Search Results (1,624)

Background: Vitamin D deficiency has been implicated in disturbances of glucose and lipid metabolism, particularly in occupational groups with limited sunlight exposure. This study aimed to examine the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and markers of carbohydrate and lipid metabolism in salt mine workers. Methods: This cross-sectional study involved 62 male salt miners (aged 25–63 years), stratified by work depth (surface, ≤750 m, and >750 m). Anthropometric characteristics, body composition, cardiorespiratory fitness (VO_2max), and biochemical parameters were assessed. Blood analyses included fasting glucose, insulin, lipid profile, TSH, and 25(OH)D. Insulin resistance was evaluated via the HOMA-IR index. Results: The cohort exhibited a high prevalence of overweight and obesity (mean BMI > 28 kg/m²). Significant differences in VO_2max were observed between groups (p < 0.05). Elevated fasting glucose (>100 mg/dL) was observed in 47% of participants, and 22% presented HOMA-IR values > 2.5. In the regression model, vitamin D supplementation was the strongest predictor of 25(OH)D levels, explaining 25.5% of its variance. The addition of HDL cholesterol increased the explained variance to 35.6%, whereas HOMA-IR contributed an additional 3.9% (p = 0.094). Conclusions: In salt miners, insufficient vitamin D status coexists with excess adiposity and impaired glucose homeostasis. Serum 25(OH)D was more strongly associated with supplementation and HDL-C than with HOMA-IR. These findings suggest that monitoring vitamin D status is relevant in the occupational health evaluation of this group. Full article

Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease. Optical coherence tomography (OCT) is a non-invasive imaging technique of the retina. The thickness of the ganglion cell–inner plexiform layer (GCIPL) obtained from an OCT image is a valuable biomarker for monitoring MS. Since the functional shape (F-shape)-based technique has proven to be an effective platform for detecting glaucoma using OCT images, in this paper, we develop an F-shape-based framework to distinguish MS subjects from healthy ones using the thickness of GCIPL. The thickness of the GCIPL layers in the macula region of OCT images in a selected region of interest (ROI) for a set of healthy and MS subjects is represented as F-shape objects, which are registered to a common template using atlas registration. The residual F-shapes, defined as the difference between the F-shape of this common template and the individual registered F-shapes, are used to train an support vector machine (SVM) classifier and subsequently to detect MS. Accuracy, sensitivity, specificity, and area under the curve (AUC) are used to evaluate and compare the classification performance of the proposed F-shape-based scheme and those of sectoral-based schemes. The proposed F-shape-based scheme is shown to significantly outperform the sectoral-based schemes. The superior performance of the proposed F-shape-based scheme can be attributed to the use of (i) a highly dense mesh formed on the ROI in the macula region, (ii) atlas registration that puts the F-shapes of all the subjects on a common platform, and (iii) residual thicknesses as input features for the classification. Full article

Background/Objectives: People with HIV (PWH) remain at high risk for cardiovascular and metabolic complications despite effective antiretroviral therapy (ART). Diet quality is an important modifiable factor that may influence these complications. Diets high in ultra-processed foods (UPF) have been linked to adverse metabolic and inflammatory profiles in the general population, but their impact on PWH remains poorly understood. The NOVA 4 classification categorizes foods by degree of processing, from unprocessed/minimally processed (NOVA 1) to UPF (NOVA 4). Methods: We conducted a cross-sectional study of adults with virologically suppressed HIV on stable ART. Assessments included dietary intake consisting of 24 h recalls analyzed with Nutrition Data System for Research software (NDSR) and classified into NOVA categories by a registered dietitian and the following characteristics: body composition (total and regional fat by DEXA and CT scan abdomen), cardiometabolic variables (glucose, HbA1C, HOMA-IR, lipids, blood pressure), and biomarkers of inflammation, immune activation, and gut integrity quantified by ELISA. Patients were stratified into NOVA 4 groups based on the median and quartile proportions of total energy intake from NOVA 4 foods. Associations between dietary NOVA and outcomes were analyzed using generalized additive models (GAMs) adjusted for age, sex, race, and CD4 count. Results: Among 222 PWH (mean age 45.4 ± 14.2 years; 31% female; 66% non-white; BMI 30.61 ± 7.91 kg/m²), median NOVA 4 intake was 45.6% of total energy intake. Participants with higher vs. lower NOVA 4 intake showed differences in diet quality, but in GAMs, higher NOVA 4 intake was not associated with higher levels of inflammatory, cardiometabolic, gut integrity, and body composition variables. Conclusions: In PWH, UPF consumption was high but not associated with markers of cardiometabolic health, systemic inflammation, or gut integrity. This may reflect the multifactorial nature of the heightened inflammation in PWH, potentially obscuring the effect of diet. Full article

Background: The real-world risk profiles of newly defined steatotic liver disease (SLD) subtypes—MASLD, MetALD, and ALD—remain incompletely described in community settings. Methods: A cross-sectional analysis of 950 health-checkup participants was conducted. SLD (CAP ≥ 248 dB/m) and significant fibrosis (LSM ≥ 7.0 kPa) were evaluated by transient elastography. Associations between alcohol intake, cardiometabolic factors, fibrosis, and gut microbiota (16S rRNA sequencing) were assessed. Results: Among 950 participants, 310 (33%) had SLD (MASLD, n = 222; MetALD, n = 41; ALD, n = 23). Treated as a continuous exposure, higher alcohol intake was significantly correlated with elevated systolic/diastolic blood pressure, triglycerides, AST, and γ-GTP, but inversely correlated with HOMA-IR (all p < 0.05). In multivariable logistic regression adjusting for cardiometabolic factors, BMI was the only independent predictor of fibrosis (adjusted OR 1.22, 95% CI 1.11–1.35, p < 0.01), whereas alcohol intake showed no independent association. Furthermore, microbiota analysis revealed that ALD-related SLD was characterized by significant depletion of Blautia and enrichment of Gemella (FDR q < 0.05) compared to non-SLD controls, indicating an alcohol-associated dysbiosis signature. Conclusions: In early-stage SLD, alcohol intake continuously exacerbates cardiometabolic risk factors, whereas fibrosis is predominantly driven by BMI. These findings support quantitative alcohol/BMI integration for risk stratification, alongside microbiota profiling to detect ALD-related dysbiosis. Full article

Background/Objectives: Obesity is a chronic, relapsing disease in which lifestyle modification represents the cornerstone of treatment. Among dietary strategies, ketogenic diets can induce rapid weight loss, whereas the Mediterranean diet is associated with established cardiometabolic benefits but typically produces slower weight reduction. Very-low-calorie ketogenic diets (VLCKDs) are effective for weight loss but are often limited by cost, reliance on meal replacements, and reduced long-term feasibility. This study aimed to evaluate whether a whole-food Mediterranean ketogenic diet with moderate caloric restriction (MedKD) could represent a feasible and effective alternative to VLCKD for weight loss and metabolic improvement in adults with obesity. Methods: This 3-month prospective, real-world study compared VLCKD and MedKD in adults with obesity attending a clinical nutrition program. The primary outcome was percentage weight loss. Secondary outcomes included changes in waist circumference, waist-to-height ratio, insulin resistance (HOMA-IR), lipid profile, kidney function, and treatment tolerability. Clinical and biochemical parameters were assessed at baseline and after the intervention. Group differences and time-by-group interactions were analyzed to evaluate changes over the study period. Results: Sixty-two participants were enrolled, and 55 completed the study (27 VLCKD, 28 MedKD). Baseline characteristics were generally comparable, although the MedKD group had a higher prevalence of diabetes and higher baseline insulin resistance and triglyceride levels. Both dietary interventions resulted in substantial and comparable weight loss (approximately 15% of initial body weight), accompanied by significant reductions in waist circumference and waist-to-height ratio. Insulin resistance improved in both groups, with a greater reduction in HOMA-IR observed in the MedKD group (time × group p = 0.031). Serum creatinine decreased in the VLCKD group and slightly increased in the MedKD group (p = 0.025). Changes in lipid profile were not significantly different between groups. No severe adverse events were reported. Conclusions: A whole-food Mediterranean ketogenic diet with moderate caloric restriction achieved weight loss and metabolic improvements comparable to those observed with VLCKD over three months. These findings suggest that MedKD may represent a feasible alternative to formula-based ketogenic programs, supporting more flexible and personalized dietary strategies in the clinical management of obesity. Full article

Background and Objectives: Human data on obesity and type 2 diabetes mellitus (T2DM) remain limited and inconsistent, particularly with respect to adiposity-related phenotypes and renal involvement. We aimed to assess PNX-14 across body mass index (BMI) categories and to investigate its associations with BMI, insulin resistance indicators, and proteinuria in adults with T2DM. Materials and Methods: In this prospective cross-sectional study, participants were classified into four groups according to World Health Organization body mass index (BMI) thresholds: 18.5–24.9, 25.0–29.9, 30.0–34.9, and ≥35.0 kg/m². Serum PNX-14 was measured using a human ELISA kit. Group comparisons, trend analysis, false discovery rate-adjusted Spearman correlations, HC3-robust multivariable regression, and parsimonious structural equation modeling were performed. Results: PNX-14 differed significantly across BMI categories and increased monotonically with increasing BMI (p < 0.001 for both the overall comparison and the trend). PNX-14 showed a positive correlation with BMI (ρ = 0.491; qFDR < 0.001), whereas no significant relationship was observed with insulin or HOMA-IR after FDR correction (qFDR = 0.795 for insulin and qFDR = 0.793 for HOMA-IR). In the model adjusted for age, sex, and BMI, higher PNX-14 was independently associated with lower proteinuria (β = −0.326, 95% CI −0.584 to −0.067; p < 0.05), whereas BMI was positively associated with proteinuria (β = 0.407, 95% CI 0.132 to 0.682; p < 0.01). Structural equation modeling supported positive BMI→PNX-14 and BMI → proteinuria paths, a negative PNX-14→proteinuria path, and a non-significant PNX-14→HOMA-IR path. Conclusions: In adults with T2DM, PNX-14 appears to be more consistently related to adiposity than to glycemic or insulin resistance indicators. However, when evaluated together with proteinuria, it may offer a testable framework for phenotyping based on renal involvement within the obesity spectrum. Nevertheless, this approach needs to be validated in studies from different centers and with repeated measurements. Full article

The field of perovskites continues to advance each day, with new materials being discovered in order to eliminate the toxic and less efficient ones. Some of the challenges currently facing the perovskite industry include coming up with materials with higher electrical conductivity and lower thermal conductivity, as well as p-type semiconductors. In an attempt to address these challenges, this study modeled two novel perovskites from potassium hexachloroosmate (VI) (K₂OsCl₆) by replacing some of the chlorine atoms with those of silver, then characterized their structural, electronic (using both conventional and hybrid functionals), and thermoelectric properties using Quantum Espresso and BoltzTrap2 codes. The calculations were performed within the framework of density functional theory. The results showed that the novel materials exhibited higher density, lower thermal conductivity, lower band gaps, and positive Hall coefficient, unlike the K₂OsCl₆ sample. These materials can thus be used in areas such as in p–n junctions, thermoelectric devices, and optoelectronic devices. However, since this study was purely computational, the properties need to be verified through an experimental study. Full article

Background: Childhood and adolescent overweight and obesity are major global public health concerns. High-intensity interval training (HIIT) has been increasingly investigated as a time-efficient intervention; however, evidence regarding its effects on multiple health-related outcomes and the influence of intervention characteristics remains inconsistent. Objective: The objective of this study was to evaluate the effects of HIIT on body composition, metabolic health, and cardiorespiratory fitness in children and adolescents with overweight or obesity. Methods: Systematic literature searches were conducted in PubMed, Web of Science, EBSCO, CNKI, Wanfang Data, and VIP databases. Randomized controlled trials were included. Risk of bias was assessed using the Cochrane Risk of Bias tool. Meta-analyses were conducted using random-effects models, and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity, sensitivity analyses, publication bias, and certainty of evidence (GRADE) were also evaluated. Results: A total of 21 randomized controlled trials involving 652 participants (325 in the intervention groups and 327 in the control groups) were included. Compared with control conditions, HIIT significantly improved multiple outcomes related to body composition, metabolic health, and cardiorespiratory fitness, including BMI (SMD = −1.05), body fat percentage (SMD = −0.69), total cholesterol (SMD = −0.42), HOMA-IR (SMD = −1.00), and VO₂peak (SMD = 0.91), while no significant effect was observed on lean body mass. Subgroup analyses suggested that HIIT protocols with a load duration of less than 1 min were associated with greater improvements in several outcomes, particularly body fat percentage, total cholesterol, HOMA-IR, and VO₂peak. Conclusions: HIIT may improve body composition, metabolic health, and cardiorespiratory fitness in children and adolescents with overweight or obesity. However, the certainty of evidence varied across outcomes and was limited for some findings by heterogeneity, small sample sizes, and potential risk of bias. Further high-quality, large-scale randomized controlled trials with standardized HIIT protocols are needed to confirm these findings and clarify the influence of different training characteristics (e.g., exercise mode and interval structure). Full article

Background: Insulin resistance (IR) is a hallmark of metabolic disorders including type 2 diabetes mellitus (T2DM), metabolic syndrome, metabolic dysfunction-associated steatotic liver disease (MASLD), obesity, polycystic ovary syndrome (PCOS), and cardiovascular diseases. It arises from impaired insulin signaling in muscle, liver, and adipose tissue, driven by ectopic lipid accumulation, chronic inflammation, oxidative stress, and gut microbiota dysbiosis. Methods: This narrative review synthesizes IR mechanisms and the evidence on specific dietary patterns. A structured search of PubMed/MEDLINE and Embase (up to January 2026) prioritized RCTs, systematic reviews, meta-analyses, and clinical guidelines. Results: IR assessment relies on the hyperinsulinemic–euglycemic clamp as gold standard, with HOMA-IR and QUICKI as validated clinical surrogates. The Mediterranean diet is the most evidence-supported strategy, with consistent HOMA-IR reductions, a 31% decrease in T2DM incidence (PREDIMED-Plus), and demonstrated efficacy across T2DM, MASLD, and PCOS. Low-GI and DASH diets improve postprandial insulin dynamics and are particularly effective in PCOS. Low-carbohydrate and ketogenic diets produce the largest short-term reductions in fasting glucose and insulin secretion, though long-term sustainability requires further study. Plant-based diets and intermittent fasting improve IR primarily via weight loss and gut microbiota modulation. Most studies rely on surrogate IR indices and are short-term (≤26 weeks). Conclusions: Dietary pattern selection should be individualized according to metabolic phenotype, comorbidities, and adherence potential. Larger, longer, head-to-head trials measuring hard clinical outcomes are needed. Full article

Background/Objectives: Tirzepatide (TZP), a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, induces substantial weight loss in patients with obesity; however, pharmacologically induced weight reduction may be accompanied by losses in fat-free mass (FFM), muscle strength (MS), and resting metabolic rate (RMR), potentially influencing metabolic health. The metabolic implications of short-term preservation of metabolically active tissue during TZP therapy remain incompletely characterized. Methods: We performed a secondary, exploratory analysis of a previously published 12-week prospective, non-randomized comparative study including 60 patients with obesity treated with TZP (n = 30 TZP+Low Energy Ketogenic Therapy [LEKT]; n = 30 TZP+Low Calorie Diet [LCD]). Body weight (BW), fat mass (FM), FFM, MS, and RMR were assessed at baseline and week 12. Glycaemic parameters included fasting glucose, insulin, hemoglobin A1c (HbA1c), and HOMA-IR. All analyses were exploratory and hypothesis-generating. Results: Both groups achieved comparable reductions in BW after 12 weeks. FM decreased in both groups, while relative preservation of FFM, MS, and RMR was observed in one dietary context. Short-term changes in HbA1c, insulin, and HOMA-IR were statistically associated with concurrent changes in FFM, MS, and RMR, whereas no consistent associations were observed with changes in total BW or FM. Baseline glycaemic values were largely within the normoglycemic range. Conclusions: In this short-term secondary exploratory analysis, preservation of metabolically active tissue during TZP therapy was associated with concurrent glycaemic profiles, whereas no consistent associations were observed with total weight loss magnitude. These findings do not imply causality and should be interpreted as hypothesis-generating, warranting confirmation in larger, randomized, long-term studies. Full article

Background: Chronic low-grade inflammation plays a central role in the pathogenesis of type 2 diabetes (T2DM) and its complications. Neopterin, a marker of macrophage activation and Th1-mediated immune response, has been associated with cardiovascular disease and metabolic disorders. However, its relationship with diabetic autonomic neuropathy remains insufficiently investigated. Methods: We conducted a cross-sectional study including 129 participants (93 with T2DM and 36 with obesity without carbohydrate disturbances). Clinical, anthropometric, and biochemical assessments were performed. Cardiovascular autonomic neuropathy was evaluated using Ewing cardiovascular reflex tests and sudomotor dysfunction scoring. Neopterin concentrations were measured in serum. Correlation, ROC, and logistic regression analyses were performed. Results: Neopterin levels were not significantly different between T2DM and obesity groups. No differences were observed in patients with versus without peripheral neuropathy, nephropathy, or retinopathy. However, neopterin levels were significantly higher in individuals with cardiovascular autonomic neuropathy (p = 0.013). Neopterin correlated with cardiovascular autonomic neuropathy score, sudomotor dysfunction, fasting glucose, fasting insulin, and HOMA-IR. It showed a moderate negative monotonic correlation with eGFR (Spearman’s rho = −0.41, p< 0.001). In multivariable logistic regression adjusted for age, HbA1c, BMI, eGFR, and diabetes duration, each 1-SD increase in neopterin was associated with 2.67-fold higher odds of cardiovascular autonomic neuropathy (95% CI 1.21–5.89; p = 0.015). Conclusions: Circulating neopterin is independently associated with cardiovascular autonomic neuropathy in T2DM but not with classical microvascular complications. These findings suggest a potential role of immune-mediated mechanisms in the pathogenesis of diabetic cardiovascular autonomic neuropathy. Full article

Background: Altered gut microbiota and gut-derived inflammation impair glucose regulation and promote metabolic endotoxemia, yet evidence on probiotic effects across combined glycaemic, inflammatory and short-chain fatty acid (SCFA) outcomes remains limited. This study investigated the effects of a 12-week multi-species probiotic on glucose homeostasis, incretin hormones, inflammatory biomarkers and circulating SCFAs in adults with subthreshold depression. Methods: In a 12-week double-blind, randomised, placebo-controlled trial, 39 adults with subthreshold depression were allocated to either a probiotic supplement containing Limosilactobacillus fermentum LF16, Lacticaseibacillus rhamnosus LR06, Lactiplantibacillus plantarum LP01 and Bifidobacterium longum 04 (n = 19) or placebo (n = 20). Fasting glucose, insulin, HOMA-IR, glucose-dependent insulinotropic peptide (GIP), high-sensitivity C-reactive protein (hs-CRP), lipopolysaccharide-binding protein (LBP), soluble CD14 (sCD14) and SCFAs were evaluated at three time points: baseline, week 6 and week 12. Between-group and treatment × time effects were analysed using general linear models. Results: Probiotic supplementation significantly reduced fasting glucose at 12 weeks compared with placebo (−1.8 vs. 0.1 mmol/L; p = 0.036). In the probiotic group, greater reductions in GIP (p = 0.012; p = 0.037), LBP (p < 0.001), sCD14 (p = 0.002; p = 0.001) and hs-CRP (p = 0.047) were also observed compared with placebo. Plasma SCFA concentrations remained largely unchanged, with no significant treatment × time interactions, except for higher valerate levels at 12 weeks in the probiotic group (p = 0.019). Conclusions: Twelve weeks of multi-species probiotic supplementation improved fasting glucose, reduced incretin and inflammatory biomarkers and attenuated metabolic endotoxemia, without alterations in circulating SCFAs. These findings support beneficial modulation of metabolic–immune pathways and highlight the promising role of probiotics to enhance glucose regulation and systemic inflammatory tone in adults with subthreshold depression. Full article

Obesity represents a heterogeneous metabolic disorder characterized by substantial interindividual variation in inflammatory status, insulin sensitivity, and cardiometabolic risk. Traditional anthropometric measures fail to capture this metabolic diversity, limiting risk stratification and personalized intervention strategies. This review critically examines nutritional and metabolic biomarkers that reflect the physiological dysregulation underlying obesity, including adipokines (leptin, adiponectin, resistin), inflammatory markers (C-reactive protein, interleukin-6, TNF-α), insulin resistance indices (HOMA-IR, fasting insulin, HbA1c), and lipid metabolism indicators (LDL cholesterol, triglycerides, HDL cholesterol, and liver enzymes such as ALT and GGT). Among these, elevated CRP, reduced adiponectin, and increased HOMA-IR have demonstrated the strongest clinical utility for early metabolic risk identification. We further evaluate emerging biomarkers—including circulating microRNAs, gut microbiota-derived metabolites (short-chain fatty acids, TMAO, lipopolysaccharides), and bile acid profiles—which offer additional mechanistic insight into diet–microbiome–host interactions. We systematically assess the mechanistic basis, clinical relevance, and nutritional modulation of each biomarker class, emphasizing how dietary composition—particularly fatty acid quality, fiber intake, and overall dietary patterns such as the Mediterranean diet—influences biomarker profiles and metabolic outcomes. Furthermore, we explore how biomarker-based phenotyping enables precision nutrition approaches by identifying individuals most likely to benefit from specific dietary interventions. Integration of multi-biomarker panels with clinical and genetic data holds promise for advancing from population-based dietary guidelines toward individualized nutrition strategies that optimize metabolic health and prevent obesity-related complications. Future research should prioritize validating biomarker-guided intervention frameworks, establishing standardized thresholds across diverse populations, and developing clinically implementable tools for personalized nutritional medicine. Full article

In this work, Filipendula ulmaria (L.) Maxim, a perennial herbaceous plant from the Rosaceae family, was considered a novel source of obtaining rutin for pharmaceutical purposes. Rutin was extracted from the plant parts collected in the flowering summer period and dried at 40 ± 3 °C. The process was carried out using the ethanol extraction and fractionation of extracted compounds, and it yields the 95 wt% purity crystalline product. The phase composition of the extracted rutin was verified by the XRD analysis and NMR measurements. It was found that 2.85% of rutin could be extracted from Filipendula ulmaria, which is 1.2 times higher than the results of similar studies. The biological activity of the isolated rutin was tested on rats. It was established in vivo that the extracted rutin normalizes blood glucose levels (glucose and glycosylated hemoglobin), insulin resistance (HOMA-IR index) and reduces the severity of dystrophic changes in the liver caused by high-fat and high-carbohydrate diets. The introduction of rutin corrects lipid profile indicators (triglycerides, cholesterol, cholesterol fractions in lipoproteins and atherogenic indices), cytolysis indicators of hepatocytes, and liver steatosis (ALT, AST/ALT, triglycerides). Thus, the novel source of rutin opens the possibility for a wide use of this flavonoid in the food technology and pharmaceutical industry. Full article

Background: Elevated prolactin levels are associated with disturbances in female sexual function. While long-term therapy with dopamine agonists has been shown to improve these disturbances, the therapeutic benefits appear to be reduced in the presence of vitamin D deficiency or insufficiency. Therefore, the present study aimed to examine whether vitamin D status modulates the effects of metformin—a medication with less pronounced prolactin-lowering properties—on sexual function and depressive symptoms. Methods: The study cohort comprised three groups of reproductive-age women with drug-induced hyperprolactinemia and prediabetes, matched for age, glycated hemoglobin, and prolactin concentrations. Group I included 25 women with normal vitamin D status who were not receiving vitamin D supplementation. Group II consisted of 25 women with vitamin D deficiency or insufficiency that was adequately corrected through supplementation, while group III included 25 women with untreated vitamin D deficiency or insufficiency. All participants received metformin throughout the six-month study period. Female sexual function and depressive symptoms were assessed before and after metformin therapy using the Female Sexual Function Index (FSFI) and the Beck Depression Inventory-II (BDI-II), respectively. Additional outcome measures included plasma 25-hydroxyvitamin D, fasting plasma glucose, glycated hemoglobin (HbA_1c), the homeostatic model assessment of insulin resistance (HOMA-IR), prolactin, gonadotropins, and sex hormones. Results: Improvements in glucose homeostasis were observed across all groups; however, these changes were more pronounced in groups I and II than in group III. Reductions in prolactin concentrations (total and monomeric), accompanied by increases in gonadotropins, estradiol, and testosterone, were observed exclusively in women with normal vitamin D status. In groups I and II, metformin therapy resulted in significant improvements in total FSFI scores as well as in all individual domain scores. In contrast, in group III, the effects of metformin were limited to increases in the domain scores for lubrication and sexual satisfaction. Improvements in sexual function were positively associated with baseline 25-hydroxyvitamin D levels, reductions in prolactin concentrations, and, to a lesser extent, treatment-related changes in HbA_1c and increases in testosterone. A treatment-induced reduction in total BDI-II scores was observed only among women with normal vitamin D status. Conclusions: Low vitamin D status diminishes the beneficial effects of metformin on sexual function and depressive symptoms in reproductive-age women with iatrogenic hyperprolactinemia. Full article