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Search Results (297)

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Keywords = cardiometabolic risk indices

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12 pages, 264 KiB  
Article
Discriminative Capacity of Visceral Adiposity and Triglyceride Glucose-Waist Circumference Indices for Metabolic Syndrome in Spanish Adolescents: A Cross-Sectional Study
by Ángel Fernández-Aparicio, Miriam Mohatar-Barba, Javier S. Perona, Jacqueline Schmidt-RioValle, Carmen Flores Navarro-Pérez and Emilio González-Jiménez
Metabolites 2025, 15(8), 535; https://doi.org/10.3390/metabo15080535 - 7 Aug 2025
Abstract
Background/Objectives: Adolescence is a critical period for the early detection of metabolic syndrome (MetS), a condition that increases the risk of cardiometabolic diseases in adulthood. Timely identification of at-risk adolescents enables targeted prevention strategies. This study aimed to analyze the discriminative capacity and [...] Read more.
Background/Objectives: Adolescence is a critical period for the early detection of metabolic syndrome (MetS), a condition that increases the risk of cardiometabolic diseases in adulthood. Timely identification of at-risk adolescents enables targeted prevention strategies. This study aimed to analyze the discriminative capacity and accuracy of six biochemical and/or anthropometric indices related to lipid metabolism and adiposity for the early detection of MetS in a sample of Spanish adolescents. Methods: A cross-sectional study carried out according to the STROBE guidelines. A sample of 981 adolescents aged 11–16 years old were randomly recruited from schools in Southeastern Spain. The presence or absence of MetS was determined according to the International Diabetes Federation criteria. The following biochemical and/or anthropometric indices were evaluated: triglyceride glucose index, visceral adiposity index, logarithm children’s lipid accumulation product, triglyceride glucose-body mass index, triglyceride glucose-waist circumference, and triglyceride glucose-waist-to-hip ratio. Results: The triglyceride glucose-waist-to-hip ratio and triglyceride glucose-body mass index parameters were the strongest indicators associated with MetS in boys and girls, respectively, after adjusting for several factors. Moreover, all evaluated indices showed optimal AUC values, with the visceral adiposity index and triglyceride glucose-waist circumference index exhibiting the highest discriminative capacity in both genders. Conclusions: The evaluated biochemical and anthropometric indices—particularly visceral adiposity index and triglyceride-glucose-waist circumference—show promise as accessible biomarkers for identifying adolescents at metabolic risk. These indices may serve as practical tools in preventive health strategies aimed at improving metabolic health by screening adolescents at risk of MetS, thereby helping to reduce the future burden of non-communicable diseases. Full article
(This article belongs to the Special Issue Effects of Diet on Metabolic Health of Obese People)
16 pages, 424 KiB  
Article
Evaluation of Clinical and Quality of Life Effects of Oral Semaglutide Use in Type 2 Diabetes from a Public Health View: A Prospective Study in Italy
by Paola Pantanetti, Vanessa Ronconi, Stefano Mancin, Cristina De Carolis, Sara Alberti, Orietta Pazzi, Sandra Di Marco, Grazia Michetti, Silvia Coacci, Veronica Mignini, Franco Gregorio, Giulia Baldoni, Sara Toderi, Sara Morales Palomares, Fabio Petrelli, Gabriele Caggianelli, Mauro Parozzi and Giovanni Cangelosi
Diabetology 2025, 6(8), 80; https://doi.org/10.3390/diabetology6080080 - 4 Aug 2025
Viewed by 135
Abstract
Background and Aim: Type 2 diabetes (T2D) continues to pose a significant public health challenge worldwide. Among therapeutic options, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven effective in optimizing glycemic control and improving cardiometabolic profiles. Semaglutide, now available in an oral formulation, [...] Read more.
Background and Aim: Type 2 diabetes (T2D) continues to pose a significant public health challenge worldwide. Among therapeutic options, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven effective in optimizing glycemic control and improving cardiometabolic profiles. Semaglutide, now available in an oral formulation, represents a modern strategy to improve patient adherence while supporting glucose and weight regulation. This study primarily investigated the effects of oral semaglutide on key metabolic indicators and secondary endpoints included cardiovascular risk markers (blood pressure and lipid profile) and patient-reported quality of life (QoL). Study Design and Methods: A longitudinal, prospective observational study was conducted involving patients with T2D across two Italian healthcare facilities. Participants were assessed at baseline (T0) and at three subsequent intervals—6 months (T1), 12 months (T2), and 18 months (T3)—following the initiation of oral semaglutide use. Key Findings: Out of 116 participants enrolled, 97 had complete and analyzable data. Across the 18-month follow-up, significant improvements were observed in glycemic parameters, with a notable reduction in HbA1c levels (T0 vs. T3, p = 0.0028; p ≤ 0.05, statistically significant). Self-reported outcomes showed enhanced quality of life, especially in treatment satisfaction and perceived flexibility (T0 vs. T3, p < 0.001). Conclusions: Daily administration of 14 mg oral semaglutide in individuals with T2D resulted in substantial benefits in glycemic regulation, weight reduction, cardiovascular risk management, and overall patient satisfaction. These findings reinforce its potential role as a sustainable and effective option in long-term diabetes care from both a clinical and public health perspective. Full article
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15 pages, 976 KiB  
Article
Endocannabinoid and AGE Interactions in Prediabetes: The Role of Mediterranean Diet Adherence
by Marko Grahovac, Marko Kumric, Marino Vilovic, Daniela Supe-Domic, Nikola Pavlovic, Josipa Bukic, Tina Ticinovic Kurir and Josko Bozic
Nutrients 2025, 17(15), 2517; https://doi.org/10.3390/nu17152517 - 31 Jul 2025
Viewed by 254
Abstract
Objectives: To determine whether plasma concentrations of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) are elevated in adults with prediabetes, we explored their association with tissue advanced glycation end-products (AGEs) and assessed the influence of Mediterranean diet adherence. Methods: This cross-sectional single-centre study [...] Read more.
Objectives: To determine whether plasma concentrations of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) are elevated in adults with prediabetes, we explored their association with tissue advanced glycation end-products (AGEs) and assessed the influence of Mediterranean diet adherence. Methods: This cross-sectional single-centre study included 92 adults with prediabetes and 86 age-/sex-matched normoglycaemic controls. Anthropometry, blood pressure, biochemical indices, and skin autofluorescence-derived AGEs were measured. Serum AEA and 2-AG were quantified by competitive ELISA, while Mediterranean diet adherence was assessed using the Mediterranean Diet Serving Score (MDSS). Results: Prediabetes was associated with higher AEA (p = 0.004) but not 2-AG (p = 0.520). Also, AEA correlated positively with AGE values (r = 0.36; p = 0.002) and increased across AGE-based cardiovascular risk categories. In multivariable models, both prediabetes status and AGE burden independently predicted AEA. Participants achieving MDSS ≥ 14 exhibited lower AEA (p = 0.038); 2-AG remained unaffected. Finally, the multivariable analysis confirmed that both prediabetes (β = 11.9; p = 0.005) and AGE values (β = 0.25; p = 0.003) are positively associated with plasma AEA levels, independent of age, sex, BMI, and fasting plasma glucose levels. Conclusions: Circulating AEA, but not 2-AG, is elevated in prediabetes and independently linked to cumulative AGE burden, suggesting early endocannabinoid activation contributes to cardiometabolic risk. High adherence to a Mediterranean diet may mitigate this dysregulation. Full article
(This article belongs to the Section Nutrition and Diabetes)
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26 pages, 2591 KiB  
Systematic Review
Effect of Polyphenol-Rich Interventions on Gut Microbiota and Inflammatory or Oxidative Stress Markers in Adults Who Are Overweight or Obese: A Systematic Review and Meta-Analysis
by Álvaro González-Gómez, Martina Cantone, Ana María García-Muñoz, Desirée Victoria-Montesinos, Carmen Lucas-Abellán, Ana Serrano-Martínez, Alejandro M. Muñoz-Morillas and Juana M. Morillas-Ruiz
Nutrients 2025, 17(15), 2468; https://doi.org/10.3390/nu17152468 - 29 Jul 2025
Viewed by 450
Abstract
Background/Objectives: Being overweight and obesity are major public health concerns that demand effective nutritional strategies for weight and body composition management. Beyond excess weight, these conditions are closely linked to chronic inflammation, oxidative stress, and gut dysbiosis, all of which contribute to cardiometabolic [...] Read more.
Background/Objectives: Being overweight and obesity are major public health concerns that demand effective nutritional strategies for weight and body composition management. Beyond excess weight, these conditions are closely linked to chronic inflammation, oxidative stress, and gut dysbiosis, all of which contribute to cardiometabolic risk. Polyphenols—bioactive compounds in plant-based foods—may support improvements in body composition and metabolic health by modulating gut microbiota, reducing oxidative stress, and suppressing inflammation. This systematic review and meta-analysis aimed to evaluate the effects of polyphenol-rich interventions on gut microbiota composition, in combination with either oxidative stress or inflammatory biomarkers, and their potential impact on body composition in overweight or obese adults. Methods: A systematic search of PubMed, Scopus, Cochrane, and Web of Science was conducted through May 2025. Eligible randomized controlled trials included adults (BMI ≥ 25 kg/m2) receiving polyphenol-rich interventions, with reported outcomes on gut microbiota and at least one inflammatory or oxidative stress biomarker. Standardized mean differences (SMDs) were pooled using a random-effects model. Results: Thirteen trials (n = 670) met inclusion criteria. Polyphenol supplementation significantly reduced circulating lipopolysaccharides (LPSs; SMD = −0.56; 95% CI: −1.10 to −0.02; p < 0.04), indicating improved gut barrier function. Effects on cytokines (IL-6, TNF-α) and CRP were inconsistent. Catalase activity improved significantly (SMD = 0.79; 95% CI: 0.30 to 1.28; p < 0.001), indicating enhanced antioxidant defense. Gut microbiota analysis revealed increased butyrate (SMD = 0.57; 95% CI: 0.18 to 0.96; p < 0.001) and acetate (SMD = 0.42; 95% CI: 0.09 to 0.75; p < 0.01), supporting prebiotic effects. However, no significant changes were observed in BMI or body weight. Conclusions: Polyphenol supplementation in overweight or obese adults may reduce metabolic endotoxemia, boost antioxidant activity, and promote SCFAs production. Effects on inflammation and body weight remain unclear. Further long-term trials are needed. Full article
(This article belongs to the Special Issue Dietary Assessments for Weight Management)
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15 pages, 470 KiB  
Review
The Visceral Adiposity Index and Its Usefulness in the Prediction of Cardiometabolic Disorders
by Grzegorz K. Jakubiak, Georgian Badicu, Stanisław Surma, Ewa Waluga-Kozłowska, Artur Chwalba and Natalia Pawlas
Nutrients 2025, 17(14), 2374; https://doi.org/10.3390/nu17142374 - 20 Jul 2025
Viewed by 704
Abstract
Obesity is currently one of the most critical public health problems. Although there is no doubt that obesity is a significant risk factor for developing metabolic disorders, this relationship is not completely straightforward. On the one hand, some patients affected by obesity are [...] Read more.
Obesity is currently one of the most critical public health problems. Although there is no doubt that obesity is a significant risk factor for developing metabolic disorders, this relationship is not completely straightforward. On the one hand, some patients affected by obesity are metabolically unhealthy, while others are metabolically healthy; on the other hand, metabolic syndrome (MetS) can also occur in people with a normal body weight. A commonly used tool for diagnosing obesity is the body mass index (BMI), but the search for better anthropometric measures is ongoing due to the significant limitations of this measure. Obesity can lead to MetS and cardiovascular diseases (CVDs). Adipose tissue dysfunction is the fundamental mechanism linking obesity and cardiometabolic diseases, which is rooted in the disturbed secretion of adipokines. The visceral adiposity index (VAI) is calculated based on the BMI, waist circumference (WC), blood triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) concentrations. It was proposed in 2010 by Amato et al. as a parameter indicating adipose tissue dysfunction and cardiometabolic risk. According to the research conducted so far, some data confirm a relationship between the VAI value and the risk of developing prediabetes, diabetes, insulin resistance, fatty liver disease, MetS, CVD, and chronic kidney disease. Further research is needed to support the implementation of VAI assessment in routine clinical practice. The purpose of this paper is to present the results of a narrative literature review summarizing current knowledge regarding the VAI and its usefulness in clinical practice for assessing cardiometabolic risk. Full article
(This article belongs to the Special Issue Nutritional and Hormonal Pathways in Metabolic Disease)
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11 pages, 285 KiB  
Article
Age-Related Trends in Dual-Energy X-Ray Absorptiometry–Measured Adiposity and Their Clinical Relevance: A Multicenter Cross-Sectional Study of Korean Peri- and Postmenopausal Women
by Jung Yoon Park, Hyoung Moo Park, Youn-Jee Chung, Mee-Ran Kim, Kyung Jin Hwang and Jae-Yen Song
Medicina 2025, 61(7), 1301; https://doi.org/10.3390/medicina61071301 - 19 Jul 2025
Viewed by 306
Abstract
Background and Objectives: Body composition changes with aging and menopause, often leading to increased adiposity and a shift in fat distribution. While BMI is commonly used in clinical practice, it does not accurately reflect fat mass or distribution. This study aims to evaluate [...] Read more.
Background and Objectives: Body composition changes with aging and menopause, often leading to increased adiposity and a shift in fat distribution. While BMI is commonly used in clinical practice, it does not accurately reflect fat mass or distribution. This study aims to evaluate age-related changes in both total and regional adiposity using DXA-derived indices in Korean women aged ≥ 40 years and to assess the limitations of BMI-based obesity classification. Materials and Methods: This retrospective multicenter study analyzed the DXA scans and clinical records of 914 Korean women aged 40–80 years who attended menopause clinics across multiple institutions between 2018 and 2021. We analyzed five adiposity indices: body mass index (BMI), total body fat percentage (TB%F), fat mass index (FMI), visceral adipose tissue (VAT) area, and android-to-gynoid (A/G) fat ratio. Excess adiposity was defined as BMI ≥ 23 kg/m2, TB%F ≥ 40%, FMI ≥ 9 kg/m2, VAT > 100 cm2, or A/G ratio > 1.0. Age group comparisons were made using ANOVA, and misclassification was assessed by comparing BMI with other indices. Results: Mean BMI increased with age, peaking in the 60s before declining in the 70s. TB%F and FMI peaked in the 50s, while VAT and A/G ratio increased continuously with age. Excess adiposity was found in 41.9% of women by TB%F, 40.5% by FMI, and 59.4% by VAT in the 70s. Notably, 22% of women with normal BMI (<23 kg/m2) had VAT > 100 cm2, and 35.7% had A/G > 1.0, indicating central obesity. Conclusions: DXA-based indices provide a more accurate assessment of adiposity and associated cardiometabolic risks in aging women than BMI alone. Clinical screening strategies should consider incorporating regional fat distribution markers, particularly in midlife and postmenopausal populations, to better identify individuals at risk. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
17 pages, 3908 KiB  
Article
Metagenomic Characterization of Gut Microbiota in Individuals with Low Cardiovascular Risk
by Argul Issilbayeva, Samat Kozhakhmetov, Zharkyn Jarmukhanov, Elizaveta Vinogradova, Nurislam Mukhanbetzhanov, Assel Meiramova, Yelena Rib, Tatyana Ivanova-Razumova, Gulzhan Myrzakhmetova, Saltanat Andossova, Ayazhan Zeinoldina, Malika Kuantkhan, Bayan Ainabekova, Makhabbat Bekbossynova and Almagul Kushugulova
J. Clin. Med. 2025, 14(14), 5097; https://doi.org/10.3390/jcm14145097 - 17 Jul 2025
Viewed by 403
Abstract
Background/Objectives: Cardiovascular diseases remain the leading cause of global mortality, with the gut microbiome emerging as a critical factor. This study aimed to characterize gut microbiome composition and metabolic pathways in individuals with low cardiovascular risk (LCR) compared to healthy controls to reveal [...] Read more.
Background/Objectives: Cardiovascular diseases remain the leading cause of global mortality, with the gut microbiome emerging as a critical factor. This study aimed to characterize gut microbiome composition and metabolic pathways in individuals with low cardiovascular risk (LCR) compared to healthy controls to reveal insights into early disease shifts. Methods: We performed shotgun metagenomic sequencing on fecal samples from 25 LCR individuals and 25 matched healthy controls. Participants underwent a comprehensive cardiovascular evaluation. Taxonomic classification used MetaPhlAn 4, and functional profiling employed HUMAnN 3. Results: Despite similar alpha diversity, significant differences in bacterial community structure were observed between groups (PERMANOVA, p < 0.05). The LCR group showed enrichment of Faecalibacterium prausnitzii (p = 0.035), negatively correlating with atherogenic markers, including ApoB (r = −0.3, p = 0.025). Conversely, Fusicatenibacter saccharivorans positively correlated with ApoB (r = 0.4, p = 0.006). Metabolic pathway analysis revealed upregulation of nucleotide biosynthesis, glycolysis, and sugar degradation pathways in the LCR group, suggesting altered metabolic activity. Conclusions: We identified distinct gut microbiome signatures in LCR individuals that may represent early alterations associated with cardiovascular disease development. The opposing correlations between F. prausnitzii and F. saccharivorans with lipid parameters highlight their potential roles in cardiometabolic health. These findings suggest gut microbiome signatures may serve as indicators of early metabolic dysregulation preceding clinically significant cardiovascular disease. Full article
(This article belongs to the Section Cardiovascular Medicine)
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36 pages, 1400 KiB  
Review
Molecular Insights into the Potential Cardiometabolic Effects of GLP-1 Receptor Analogs and DPP-4 Inhibitors
by Małgorzata Król, Patrycja Kupnicka, Justyna Żychowska, Patrycja Kapczuk, Izabela Szućko-Kociuba, Eryk Prajwos and Dariusz Chlubek
Int. J. Mol. Sci. 2025, 26(14), 6777; https://doi.org/10.3390/ijms26146777 - 15 Jul 2025
Viewed by 447
Abstract
Cardiovascular diseases (CVDs) are the leading cause of global mortality, with type 2 diabetes mellitus (T2DM) and obesity significantly increasing the risk of CVD. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4is) have gained attention for their potential cardioprotective effects. [...] Read more.
Cardiovascular diseases (CVDs) are the leading cause of global mortality, with type 2 diabetes mellitus (T2DM) and obesity significantly increasing the risk of CVD. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4is) have gained attention for their potential cardioprotective effects. Therefore, this review aims to explore the molecular mechanisms underlying the cardiovascular benefits of these agents. A literature review was conducted searching PubMed databases from 1990 to January 2025, including research on the effects of GLP-1 RA and DPP-4i on cardiovascular health, specifically concerning atherosclerosis, coronary artery disease, vascular health, cardiac arrhythmias, myocardial infarction (MI), and heart failure, with a focus on the biochemical and molecular effects of these drugs. We analyzed 131 scientific publications, which indicate that GLP-1 RA and DPP-4i significantly reduce cardiovascular risk and major adverse cardiovascular events (MACEs), including atherosclerosis, myocardial infarction, and cardiac arrhythmias. These clinical outcomes are attributed to the mitigation of oxidative stress, inflammation, and endothelial dysfunction as well as improvement in mitochondrial function and lipid metabolism. GLP-1 RAs offer substantial cardiovascular benefits, making them valuable in managing T2DM and reducing CVD risk. Their integration into treatment regimens for CVD can reduce hospitalization rates, improve quality of life, and extend life expectancy. DPP-4is, while beneficial, are less effective in cardiovascular protection. Further research is needed to optimize therapeutic strategies and broaden the clinical application of these agents in cardiometabolic care. Full article
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19 pages, 1172 KiB  
Article
Serum Osteopontin and Procollagen Type 1 N-Terminal Propeptide Concentrations: Links to Liver Function, Muscle Mass, and Bone Mineral Density in MASLD and Hypertension
by Anna F. Sheptulina, Anastasia Yu. Elkina, Elvira M. Mamutova, Yuriy S. Timofeev, Victoria A. Metelskaya and Oxana M. Drapkina
Metabolites 2025, 15(7), 459; https://doi.org/10.3390/metabo15070459 - 6 Jul 2025
Viewed by 457
Abstract
Background/Objectives: Increasing evidence suggests that metabolic dysfunction-associated steatotic liver disease (MASLD) and hypertension (HTN), a well-established cardiometabolic risk factor, both negatively impact bone metabolism. This study aimed to investigate the associations between bone turnover markers (BTMs)—namely, osteopontin (OPN) and procollagen type 1 N-terminal [...] Read more.
Background/Objectives: Increasing evidence suggests that metabolic dysfunction-associated steatotic liver disease (MASLD) and hypertension (HTN), a well-established cardiometabolic risk factor, both negatively impact bone metabolism. This study aimed to investigate the associations between bone turnover markers (BTMs)—namely, osteopontin (OPN) and procollagen type 1 N-terminal propeptide (P1NP)—and metabolic health indicators, non-invasive measures of liver disease severity, as well as skeletal muscle mass (SMM), muscle strength, and bone mineral density (BMD) in patients with MASLD and HTN. Methods: We enrolled 117 patients diagnosed with MASLD and HTN and conducted anthropometric measurements, laboratory analyses, abdominal ultrasound, and point shear-wave elastography. Muscle strength was evaluated using grip strength measurements and the Five Times Sit-to-Stand Test (FTSST). SMM and BMD were quantified using dual-energy X-ray absorptiometry (DEXA). Serum OPN and P1NP concentrations were quantified using enzyme-linked immunosorbent assays (ELISAs). Results: Serum OPN concentrations below 2.89 ng/mL were associated with significantly elevated levels of AST (p = 0.001), ALT (p = 0.006), and GGT (p = 0.025), while serum P1NP concentrations above 47.5 pg/mL were associated only with significantly elevated GGT levels (p = 0.024). In addition, patients with MASLD and HTN with lower serum OPN levels had higher liver stiffness values (p = 0.003). Serum OPN concentrations were inversely associated with the following metabolic health indicators: waist circumference (WC, p < 0.001) and epicardial fat thickness (EFT, p = 0.001). In addition, they were significantly elevated in patients with MASLD and HTN who had decreased spinal BMD (p = 0.017). In turn, serum P1NP levels were reduced in patients with decreased SMM (p = 0.023). Conclusions: These findings in patients with MASLD and HTN suggest an association between serum P1NP levels and SMM, and between OPN levels and spinal BMD, indicating a potential interplay among liver function, muscle mass, and bone health. Furthermore, OPN appeared to be strongly associated with overall metabolic health indicators, such as WC and EFT, whereas P1NP exhibited a stronger association with muscle mass. Full article
(This article belongs to the Section Endocrinology and Clinical Metabolic Research)
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19 pages, 1522 KiB  
Article
Assessing Metabolic Syndrome Risk in Children and Adolescents with Prader–Willi Syndrome: A Comparison of Index Performance
by Graziano Grugni, Fiorenzo Lupi, Mirko Bonetti, Sarah Bocchini, Carmen Bucolo, Domenico Corica, Antonino Crinò, Maria Felicia Faienza, Danilo Fintini, Maria Rosaria Licenziati, Mohamad Maghnie, Enza Mozzillo, Roberta Pajno, Giuseppe Zampino, Alessandro Sartorio and Giorgio Radetti
J. Clin. Med. 2025, 14(13), 4716; https://doi.org/10.3390/jcm14134716 - 3 Jul 2025
Viewed by 424
Abstract
Background: Currently, there is a lack of data regarding the reliability of different anthropometric, instrumental, and biochemical indexes in detecting metabolic syndrome (MetS) in pediatric patients with Prader–Willi syndrome (PWS). Therefore, this study aimed to compare the accuracy of different indices to identify [...] Read more.
Background: Currently, there is a lack of data regarding the reliability of different anthropometric, instrumental, and biochemical indexes in detecting metabolic syndrome (MetS) in pediatric patients with Prader–Willi syndrome (PWS). Therefore, this study aimed to compare the accuracy of different indices to identify the simplest and most accurate predictor of MetS in this at-risk population. Methods: We conducted a multicenter study involving 124 children and adolescents with PWS (61 males and 63 females), aged 13.6 ± 3.7 years. For each participant, we assessed all components of MetS, defined according to either the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study or the International Diabetes Federation (IDF) criteria, based on age. The following indexes were calculated: Body Mass Index (BMI), BMI standard deviation score (BMI-SDS), tri-ponderal mass index, body mass fat index, fat mass index, fat-free mass index, body shape index, visceral adiposity index, waist-to-height ratio, cardiometabolic index, total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, and triglycerides/HDL-C (TG/HDL-C) ratio. Results: MetS was identified in 24 subjects (9 females and 15 males), representing 19.4% of the sample. When comparing the receiver operating characteristic (ROC) curves, the TG/HDL-C ratio and cardiometabolic index demonstrated significantly better performance than the other indices in detecting MetS, with no difference between the two. As a result, we focused on the TG/HDL-C ratio since it is the simplest measure, requiring no additional anthropometric data compared to the cardiometabolic index. Additionally, applying age- and gender-specific thresholds can further improve its accuracy. Conclusions: The TG/HDL-C ratio, which requires only two standard biochemical markers, provides the same accuracy as more complex indexes in detecting MetS in children and adolescents with PWS, making it the optimal predictor for MetS in this population. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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17 pages, 465 KiB  
Article
Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices
by Javier Tosoratto, Pedro Juan Tárraga López, Ángel Arturo López-González, Carla Busquets-Cortes, Joan Obrador de Hevia and José Ignacio Ramirez-Manent
J. Clin. Med. 2025, 14(13), 4604; https://doi.org/10.3390/jcm14134604 - 29 Jun 2025
Viewed by 446
Abstract
Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified [...] Read more.
Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance—TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)—in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p < 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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37 pages, 5417 KiB  
Article
The Interplay of Cardiometabolic Syndrome Phenotypes and Cardiovascular Risk Indices in Patients Diagnosed with Diabetes Mellitus
by Daniela Denisa Mitroi Sakizlian, Lidia Boldeanu, Adina Mitrea, Diana Clenciu, Ionela Mihaela Vladu, Alina Elena Ciobanu Plasiciuc, Andra Veronica Șarla, Isabela Siloși, Mihail Virgil Boldeanu, Mohamed-Zakaria Assani and Daniela Ciobanu
Int. J. Mol. Sci. 2025, 26(13), 6227; https://doi.org/10.3390/ijms26136227 - 27 Jun 2025
Viewed by 550
Abstract
Metabolic syndrome (MetS) and its associated cardiometabolic phenotypes significantly contribute to the global burden of cardiovascular disease (CVD), especially in individuals with type 2 diabetes mellitus (T2DM) and prediabetes. This study aimed to explore the association between cardiometabolic phenotypes—specifically, metabolically unhealthy normal weight [...] Read more.
Metabolic syndrome (MetS) and its associated cardiometabolic phenotypes significantly contribute to the global burden of cardiovascular disease (CVD), especially in individuals with type 2 diabetes mellitus (T2DM) and prediabetes. This study aimed to explore the association between cardiometabolic phenotypes—specifically, metabolically unhealthy normal weight (MUHNW) and metabolically unhealthy obese (MUHO)—and various cardiovascular risk indices including the triglyceride-glucose (TyG) index and its derivatives, the atherogenic index of plasma (AIP), the cardiometabolic index (CMI), and the cardiac risk ratio (CRR). A total of 300 participants were evaluated (100 with prediabetes and 200 with T2DM). Anthropometric, biochemical, and lifestyle parameters were assessed and stratified across phenotypes. The results demonstrated that cardiovascular risk indices were significantly elevated in the MUHO compared to MUHNW phenotypes, with T2DM patients consistently exhibiting higher risk profiles than their prediabetic counterparts. TyG-derived indices showed strong correlations with BMI, waist–hip ratio (WHR), waist–height ratio (WHtR), and body fat percentage (%BF). The findings suggest that cardiometabolic phenotypes are more strongly associated with elevated cardiometabolic risk indices than body weight alone. These indices may enhance early risk stratification and intervention efforts. The study investigates the association of cardiometabolic phenotypes with surrogate cardiovascular risk indices, not direct CVD outcomes, However, the cross-sectional design and population homogeneity limit the generalizability of the results and preclude causal inference. Full article
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16 pages, 5964 KiB  
Article
Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization
by Peijiang Pan, Hao Liang and Mingli Li
Curr. Issues Mol. Biol. 2025, 47(7), 494; https://doi.org/10.3390/cimb47070494 - 27 Jun 2025
Viewed by 337
Abstract
The causal nature of sex hormone-binding globulin (SHBG) in the pathogenesis of stroke remains uncertain. We explored whether SHBG levels are causally associated with stroke via cardiometabolic traits. A network two-sample Mendelian randomization (MR) study was conducted to determine the mediating roles of [...] Read more.
The causal nature of sex hormone-binding globulin (SHBG) in the pathogenesis of stroke remains uncertain. We explored whether SHBG levels are causally associated with stroke via cardiometabolic traits. A network two-sample Mendelian randomization (MR) study was conducted to determine the mediating roles of cardiometabolic traits in the causal effects of SHBG levels on stroke subtypes. Further two-sample MR analyses were performed to explore the inverse associations between significant cardiometabolic mediators and SHBG levels. The MR results indicated a protective effect of genetically increased SHBG levels on any stroke (odd ratio [OR] = 0.941; 95% confidence interval [CI]: 0.898, 0.984), any ischemic stroke (OR = 0.951; 95% CI: 0.922, 0.981), and small-vessel stroke (OR = 0.871; 95% CI: 0.765, 0.977). Moreover, genetically elevated SHBG levels were associated with lower waist circumference (WC, β = −0.091; 95% CI: −0.136, −0.046), waist-to-hip ratio (WHR, β = −0.057; 95% CI: −0.084, −0.030), triglycerides (TG, β = −0.188; 95% CI: −0.249, −0.127), systolic blood pressure (β = −0.799; 95% CI: −1.068, −0.530), and diastolic blood pressure (β = −0.436; 95% CI: −0.605, −0.267), and a reduced risk of type 2 diabetes mellitus (OR = 0.684; 95% CI: 0.400, 0.968) in both the discovery and replication datasets. The proportions of such cardiometabolic traits that mediated the causal effects of SHBG levels on any stroke, any ischemic stroke, or small-vessel stroke ranged from 17.8% to 52.7%; while the mediating effects of SHBG levels on the causal associations between WC, WHR, and TG and stroke ranged from 18.4% to 68.3%. Our findings suggest a protective effect of genetically elevated SHBG levels on stroke risk via key cardiometabolic mediators, primarily WC, WHR, and TG. The mediating roles of SHBG levels in the causal links from WC, WHR and TG to stroke risk were also established. These pathways support SHBG as a potential biomarker and therapeutic target in stroke prevention. Full article
(This article belongs to the Collection Bioinformatics Approaches to Biomedicine)
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12 pages, 258 KiB  
Article
The Effectiveness of Novel e-Health Applications for the Management of Obesity in Childhood and Adolescence During the COVID-19 Outbreak in Greece
by Eleni Ramouzi, George Paltoglou, Diamanto Koutaki, Maria Manou, Christos Papagiannopoulos, Athanasia Tragomalou, Aikaterini Vourdoumpa, Penio Kassari and Evangelia Charmandari
Nutrients 2025, 17(13), 2142; https://doi.org/10.3390/nu17132142 - 27 Jun 2025
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Abstract
Background/Objectives: The prevalence of childhood obesity has recently increased, particularly during the COVID-19 pandemic, owing to lifestyle changes as a result of public health regulations and guidelines introduced by governments worldwide. The aim of our study was to evaluate the impact of [...] Read more.
Background/Objectives: The prevalence of childhood obesity has recently increased, particularly during the COVID-19 pandemic, owing to lifestyle changes as a result of public health regulations and guidelines introduced by governments worldwide. The aim of our study was to evaluate the impact of novel e-Health applications in addressing childhood obesity prior to and during the COVID-19 pandemic. Methods: The study was conducted as part of the four-year European project BigO (Horizon2020, No.727688). A total of 86 children and adolescents with overweight and obesity (mean age ± standard error of the mean: 11.82 ± 0.25 years; 49 males, 37 females; 31 prepubertal, 55 pubertal) were studied prospectively for 1 year prior to the pandemic (non-COVID-19 group, n = 50) and during the pandemic (COVID-19 group, n = 36). Based on the body mass index (BMI), subjects were classified as having morbid obesity (n = 40, 46,51%) obesity (n = 21, 24.42%), overweight (n = 22, 25.58%), and normal ΒΜΙ (n = 3, 3.49%) according to the International Obesity Task Force cut-off points. The data collection system utilized the BigO technology platform, which connects to a smartphone and smartwatch to objectively record each patient’s diet, sleep, and physical activity. Participants used the BigO system continuously for 4 weeks and wore the smartwatch for specific periods during the week. Subsequently, they entered a personalized, multidisciplinary lifestyle intervention program for 4 months and used the system again for 4 weeks. Results: The key finding was a significantly higher improvement rate in BMI category among children and adolescents during the COVID-19 pandemic (58.3%) compared to before the pandemic (36%). Both groups showed significant reductions in BMI, BMI z-score, insulin resistance indices (homeostatic model assessment and quantitative insulin sensitivity check index), blood pressure, gamma-glutamyl transferase, and insulin concentrations, alongside increases in high-density lipoprotein cholesterol (p < 0.01). Notably, the COVID-19 group experienced a significantly greater reduction in BMI z-score at 12 months compared to the non-COVID-19 group (p < 0.05). Conclusions: Our results reveal that the COVID-19 group demonstrated better compliance with lifestyle interventions and experienced more significant improvements in cardiometabolic risk factors. This suggests that the innovative e-Health applications were successful in managing childhood obesity despite the challenges caused by the COVID-19 pandemic. Full article
13 pages, 1942 KiB  
Article
MAFLD as a Cardiovascular Risk Factor: An Extended Retrospective Study with a Control Group
by Małgorzata Szymala-Pędzik, Marcin Piersiak, Maciej Pachana, Karolina Lindner-Pawłowicz, Wioletta Szczepaniak and Małgorzata Sobieszczańska
J. Clin. Med. 2025, 14(12), 4181; https://doi.org/10.3390/jcm14124181 - 12 Jun 2025
Viewed by 528
Abstract
Background/Objectives: Fatty liver disease (FLD) is currently the most common liver disorder, affecting 25–30% of the global population. Its occurrence is strongly associated with overweight, obesity, and type 2 diabetes. In 2020, the disease definition was revised from NAFLD (non-alcoholic fatty liver [...] Read more.
Background/Objectives: Fatty liver disease (FLD) is currently the most common liver disorder, affecting 25–30% of the global population. Its occurrence is strongly associated with overweight, obesity, and type 2 diabetes. In 2020, the disease definition was revised from NAFLD (non-alcoholic fatty liver disease) to MAFLD (metabolic-associated fatty liver disease), emphasizing its link to metabolic dysfunction and marking a major shift in clinical evaluation and risk stratification. We assessed the association between MAFLD and cardiovascular risk factors in a geriatric population by comparing patients with and without fatty liver disease and evaluating the influence of selected metabolic and echocardiographic parameters on MAFLD prevalence. Methods: This retrospective study was conducted using data from patients treated at the Department of Geriatrics, the University Clinical Hospital, in Wrocław. The study included 237 patients diagnosed with fatty liver disease and 148 controls without liver pathology. The groups were compared in terms of comorbidities, laboratory abnormalities, body mass index (BMI), and left ventricular hypertrophy. Statistical analysis was performed to assess the association between the severity of selected variables and the risk of MAFLD. Results: Patients with MAFLD had significantly higher body weight and BMI compared to controls. Diabetes mellitus and hypertriglyceridemia were more frequent in the MAFLD group, whereas HDL and vitamin D3 levels were lower. Echocardiographic indicators of left ventricular hypertrophy [IVSd, LVPWd, (IVSd + LVPWd)/2] were significantly elevated in MAFLD patients. Conclusions: This study confirms a strong association between MAFLD and cardiovascular risk factors in elderly patients. The inclusion of a control group allowed for more precise evaluation, supporting the role of MAFLD as an independent cardiometabolic risk indicator in geriatric care. Full article
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