Search Results (90)

Background: High-chloride solutions such as 0.9% saline are widely used for medication dilution in intensive care units (ICUs) and are an underrecognized source of hyperchloremia and acid–base disturbances. Excess chloride reduces the strong ion difference (SID), contributing to hyperchloremic metabolic acidosis and worse clinical outcomes. This study evaluated the impact of replacing isotonic saline with 5% dextrose as a diluent on ICU outcomes in mechanically ventilated patients. Methods: In this retrospective cohort study, 4347 adult ICU patients requiring ≥12 h of mechanical ventilation were analyzed across two periods with different diluent strategies (2015–2018: saline-based; 2019–2025: chloride-sparing, dextrose-based). Demographics, comorbidities, illness severity (APACHE II, SOFA), fluid exposure, SID, and laboratory values over the first 48 h were compared. Predictors of mortality were identified using multivariate logistic regression. Results: Mortality decreased from 44.6% to 39.2% after adoption of chloride-sparing diluents (absolute reduction 5.4%, p = 0.003), despite similar renal function across periods. The later cohort demonstrated significantly higher SID (median 39 vs. 38 mmol/L; p < 0.001), lower chloride levels, and more favorable acid–base profiles. In 2015–2018, chloride showed a strong association with mortality (~12–13% increased odds per mmol/L), while in 2019–2025 the association persisted but was attenuated (~2% per mmol/L). SID emerged as a significant marker of improved acid–base balance after the diluent transition. pH remained the most powerful predictor of mortality in both periods. Mean glucose levels increased by ~30–40 mg/dL after switching to dextrose diluents, although insulin requirements did not change. Conclusions: Transitioning from chloride-rich to chloride-sparing diluents was associated with reduced ICU mortality and improved acid–base balance, without changes in renal function. However, modestly increased glucose levels highlight the need for strict glycemic monitoring. These findings support chloride-sparing strategies with robust glycemic monitoring in critical care. Full article

Background and Objectives: Midlife represents a critical window for the emergence of metabolic risk factors. This study aimed to investigate age- and sex-related changes in lipid profiles, body composition, oxidative stress, and fatty acid content. Materials and Methods: This cross-sectional study included adults grouped by age: <30, 30–39, and 40–49 years. The assessments covered body composition (fat mass, fat distribution, and lean mass), fasting lipids, inflammation markers measurements, and platelet fatty acids evaluation. Results: In total, 169 adults took part in this study (60 men and 109 women), aged 36.30 ± 6.25 years. Fat mass and its regional distribution were higher after age 40, especially in females. In women, fat mass was lower in the thirties and higher again in the forties, while, in men, fat accumulation was progressive. Participants aged 40–49 had a significantly worse metabolic profile than younger individuals. Statistically significant higher total cholesterol, LDL cholesterol, triglycerides, and glucose were shown in the 40–49-years group when compared to younger groups. Malondialdehyde was higher in the 40–49-years vs. 30–39-years group (105.83 vs. 99.72, p = 0.034). In women aged 40–49, a more adverse lipid and glycemic profile was observed compared to younger groups. Platelet fatty acids in the 40–49-years group showed higher polyunsaturated fatty acids and ω6 percentages (12.85% vs. 10.14%, p = 0.046 and 11.44% vs. 8.79%, p = 0.031), including higher linoleic (8.80 ± 5.18 vs. 6.97 ± 5.05, p = 0.045), arachidonic (2.64 ± 2.64 vs. 1.82 ± 1.73, p = 0.030), and docosahexaenoic (0.61 ± 0.86 vs. 0.31 ± 0.49, p = 0.008) acids, when compared to younger groups. Fat mass strongly correlated with insulin resistance, triglycerides, and CRP, and inversely with HDL-C. Conclusions: Significant age-related changes in body composition, metabolic biomarkers, and platelet fatty acid profiles occur after the age of 40, with distinct gender-specific patterns. The fifth decade of life is a transitional period characterized by central adiposity, deteriorating metabolic profiles, and altered fatty acid composition, especially in women. Full article

Early postnatal stress is a critical factor in metabolic programming. Maternal separation (MS) in rodents, a widely validated model, has been linked to pancreatic alterations. This systematic review and meta-analysis aimed to evaluate the effect of MS on pancreatic morphology and function in rodents. This review followed the PRISMA and SYRCLE guidelines, with a protocol registered in PROSPERO (CRD420251004633). Experimental studies in rodents comparing MS with standard rearing, which reported pancreatic morphofunctional and metabolic parameters, were included. A comprehensive search was performed in the Web of Science, Embase, Medline, Scopus, BIREME-BVS, and SciELO databases until March 2025, without language restrictions. Extracted data included glucose, insulin, insulin sensitivity indices (QUICKI, HOMA), and glucose tolerance tests (GTTs). Meta-analyses were performed using random-effects models, and subgroup analyses were applied to explore sources of heterogeneity. Of 491 references, 25 studies were included in the meta-analysis, which showed that MS was associated with significantly higher glucose levels (SMD −0.41; 95% CI: −0.71 to −0.11) and worse GTT response (SMD −1.02; 95% CI: −1.23 to −0.82). Furthermore, the QUICKI index was significantly decreased (SMD 0.75; 95% CI: 0.14 to 1.35), indicating insulin resistance. MS in rodents induces pancreatic alterations associated with insulin resistance and glucose intolerance, suggesting that early stress could program long-term metabolic vulnerability. Full article

Collagens make up the main components of the extracellular matrix (ECM), and, in cancer, are often aberrantly secreted by both tumor cells and stromal cells in the tumor microenvironment (TME). Collagen prolyl 4-hydroxylase (C-P4H), an enzyme that hydroxylates proline into 4-hydroxyproline at the Y position of the collagen -X-Y-Gly- triplet motif, is essential for the stability of the mature collagen trimer and collagen secretion. In this review, we summarize the research on the structure and function of C-P4H, the regulation of C-P4H enzyme activity, and the role of overexpression of its α-subunit, P4HA1, in promoting cancer progression as well as its potential as a prognostic marker and therapeutic target. Overexpression of P4HA1 is displayed in almost all solid cancers, including breast, colorectal, and lung cancer, and is associated with cancer progression, worse response to therapy, and poorer patient survival. Characterization of P4HA1 overexpression has demonstrated links to key hallmarks of cancer, not only in the canonical collagen deposition role, but also in non-canonical functions, such as cell stemness, hypoxic response, glucose metabolism, angiogenesis, and modulation of tumor-infiltrating lymphocytes (TILs) in the tumor microenvironment. P4HA1 is thus an attractive target for developing novel targeted therapies to improve treatment response in many cancer types. Full article

Circulating levels of endothelial progenitor cells (EPCs) involved in endothelial homeostasis are often reduced in people with type 1 diabetes (T1D). The Glycemia Risk Index (GRI) quantifies the quality of glucose control by assessing both hypo- and hyperglycemia risk. We aim to investigate the association between the GRI and circulating EPC levels in people with T1D. This cross-sectional study included 132 adults with T1D, on intensive insulin therapy. We calculated GRI from 14 days continuous glucose monitoring-derived metrics and quantified EPCs count by flow cytometry, stratifying results by GRI zones, ranging from A (lowest risk) to E (highest risk). Higher GRI scores were significantly associated with poorer metabolic parameters. Circulating levels of CD34⁺, CD133⁺, KDR⁺, and CD34⁺KDR⁺ cells were lower in participants with a worse GRI compared to adults with a better GRI. Linear regression analyses showed a negative association between GRI and CD34⁺ (β = −1.079, p = 0.006), CD34⁺CD133⁺ (β = −0.581, p = 0.008), and CD34⁺KDR⁺ (β = −0.147, p = 0.010). No significant association was found between HbA_1c and any EPC phenotype. Adults with T1D and a high GRI level had a lower EPCs count. GRI was significantly associated with certain EPC phenotypes, suggesting its potential role as a biomarker for cardiovascular risk assessment. Full article

Objectives: This study aimed to evaluate the impact of the 6 February 2023 Kahramanmaraş-centered earthquakes on glycemic control in adults with type 2 diabetes mellitus (T2DM) by analyzing pre–post changes in HbA1c and fasting glucose. In addition, it sought to identify key clinical and biochemical predictors of glycemic worsening in the post-disaster period using routinely available laboratory data. Materials and Methods: This retrospective pre–post observational cohort study included 550 adult patients with established T2DM who received care at two centers in Gaziantep, Türkiye. Laboratory data—including HbA1c, fasting glucose, triglycerides, HDL, and albumin—were compared between two periods: three months before and three to five months after the earthquake. Paired samples t-tests, Spearman’s correlation, multiple linear regression, and ROC analysis were used to evaluate changes in glycemic control and its predictors. Results: The mean age of the participants was 56.2 ± 11.0 years; 43.3% were male and 56.7% female. Post-earthquake, HbA1c (p = 0.012) and fasting glucose (p < 0.001) increased significantly, indicating deterioration in metabolic control. White blood cell (p = 0.003) and platelet counts (p < 0.001) rose, while HDL (p < 0.001), ALT (p = 0.002), and triglycerides (p = 0.010) decreased. ΔHbA1c correlated positively with ΔGlucose (r = 0.362, p < 0.001), ΔTriglyceride (r = 0.323, p < 0.001), LDL (r = 0.173, p < 0.001), and total cholesterol (r = 0.107, p = 0.032), and negatively with ΔAlbumin (r = −0.332, p = 0.029), ΔHDL (r = −0.175, p < 0.001), and WBC (r = −0.112, p = 0.009). In the fully adjusted multivariable model (age, sex, BMI, diabetes duration, insulin use), independent predictors of ΔHbA1c included ΔGlucose (β = 0.007, p < 0.001), ΔTriglyceride (β = 0.004, p = 0.001), ΔHDL (β = −0.010, p = 0.011), ΔAlbumin (β = −0.016, p = 0.007), and ΔWBC (β = −0.009, p = 0.022). Clinical predictors were BMI (β = 0.006, p = 0.045), diabetes duration >10 years (β = 0.094, p = 0.009), and insulin use (β = 0.121, p = 0.003) (Adjusted R² = 0.319). ROC analysis confirmed ΔGlucose as the strongest predictor of worsening glycemic control (AUC = 0.81; sensitivity 82.1%, specificity 73.4%). Additional predictors included insulin use (AUC = 0.66, p < 0.001), ΔTriglyceride (AUC = 0.65, p < 0.001), BMI (AUC = 0.63, p = 0.002), diabetes duration >10 years (AUC = 0.62, p = 0.004), and ΔHDL (AUC = 0.61, p = 0.016), each providing more modest predictive value. Conclusions: Glycemic control became significantly worse in adults with T2DM after the February 2023 earthquake, as reflected by increases in HbA1c and fasting glucose. Both biochemical parameters (Glucose, Triglyceride, HDL, Albumin, WBC) and clinical characteristics (BMI, diabetes duration >10 years, insulin use) were independently associated with glycemic deterioration. Among these, glucose remained the strongest predictor (AUC = 0.81), while BMI, insulin therapy, and longer diabetes duration provided additional predictive value. These findings suggest that routinely available clinical and laboratory data can be used to identify patients at highest risk of metabolic decompensation in disaster settings. Full article

Background/Objectives: After diagnosis, it is common for women with breast cancer to gain weight, which is associated with worse clinical outcomes. However, traditional measures such as body weight, BMI, and waist circumference do not detect key changes in body composition, such as fat redistribution or muscle loss. The objective of this exploratory study was to assess the evolution of body composition and muscle strength after one year of treatment, and their relationship with metabolic biomarkers. Methods: Prospective observational study in newly diagnosed breast cancer patients. Body composition was assessed using bioelectrical impedance analysis (BIA) and ultrasound (US); muscle strength was measured by handgrip dynamometry. Biomarkers analyzed included glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), glycosylated hemoglobin (HbA1c), total cholesterol (and its fractions), triglycerides, C-reactive protein (CRP), 6-interleukin (IL-6), vitamin D, myostatin, and fibroblast growth factor 21 (FGF-21). Results: Sixty-one women (mean age 58 years) were included. After one year, fat mass and related parameters significantly increased, while skeletal muscle mass and muscle strength decreased. Sarcopenic obesity prevalence rose from 1.16% to 4.9%. No significant changes were found in biomarkers, but positive correlations were observed between fat parameters and insulin, HOMA-IR, and triglycerides, and negative correlations with HDL-cholesterol. Conclusions: BIA and US can detect unfavorable changes in body composition that are not reflected in conventional measurements. At one year post-diagnosis, women showed increased fat accumulation, muscle loss, and reduced strength, even without significant metabolic biomarker changes. Further research is warranted to elucidate the long-term clinical implications of these findings and the external validity in larger cohorts. Full article

Background: Metabolic syndrome (MetS) is a multifactorial condition involving central obesity, dyslipidemia, hypertension, and impaired glucose metabolism, significantly increasing the risk of type 2 diabetes and cardiovascular disease. Objectives: Given the clinical heterogeneity of MetS, this study aimed to identify distinct metabolic phenotypes, referred to as metabotypes, using validated biomarkers and to examine their association with MetS. Materials and Methods: A total of 1245 Korean adults aged 19–79 years were selected from the 2016–2023 Korea National Health and Nutrition Examination Survey. Metabotype risk clusters were derived using k-means clustering based on five biomarkers: body mass index (BMI), uric acid, fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDLc), and non-HDL cholesterol (non-HDLc). Multivariable logistic regression was used to assess associations with MetS. Results: Three distinct metabotype risk clusters (low, intermediate, and high risk) were identified. The high-risk cluster exhibited significantly worse metabolic profiles, including elevated BMI, FBG, HbA1c, triglyceride, and reduced HDLc. The prevalence of MetS increased progressively across metabotype risk clusters (OR: 5.46, 95% CI: 2.89–10.30, p < 0.001). In sex-stratified analyses, the high-risk cluster was strongly associated with MetS in both men (OR: 9.22, 95% CI: 3.49–24.36, p < 0.001) and women (OR: 3.70, 95% CI: 1.56–8.75, p = 0.003), with notable sex-specific differences in lipid profiles, particularly in HDLc. Conclusion: These findings support the utility of metabotyping using routine biomarkers as a tool for early identification of high-risk individuals and the development of personalized prevention strategies in clinical and public health settings. Full article

Background: Brain injuries, including stroke and traumatic brain injury (TBI), pose a major healthcare challenge due to their severe consequences and complex recovery. While ischemic strokes are more common, hemorrhagic strokes have a worse prognosis. TBI often affects young adults and leads to long-term disability. A critical concern in these patients is the frequent development of chronic critical illness, compounded by metabolic disturbances and malnutrition that hinder recovery. Objective: This study aimed to compare changes in nutritional status parameters under standard enteral nutrition protocols and clinical outcomes in prolonged/chronic critically ill patients with TBI or stroke versus such a population of patients without TBI or stroke. Methods: This matched prospective–retrospective cohort study included intensive care unit (ICU) patients with TBI or stroke from the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology and patients without these conditions from the eICU-CRD database. Inclusion criteria comprised age 18–74 years, ICU stay >5 days, and enteral nutrition. Patients with re-hospitalization, diabetes, acute organ failure, or incomplete data were excluded. Laboratory values and clinical outcomes were compared between the two groups. Propensity score matching (PSM) was used to balance baseline characteristics (age, sex, and body mass index). Results: After PSM, 29 patients with TBI or stroke and 121 without were included. Univariate analysis showed significant differences in 21 laboratory parameters and three hospitalization outcomes. On day 1, the TBI/stroke group had higher hemoglobin, hematocrit, lymphocytes, total protein, and albumin, but lower blood urea nitrogen (BUN), creatinine, and glucose. By day 20, they had statistically significantly lower calcium, BUN, creatinine, and glucose. This group also showed less change in lymphocytes, calcium, and direct bilirubin. Hospitalization outcomes showed longer mechanical ventilation duration (p = 0.030) and fewer cases of acute kidney injury (p = 0.0220) in the TBI/stroke group. Conclusions: TBI and stroke patients exhibit unique metabolic patterns during prolonged/chronic critical illness, differing significantly from other ICU populations in protein/glucose metabolism and complication rates. These findings underscore the necessity for specialized nutritional strategies in neurocritical care and warrant further investigation into targeted metabolic interventions. Full article

Background and Objectives: Non-dipping blood pressure (BP) patterns are associated with increased cardiovascular risk, but their role in periprocedural myocardial infarction (PMI) during elective percutaneous coronary intervention (PCI) remains insufficiently clarified. The objective was to investigate whether a non-dipping BP profile independently predicts PMI in hypertensive patients undergoing elective PCI. Materials and Methods: This prospective observational study enrolled 462 hypertensive patients undergoing elective PCI, categorized as dipping or non-dipping based on 24 h ambulatory BP monitoring (ABPM). Clinical, laboratory, and angiographic data were compared. PMI was defined according to the Fourth Universal Definition of Myocardial Infarction. Independent predictors of PMI were identified using multivariate logistic regression. Results: Of the 462 patients, 243 (52.6%) exhibited a non-dipping BP pattern. Non-dipping status was significantly associated with higher incidence of PMI (32.5% vs. 13.7%, p < 0.001) and a worse metabolic profile, including elevated blood glucose (p = 0.001), Hemoglobin A1c (p = 0.002), and white blood cell count (p = 0.001), and lower high-density lipoprotein cholesterol (p = 0.047). These patients more frequently underwent complex PCI (25.1% vs. 5.0%, p < 0.001). In multivariate analysis, the non-dipping BP pattern emerged as the strongest independent predictor of PMI (odds ratio 25.99, 95% confidence interval 3.16–213.92, p = 0.002), followed by complex PCI, number of stents, stent length, and diabetes mellitus. Conclusions: Non-dipping BP pattern is a powerful and independent predictor of PMI in hypertensive patients undergoing PCI. Incorporating ABPM into routine cardiovascular risk assessment may improve the identification of high-risk patients and allow for tailored preventive strategies. Full article

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease often associated with metabolic disorders such as diabetes mellitus. Recent research suggests a link between systemic inflammation and insulin–glucose dysregulation in HS. This study investigates the relationship between insulin–glucose homeostasis, diabetes mellitus and the haptoglobin concentration in HS patients. Methods: We assessed 95 HS patients and 49 controls using validated fasting-based function tests, including the Structural Parameter Inference Approach (SPINA), Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI). Results: The HS patients had a significantly higher fasting insulin concentration (97.2 vs. 69.0 pmol/L, p = 0.035), increased insulin resistance (HOMA-IR: 3.47 vs. 2.57, p = 0.016) and impaired insulin sensitivity (SPINA-GR: 1.34 vs. 1.76 mol/s, p = 0.017). In diabetes, the insulin sensitivity was more strongly reduced (SPINA-GR: 0.61 vs. 1.41 mol/s, p = 0.0057) and the insulin resistance increased (HOMA-IR: 7.3 vs. 3.2, p = 0.017). Higher haptoglobin concentrations were accompanied by worse glycaemic control, demonstrating a significantly elevated fasting glucose (5.77 vs. 5.11 mmol/L, p = 0.043) concentration and HbA1c (5.7% vs. 5.4%, p = 0.0081) fraction. Conclusions: Our findings suggest that chronic inflammation in HS contributes to metabolic dysregulation, worsening insulin resistance and glycaemic control, particularly in those with elevated haptoglobin or diabetes. Full article

Background: Metabolic syndrome (MetS) and related disorders, such as insulin resistance, pose significant health risks in middle-aged women, including cognitive decline. Chronic inflammation, characterized by elevated levels of interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), has been identified as a key mechanism linking metabolic disturbances to neurodegenerative processes. Methods: This study aimed to examine the associations between metabolic disorders, inflammatory markers, and cognitive function among middle-aged women. A cross-sectional study was conducted on 179 non-smoking perimenopausal and postmenopausal women aged 43–73 years. Anthropometric, metabolic, and cognitive parameters were assessed, including body mass index (BMI), waist-to-height ratio (WHtR), fasting glucose (GLU), triglycerides (TG), IL-6, TNF-α, and Mini-Mental State Examination (MMSE) scores. Logistic regression models were applied to evaluate the relationships between inflammation, MetS components, and cognitive impairments. Results: Women with insulin resistance showed significantly worse metabolic profiles and lower MMSE scores (23.98 vs. 24.91, p = 0.032). IL-6 levels were strongly associated with hypertriglyceridemia (OR = 1.096, 95% CI: 1.044–1.151, p < 0.001) and insulin resistance (OR = 1.068, 95% CI: 1.030–1.107, p < 0.001), while TNF-α correlated with abdominal obesity (WHtR OR = 1.429, 95% CI: 1.005–2.031, p = 0.047). Moreover, TNF-α was a significant predictor of cognitive impairments (OR = 1.362, 95% CI: 1.153–1.610, p < 0.001), whereas IL-6 showed no significant association. Conclusions: These findings highlight that TNF-α may be a key inflammatory marker associated with metabolic disturbances and cognitive decline in middle-aged women. IL-6 appears to be more specifically linked to lipid abnormalities and insulin resistance. Targeted interventions to reduce inflammation may moderate metabolic and cognitive risks in this population. Full article

Glucose is the main source of energy in human cells. Elevated levels of glucose are one of the most common metabolic disorders, and it has been shown to have a significant, mostly negative, effect on multiple chronic and acute diseases. Lung cancer remains one of the biggest challenges for treatment in modern medicine, with a high prevalence, incidence and mortality. Hyperglycemia is not uncommon in patients with lung cancer; however, it is usually overlooked. Patients with unregulated glycemia and lung cancer have been shown to have worse outcomes, reduced therapeutic effect and more complications during treatment. Studies have identified multiple molecular pathways common in both hyperglycemia and lung cancer; however, no clear correlation has been identified. By understanding these signaling pathways, we can influence the outcome therapeutically and thereby improve the survival of patients with lung cancer. Full article

Background: In pulmonary arterial hypertension (PAH), there is still a need for new prognostic markers to precisely identify patients before clinical deterioration. We investigated the right ventricle cardiac power index (RV CPI) as a tool to assess RV function. We also hypothesized that hemodynamic changes occurring in PAH assessed with the RV CPI are related with cardiac metabolism alterations in PET imaging, which affects prognosis. Methods: Twenty-eight stable PAH patients (51.4 ± 15.9 years old) had PET/CMR and heart catheterization performed at baseline and after 24 months. The PET-derived SUV RV/LV ratio was used to estimate cardiac glucose uptake. Clinical endpoints (CEPs—death or clinical deterioration) were assessed between visits. The RV CPI was defined as cardiac index × mean pulmonary artery pressure × 2.22 × 10⁻³. Results: The baseline RV CPI was 0.28 ± 0.09 W/m² and correlated significantly with the SUV RV/LV ratio (r = 0.55, p = 0.002), confirming a relationship between RV hemodynamics and glucose metabolism. After 24 months of PAH-specific therapy, we observed significant improvement in the follow-up RV CPI—0.23 ± 0.04 W/m² (p = 0.04). During 2-year observations, 16 patients (57%) experienced CEPs (including four deaths). Patients with CEPs had a higher baseline CPI than stable patients (0.32 ± 0.09 vs. 0.21 ± 0.05, p = 0.0006). The cut-off value of the RV CPI to predict worse prognosis was 0.24 W/m² (log-rank test, p = 0.003). Conclusions: To sum up, the indexed cardiac power output parameter may reflect RV efficiency and is related to its glucose metabolism alterations in PAH. Its low value may help to identify stable patients at higher risk of death or clinical deterioration in long-term prognosis. Full article

Background/Objectives: Down syndrome (DS) is the most common cause of early-onset Alzheimer’s disease (AD). Dietary choline has been proposed as a modifiable factor to improve the cognitive and pathological outcomes of AD and DS, especially as many do not reach adequate daily intake levels of choline. While lower circulating choline levels correlate with worse pathological measures in AD patients, choline status and intake in DS is widely understudied. Perinatal choline supplementation (Ch+) in the Ts65Dn mouse model of DS protects offspring against AD-relevant pathology and improves cognition. Further, dietary Ch+ in adult AD models also ameliorates pathology and improves cognition. However, dietary Ch+ in adult Ts65Dn mice has not yet been explored; thus, this study aimed to supply Ch+ throughout adulthood to determine the effects on cognition and DS co-morbidities. Methods: We fed trisomic Ts65Dn mice and disomic littermate controls either a choline normal (ChN; 1.1 g/kg) or a Ch+ (5 g/kg) diet from 4.5 to 14 months of age. Results: We found that Ch+ in adulthood failed to improve genotype-specific deficits in spatial learning. However, in both genotypes of female mice, Ch+ significantly improved cognitive flexibility in a reverse place preference task in the IntelliCage behavioral phenotyping system. Further, Ch+ significantly reduced weight gain and peripheral inflammation in female mice of both genotypes, and significantly improved glucose metabolism in male mice of both genotypes. Conclusions: Our findings suggest that adulthood choline supplementation benefits behavioral and biological factors important for general well-being in DS and related to AD risk. Full article