus, influential studies, and future directions of NAFLD and IR.
METHODS
This study conducted a bibliometric analysis of the literature on IR and NAFLD indexed in the SciVerse Scopus database from 1999 to 2022. The search strategy used terms from the literature and medical subject headings, focusing on terms related to IR and NAFLD. VOSviewer software was used to visualize research trends, collaborations, and key thematic areas. The analysis examined publication type, annual research output, contributing countries and institutions, funding agencies, journal impact factors, citation patterns, and highly cited references.
RESULTS
This analysis identified 23124 documents on NAFLD, revealing a significant increase in the number of publications between 1999 and 2022. The search retrieved 715 papers on IR and NAFLD, including 573 (80.14%) articles and 88 (12.31%) reviews. The most productive countries were China ( = 134; 18.74%), the United States ( = 122; 17.06%), Italy ( = 97; 13.57%), and Japan ( = 41; 5.73%). The leading institutions included the Università degli Studi di Torino, Italy ( = 29; 4.06%), and the Consiglio Nazionale delle Ricerche, Italy ( = 19; 2.66%). The top funding agencies were the National Institute of Diabetes and Digestive and Kidney Diseases in the United States ( = 48; 6.71%), and the National Natural Science Foundation of China ( = 37; 5.17%). The most active journals in this field were (27 publications), the (17 publications), and the and (13 publications). The main research hotspots were "therapeutic approaches for IR and NAFLD" and "inflammatory and high-fat diet impacts on NAFLD".
CONCLUSION
This is the first bibliometric analysis to examine the relationship between IR and NAFLD. In response to the escalating global health challenge of NAFLD, this research highlights an urgent need for a better understanding of this condition and for the development of intervention strategies. Policymakers need to prioritize and address the increasing prevalence of NAFLD.
PubMed: 38948442
DOI: 10.4254/wjh.v16.i6.951 -
Beverages (Basel, Switzerland) Jun 2024The purpose of this article is to review the effects of four commonly consumed beverage types-sugar-sweetened beverages (SSBs), caffeinated beverages, green tea, and...
The purpose of this article is to review the effects of four commonly consumed beverage types-sugar-sweetened beverages (SSBs), caffeinated beverages, green tea, and alcohol-on five common benign gynecological conditions: uterine fibroids, endometriosis, polycystic ovary syndrome (PCOS), anovulatory infertility, and primary dysmenorrhea (PD). Here we outline a plethora of research, highlighting studies that demonstrate possible associations between beverage intake and increased risk of certain gynecological conditions-such as SSBs and dysmenorrhea-as well as studies that demonstrate a possible protective effect of beverage against risk of gynecological condition-such as green tea and uterine fibroids. This review aims to help inform the diet choices of those with the aforementioned conditions and give those with uteruses autonomy over their lifestyle decisions.
PubMed: 38948304
DOI: 10.3390/beverages10020033 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... May 2024To experimentally validate the effects of a self-developed heat-stable thickening agent on the textual characteristics of enteral nutrition solutions of standard...
OBJECTIVE
To experimentally validate the effects of a self-developed heat-stable thickening agent on the textual characteristics of enteral nutrition solutions of standard concentration and its applicability in improving dysphagia.
METHODS
A gradient of different doses of the self-developed thickening agent (1.0 g, 1.5 g, 2.0 g, 2.5 g, and3.0 g) and three commonly used commercial thickeners were mixed with 23.391 g of a complete nutrition formula powder dissolved in 85 mL of purified water to prepare 100 mL standard concentration nutrition solutions. The textual parameters (cohesiveness, viscosity, thickness, and hardness) of these nutrition solutions were measured using a texture analyzer at various temperature gradients (20 ℃, 40 ℃, 60 ℃, and 80 ℃) to compare their thermal stability. A dysphagia rat model was created via epiglottectomy to explore the effects of the thickener on lung tissue damage scores and levels of inflammatory markers. The rats were divided into a test intervention group, a positive control group, a negative control group, and a blank control group (no surgery and normal feeding after fasting for one day), with 15 rats in each group. After fasting for one day post-surgery, the test intervention group was fed with the standard concentration nutrition solution thickened with the self-developed thickener, while the positive control group was given a standard concentration nutrition solution thickened with product 3, and the negative control group was fed a normal diet. All groups were fed for two weeks with food dyed with food-grade green dye. General conditions, body mass, and food intake were observed and recorded. After two weeks, abdominal aorta blood was collected, and heart, liver, spleen, lung, and kidney tissues were harvested and weighed to calculate the lung tissue organ coefficient. The organ conditions were evaluated using routine H&E staining, and lung damage was semi-quantitatively analyzed based on the Mikawa scoring criteria. Blood supernatants were collected to measure the total serum protein and albumin levels to determine the nutritional status of the rats. The expression of and genes in lung tissues was measured by RT-qPCR. IL-6 and TNF-α protein expression levels in lung tissues, lung tissue homogenate, and serum were measured by ELISA. The aspiration incidence rate was calculated.
RESULTS
Within the dosage range of 1.0 g to 3.0 g, the self-developed thickener in the test samples exhibited superior thermal stability in cohesiveness compared to the three commercially available thickeners, with a statistically significant difference (<0.01). The differences in the thermal stability of viscosity and hardness between the self-developed thickener and the three commercially available thickeners were not statistically significant. The viscosity stability was optimal for the self-developed thickener, followed by the commercially available thickeners 1 and 3, with thickeners 2 being the least stable, though the differences were not statistically significant (>0.05). Product 1 showed the best thermal stability in thickness, followed by the self-developed thickener and product 2, while the product 3 exhibited the worst performance, with the difference being statistically significant (<0.01). The self-developed thickener had the best thermal stability in hardness at temperatures ranging from 20℃ to 80 ℃, followed by products 1 and 2, with product 3 being the least stable. However, the differences were not statistically significant (>0.05). Animal experiment results indicated that the body weight gain in the positive control group and the test intervention group was lower than that in the blank and negative control groups (<0.01). The spleen coefficient of the intervention group was lower than that of the positive control group and the blank control group (<0.01), while the heart, liver, and kidney coefficients were lower than those of the blank control group (<0.01). The differences in the lung coefficient of the intervention group and those of the other three groups were no statistically significant. Levels of TP and ALB in the test intervention group, the positive control group, and the negative control group were all lower than those in the blank control group, with statistically significant differences (<0.01). ELISA results showed that serum IL-6 levels in the blank and test intervention groups were lower than those in the negative and positive control groups (<0.05), while the difference in the other indicators across the four groups were not statistically significant (>0.05). There were no statistically significant differences among the four groups in terms of lung tissue damage pathology scores, or in the levels of and gene expression in lung tissues. The aspiration incidence rate was 0% in all groups.
CONCLUSION
The self-developed enteral nutrition thickening agent demonstrated excellent thermal stability and swallowing safety. Further research to explore its application in patients with dysphagia is warranted.
Topics: Animals; Rats; Deglutition Disorders; Enteral Nutrition; Rats, Sprague-Dawley; Deglutition; Male; Lung; Hot Temperature; Viscosity
PubMed: 38948293
DOI: 10.12182/20240560203 -
Cancer Innovation Aug 2024Clinical studies have shown that atherosclerotic cardiovascular disease and cancer often co-exist in the same individual. The present study aimed to investigate the role...
BACKGROUND
Clinical studies have shown that atherosclerotic cardiovascular disease and cancer often co-exist in the same individual. The present study aimed to investigate the role of high-fat-diet (HFD)-induced obesity in the coexistence of the two diseases and the underlying mechanism in apolipoprotein E-knockout (ApoE) mice.
METHODS
Male ApoE mice were fed with a HFD or a normal diet (ND) for 15 weeks. On the first day of Week 13, the mice were inoculated subcutaneously in the right axilla with Lewis lung cancer cells. At Weeks 12 and 15, serum lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and vascular endothelial growth factor levels were measured by enzyme-linked immunosorbent assay, and blood monocytes and macrophages were measured by fluorescence-activated cell sorting. At Week 15, the volume and weight of the local subcutaneous lung cancer and metastatic lung cancer and the amount of aortic atherosclerosis were measured.
RESULTS
At Week 15, compared with mice in the ND group, those in the HFD group had a larger volume of local subcutaneous cancer ( = 0.0004), heavier tumors ( = 0.0235), more metastatic cancer in the lungs ( < 0.0001), a larger area of lung involved in metastatic cancer ( = 0.0031), and larger areas of atherosclerosis in the aorta ( < 0.0001). At Week 12, serum LOX-1, serum vascular endothelial growth factor, and proportions of blood monocytes and macrophages were significantly higher in the HFD group than those in the ND group ( = 0.0002, = 0.0029, = 0.0480, and = 0.0106, respectively); this trend persisted until Week 15 ( = 0.0014, = 0.0012, = 0.0001, and = 0.0204).
CONCLUSIONS
In this study, HFD-induced obesity could simultaneously promote progression of lung cancer and atherosclerosis in the same mouse. HFD-induced upregulation of LOX-1 may play an important role in the simultaneous progression of these two conditions via the inflammatory response and VEGF.
PubMed: 38948249
DOI: 10.1002/cai2.127 -
Journal of Clinical & Translational... Jun 2024Gut microbiota influences energy homeostasis in part through circulating hormones. Insulin-like growth factor-binding protein (IGFBP)-2 is a biomarker whose increase in...
BACKGROUND AND AIM
Gut microbiota influences energy homeostasis in part through circulating hormones. Insulin-like growth factor-binding protein (IGFBP)-2 is a biomarker whose increase in systemic circulation is associated with positive effects on body weight and metabolism. In a recent clinical trial, probiotic HA-114 supplementation showed positive effects on eating behaviors and insulin resistance in overweight participants undergoing a weight-loss intervention. In this context, this ancillary study aimed at assessing the impact of HA-114 supplementation on plasma IGFBP-2 levels in these individuals, and whether this modulation correlated with changes in fat mass, energy metabolism, and eating behaviors.
METHODS
Fasting plasma IGFBP-2 concentrations were quantified in 100 overweight or obese men and women enrolled in a 12-week diet-based weight reduction program (-500 kcal/day), in combination with probiotic or placebo supplementation. Baseline and changes in circulating IGFBP-2 concentrations were correlated with anthropometric parameter, glucose and lipid metabolism, cardiorespiratory function and eating behaviors.
RESULTS
On average, the intervention reduced BMI by 4.6 % and increased IGFBP-2 by 13 %, regardless of supplementation group. Individuals who presented an increase in IGFBP-2 levels had significantly greater reductions in BMI. Changes in IGFBP-2 levels were correlated with loss in fat mass (r = 0.2, p < 0.001) in the probiotic-supplemented group, but not with other metabolic parameters or eating behaviors. Baseline IGFBP-2 levels were not associated with weight loss or improvements in cardiometabolic parameters.
CONCLUSION
Probiotic supplementation with did not modulate plasma IGFBP-2 levels. Changes in IGFBP-2 levels were correlated with greater reductions in BMI, but not with other metabolic parameters or eating behaviors, indicating that the benefits of HA-114 on eating behaviors are likely independent of IGFBP-2. Additional changes in microbiota might be required to modulate IGFBP-2 and observe its associations with eating behaviors and cardiometabolic improvements.
PubMed: 38948244
DOI: 10.1016/j.jcte.2024.100357