Deep Learning Model Based on Multisequence MRI Images for Assessing Adverse Pregnancy Outcome in Placenta Accreta.

BACKGROUND: Preoperative assessment of adverse outcomes risk in placenta accreta spectrum (PAS) disorders is of high clinical relevance for perioperative management and prognosis. PURPOSE: To investigate the association of preoperative MRI multisequence images and adverse pregnancy outcomes by establishing a deep learning model in patients with PAS. STUDY TYPE: Retrospective. POPULATION: 323 pregnant women (age from 20 to 46, the median age is 33), suspected of PAS, underwent MRI to assess the PAS, divided into the training (N = 227) and validation datasets (N = 96). FIELD STRENGTH/SEQUENCE: 1.5T scanner/fast imaging employing steady-state acquisition sequence and single shot fast spin echo sequence. ASSESSMENT: Different deep learning models (i.e., with single MRI input sequence/two sequences/multisequence) were compared to assess the risk of adverse pregnancy outcomes, which defined as intraoperative bleeding ≥1500 mL and/or hysterectomy. Net reclassification improvement (NRI) was used for quantitative comparison of assessing adverse pregnancy outcome between different models. STATISTICAL TESTS: The AUC, sensitivity, specificity, and accuracy were used for evaluation. The Shapiro-Wilk test and t-test were used. A P value of <0.05 was considered statistically significant. RESULTS: 215 cases were invasive placenta accreta (67.44% of them with adverse outcomes) and 108 cases were non-invasive placenta accreta (9.25% of them with adverse outcomes). The model with four sequences assessed adverse pregnancy outcomes with AUC of 0.8792 (95% CI, 0.8645-0.8939), with ACC of 85.93% (95%, 84.43%-87.43%), with SEN of 86.24% (95% CI, 82.46%-90.02%), and with SPC of 85.62% (95%, 82.00%-89.23%) on the test cohort. The performance of model with four sequences improved above 0.10 comparing with that of model with two sequences and above 0.20 comparing with that of model with single sequence in terms of NRI. DATA CONCLUSION: The proposed model showed good diagnostic performance for assessing adverse pregnancy outcomes. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.

Dapagliflozin Ameliorates Ovulation Disorders via Attenuating Activated Microglia-Mediated Hypothalamic Inflammation in HFD-Fed Mice.

INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have shown neuroprotective effects in obese mice. However, whether SGLT2i can ameliorate high-fat diet (HFD)-related ovulation disorders remains unknown. The aim of this research was to investigate whether dapagliflozin improves HFD-induced ovulatory dysfunction by attenuating microglia-mediated hypothalamic inflammation. METHODS: C57BL/6J female mice fed HFD were treated with dapagliflozin (1 mg/kg) for 22 weeks. Plasma insulin, leptin, luteinizing hormone (LH), estradiol (E2), and IL-1ß levels were also tested. Microglial morphology, cell numbers, and SGLT2 expression were evaluated using immunofluorescence. The expression of IL-1ß, NLRP3, kisspeptin, gonadotropin-releasing hormone (GnRH), SGLT2, insulin, and leptin receptors in the hypothalamus was determined using immunohistochemical staining. We also examined the effects of dapagliflozin on glucose metabolism and the release of inflammatory factor in palmitic acid (PA)-treated HMC3 cells. RESULTS: As expected, dapagliflozin improved HFD-induced metabolic disturbances, peripheral versus central insulin and leptin resistance and also restored the regular estrous cycle. Furthermore, dapagliflozin blunted microglia activation, NLRP3 inflammasome priming, hypothalamic inflammation, and increased the expression of GnRH and kisspeptin at proestrus in the hypothalamus. Additionally, dapagliflozin markedly reduced IL-6 and NO release and fat accumulation, decreased lactic acid production and glucose consumption, and inhibited mammalian target of rapamycin (mTOR) and hexokinase 2 (HK2) expression in PA-treated HMC3 cells. These effects suggest that dapagliflozin reduced the mTOR/HK2-mediated aerobic glycolysis. CONCLUSIONS: Dapagliflozin improved HFD-related ovulation disorders by regulating glucose metabolism through mTOR/HK2 signaling and attenuating microglia-mediated hypothalamic inflammation. These results validate the novel role for the neuroprotection of SGLT2i in HFD-induced obesity and ovulation disorders.

A Fully Biodegradable Battery for Self-Powered Transient Implants.

Biodegradable transient devices represent an emerging type of electronics that could play an essential role in medical therapeutic/diagnostic processes, such as wound healing and tissue regeneration. The associated biodegradable power sources, however, remain as a major challenge toward future clinical applications, as the demonstrated electrical stimulation and sensing functions are limited by wired external power or wireless energy harvesters via near-field coupling. Here, materials' strategies and fabrication schemes that enable a high-performance fully biodegradable magnesium-molybdenum trioxide battery as an alternative approach for an in vivo on-board power supply are reported. The battery can deliver a stable high output voltage as well as prolonged lifetime that could satisfy requirements of representative implantable electronics. The battery is fully biodegradable and demonstrates desirable biocompatibility. The battery system provides a promising solution to advanced energy harvesters for self-powered transient bioresorbable implants as well as eco-friendly electronics.

Fabrication and Emission Performance of Nanostructured Re-W Matrix Impregnated Cathodes.

In this study, rhenium-tungsten mixed particles with different content of rhenium have been prepared by spray-drying method followed by hydrogen reduction. Using such particles, the cathodes have been prepared by powder metallurgy followed by impregnating BaO, CaO, and Al2O3 with 4:1:1 molar ratio. After proper activation, electron emission test is performed in standard parallel-plate diode configuration. The emission results reveal that the Re-W matrix cathode containing 75% rhenium has the highest direct current emission density of 11.67 A/cm2 at 1000 °C. The work function of Re-W matrices has been investigated by density functional theory method in the frame of the generalized gradient approximation (GGA). The theoretical calculation results indicate that the work function of the matrix has limited contribution to the emission current density of Re-W matrix dispenser cathode. The in situ AES, SEM, and XRD were applied and the results reveal that the superior emission property of the 75Re cathode is owing to a plenty of nanoparticles and higher free barium concentration on the cathode surface, which is attributed to the Re3W single phase in 75Re matrix.

Elevated serum milk fat globule-epidermal growth factor 8 levels in type 2 diabetic patients are suppressed by overweight or obese status.

Inflammation is the most important link between obesity and type 2 diabetes (T2D). Although milk fat globule-epidermal growth factor 8 (MFG-E8) is a key mediator in anti-inflammatory responses, its role in obesity and diabetes is not yet completely understood. We aimed to measure MFG-E8 serum levels and to explore the role of MFG-E8 in obesity and T2D. Fasting serum MFG-E8 levels were quantified by enzyme-linked immunosorbent assay for 168 individuals, whose oral glucose tolerance test was conducted, and levels of inflammatory factors, including tumor necrosis factor-α (TNF-α) and C-reactive protein, were measured. The participants were subdivided into 66 newly diagnosed T2D individuals, 44 impaired glucose tolerance (IGT) subjects and 58 healthy controls. Their characteristics were further classified as lean or nonlean for investigation. MFG-E8 levels were significantly higher in T2D subjects than in healthy controls (P = 0.028). Decreased levels of MFG-E8 were found in overweight or obese individuals, compared to those in lean subjects, in both the T2D and IGT groups (P < 0.001). Interestingly, MFG-E8 levels showed a negative correlation with body mass index (BMI) and TNF-α levels in the total population and the T2D subgroup. Further, BMI and TNF-α concentrations were found to be independent predictors of MFG-E8 levels in all subjects. MFG-E8 levels are elevated in T2D but suppressed by increased adipose tissues, thereby allowing inflammatory factors to rise to high levels. MFG-E8 may serve as a potential biomarker for obesity and T2D in the clinical setting. © 2017 IUBMB Life, 69(2):63-71, 2017.

The role of m6A modification in the risk prediction and Notch1 pathway of Alzheimer's disease.

N6-methyladenosine (m6A) methylation and abnormal immune responses are implicated in neurodegenerative diseases, yet their relationship in Alzheimer's disease (AD) remains unclear. We obtained AD datasets from GEO databases and used AD mouse and cell models, observing abnormal expression of m6A genes in the AD group, alongside disruptions in the immune microenvironment. Key m6A genes (YTHDF2, LRPPRC, and FTO) selected by machine learning were associated with the Notch pathway, with FTO and Notch1 displaying the strongest correlation. Specifically, FTO expression decreased and m6A methylation of Notch1 increased in AD mouse and cell models. We further silenced FTO expression in HT22 cells, resulting in upregulation of the Notch1 signaling pathway. Additionally, increased Notch1 expression in dendritic cells heightened inflammatory cytokine secretion in vitro. These results suggest that reduced FTO expression may contribute to the pathogenesis of AD by activating the Notch1 pathway to interfere with the immune response.

Revealing the Effect of α' Decomposition on Microstructure Evolution and Mechanical Properties in Ti80 Alloy.

Three types of solution treatment and aging were designed to reveal the α' decomposition and its effect on the mechanical properties of near-α Ti-80 alloy, as follows: solution at 970 °C then quenching (ST), ST + aging at 600 °C for 5 h (STA-1), and ST + aging 600 °C for 24 h (STA-2). The results show that the microstructures of the ST samples were mainly composed of equiaxed αp and acicular α', with a large number of dislocations confirmed by the KAM results. After subsequent aging for 5 h, α' decomposed into acicular fine αs and nano-ß (intergranular ß, intragranular ß) in the STA-1 specimen, which obstructed dislocation motion during deformation, resulting in the STA-1 specimen exhibiting the most excellent yield strength (1012 MPa) and maintaining sufficient elongation (8.1%) compared with the ST (898 MPa) and STA-2 (871 MPa) samples. By further extending the aging time to 24 h, the size of acicular αs and nano-ß gradually increased while the density of dislocations decreased, which resulted in a decrease in strength and an increase in plasticity. Based on this, a microstructures-properties correlation model was proposed. This study provides a new method for strength-plasticity matching of near-α titanium alloys through α' decomposition to acicular αs+nano-ß.

Effects of Ultrasonic Treatment on Physical Stability of Lily Juice: Rheological Behavior, Particle Size, and Microstructure.

The aim of this study was to investigate the rheological properties, particle size distribution, color change, and stability of lily juice under different ultrasonic treatment conditions (152 W, 304 W, 456 W, 608 W, and 760 W). The results showed that the lily juice exhibited non-Newtonian shear thinning behavior, and the viscosity decreased with the increase in ultrasonic power. Under ultrasonic treatment conditions, there was no significant change in the pH value and zeta potential value of the samples. The content of cloudy value and total soluble solids (TSS) increased gradually. However, both the sedimentation components and centrifugal sedimentation rate showed a downward trend and an asymptotic behavior. In addition, high-power ultrasound changed the color index (L* value decreased, a* value increased), tissue structure, and particle distribution of the sample, and small particles increased significantly. To sum up, ultrasonic treatment has great potential in improving the physical properties and suspension stability of lily juice.

Static Globularization Behavior and Artificial Neural Network Modeling during Post-Annealing of Wedge-Shaped Hot-Rolled Ti-55511 Alloy.

The globularization of the lamellar α phase by thermomechanical processing and subsequent annealing contributes to achieving the well-balanced strength and plasticity of titanium alloys. A high-throughput experimental method, wedge-shaped hot-rolling, was designed to obtain samples with gradient true strain distribution of 0~1.10. The samples with gradient strain distribution were annealed to obtain the gradient distribution of globularized α phase, which could rapidly assess the globularization fraction of α phase under different conditions. The static globularization behavior under various parameters was systematically studied. The applied prestrain provided the necessary driving force for static globularization during annealing. The substructure evolution and the boundary splitting occurred mainly at the early stage of annealing. The termination migration and the Ostwald ripening were dominant in the prolonged annealing. A backpropagation artificial neural network (BP-ANN) model for static globularization was developed, which coupled the factors of prestrain, annealing temperature, and annealing time. The average absolute relative errors (AARE) for the training and validation set are 3.17% and 3.22%, respectively. Further sensitivity analysis of the factors shows that the order of relative importance for static globularization is annealing temperature, prestrain and annealing time. The developed BP-ANN can precisely predict the static globularization kinetic curves without overfitting.

Strain Rate Dependence and Recrystallization Modeling for TC18 Alloy during Post-Deformation Annealing.

In this paper, the dependence of dynamic recrystallization (DRX) and post-dynamic recrystallization (PDRX) of TC18 alloy on strain rate within the range of 0.001 s-1~1 s-1 was investigated through isothermal compression and subsequent annealing in the single-phase region. Electron backscatter diffraction (EBSD) characterization was employed to quantify microstructure evolution and to reveal the recrystallization mechanism. At the thermo-deformation stage, the DRX fraction does not exceed 10% at different strain rates, due to the high stacking fault energy of the ß phase. During the subsequent annealing process, the total recrystallization fraction increases from 10.5% to 79.6% with the strain rate increasing from 0.001 s-1 to 1 s-1. The variations in the geometrically necessary dislocation (GND) density before and after annealing exhibit a significant discrepancy with the increasing strain rate, indicating that the GND density is a key factor affecting the PDRX rate. The PDRX mechanisms, namely meta-dynamic recrystallization (MDRX), continuous static recrystallization (CSRX) and discontinuous static recrystallization (DSRX), were also revealed during the annealing process. A new kinetic model coupling DRX and PDRX was proposed to further describe the correlation between recrystallization and the strain rate during continuous deformation and annealing. This new model facilitates the prediction of recrystallization fraction during isothermal deformation and annealing of titanium alloys.

Inter-Critically Reheated CGHAZ of Ultra-High-Strength Martensitic Steel with Different Cooling Rates.

The mechanical properties of steel's inter-critically reheated coarse-grained heat-affected zone (ICR CGHAZ) directly affects the service life of machinery equipment. The hardness and toughness of ICR CGHAZ can be optimized simultaneously through tailoring microstructure where cooling rate plays a key role. In this work, the samples with different cooling rates was prepared using thermal simulation. The granite bainite (GB), bainite ferrite (BF) and MA were formed at a 1 °C/s (CR1) cooling rate, while BF and MA were formed at 10 °C/s (CR2) and 30 °C/s (CR3) cooling rates. With the increase of cooling rate, the effective grain size decreased and the number of hard phases increased, resulting in monotonic increase of hardness (260HV3, 298HV3 and 323HV3). CR1 had sparsely distributed coarse slender MA and CR3 possessed tail-head connected MA along PAGBs, which was detrimental to toughness. Therefore, CR2 possessed the best toughness(25J). The microstructural evolution mechanism of ICR CGHAZ with different cooling rates is investigated, corresponding hardening and toughening mechanisms are discussed.

Local Corrosion Behaviors in the Coarse-Grained Heat-Affected Zone in a Newly Developed Zr-Ti-Al-RE Deoxidized High-Strength Low-Alloy Steel.

Oxide metallurgy technology can improve the microstructure of a coarse-grained heat-affected zone (CGHAZ) but introduces extra inclusions. Local corrosion behavior of the CGHAZ of a Zr-Ti-Al-RE deoxidized steel was investigated in this work using theoretical calculations and experimental verification. The modified inclusions have a (Zr-Mg-Al-Ca-RE)Ox core claded by a CaS and TiN shell. CaS dissolves first, followed by the oxide core, leaving TiN parts. This confirms that the addition of rare earth can reduce lattice distortion and prevent a galvanic couple between the inclusions and the matrix, while the chemical dissolution of CaS causes localized acidification, resulting in the pitting corrosion initiation.

Response to roxadustat in a patient undergoing long-term dialysis and allergic to erythropoiesis-stimulating agents: A case report.

BACKGROUND: Hypoxia-inducible factor prolyl hydroxylase inhibitor is a new class of drugs for treating renal anemia. It is a second-generation hypoxia-inducible factor prolyl hydroxylase-2 (PHD2) inhibitor. Roxadustat can effectively increase hemoglobin in patients with dialysis-dependent chronic kidney disease, with an adverse events profile comparable to that of epoetin alfa. We administered roxadustat to a maintenance hemodialysis patient who was allergic to erythropoiesis-stimulating agents (ESAs) and depended on blood transfusion for five years. After applying Roxadustat, the patient's anemia improved significantly. CASE SUMMARY: A 77-year-old Chinese man had type 2 diabetes for 16 years, underwent maintenance hemodialysis for five years, and had fatigue for five years. Laboratory tests showed severe anemia (hemoglobin concentration of 42 g/L). The patient was administered a subcutaneous injection of ESAs before dialysis. He suffered an allergic shock immediately and fainted. His blood pressure dropped to undetectable levels. He was not administered ESAs henceforth. The patient was prescribed iron supplements and received blood transfusions occasionally for five years. His hemoglobin concentration ranged from 42-68 g/L. After taking six weeks of oral roxadustat three times weekly (100 mg TIW), the patient's hemoglobin concentration increased significantly, and his symptoms decreased. We adjusted the doses of roxadustat, and the hemoglobin concentration was maintained between 97 and 126 g/L. CONCLUSION: Oral roxadustat is effective in treating anemia in maintenance hemodialysis patients who cannot be administered ESAs.

The Predictive Value of Serum Calcium on Heart Rate Variability and Cardiac Function in Type 2 Diabetes Patients.

Background: Cardiovascular autonomic neuropathy (CAN) is common in patients with type 2 diabetes mellitus (T2DM), mainly presented as decreased heart rate variability (HRV) which often leads to cardiac death. However, HRV measurement is not convenient in most clinics. Therefore, identifying high-risk patients for CAN in diabetes with easier measurements is crucial for the early intervention and prevention of catastrophic consequences. Methods: In this cross-sectional study, 675 T2DM patients with normocalcemia were selected. Of these, they were divided into two groups: normal HRV group (n = 425, 100 ms≤ SDNN ≤180 ms) vs. declined HRV group (n = 250, SDNN <100 ms). All patients' clinical data were collected and the correlation of clinical variables with HRV were analyzed by correlation and logistic regression analysis. The area below the ROC curve was used to evaluate the predictive performance of serum calcium on HRV. Results: In this study, declines in HRV were present in 37.0% of T2DM patients. Significant differences in albumin-adjusted serum calcium levels (CaA) (8.86 ± 0.27 vs. 9.13 ± 0.39 mg/dl, p <0.001) and E/A (0.78 ± 0.22 vs. 0.83 ± 0.26, p = 0.029) were observed between declined HRV and normal HRV groups. Bivariate linear correlation analysis showed that CaA and E/A were positively correlated with HRV parameters including SDNN (p < 0.001), SDNN index (p < 0.001), and Triangle index (p < 0.05). The AUC in the ROC curve for the prediction of CaA on HRV was 0.730 (95% CI (0.750-0.815), p < 0.001). The cutoff value of CaA was 8.87 mg/dl (sensitivity 0.644, specificity 0.814). The T2DM patients with CaA <8.87 mg/dl had significantly lower HRV parameters (SDNN, SDNN index, rMSSD, and triangle index) than those with CaA ≥8.87 mg/dl (p < 0.01, respectively). Multivariate logistic regression analysis showed a significantly increased risk of declined HRV in subjects with CaA level <8.87 mg/dl [OR (95% CI), 0.049 (0.024-0.099), p < 0.001]. Conclusions: Declined HRV is associated with a lower CaA level and worse cardiac function. The serum calcium level can be used for risk evaluation of declined HRV in T2DM patients even within the normocalcemic range.

China's Stem Cell Research and Knowledge Levels of Medical Practitioners and Students.

Over the last few decades, China has greatly expanded its scope of stem cell research, generating various scientific advances and medical applications. However, knowledge of the extent and characteristics of domestic stem cell development, particularly medical workers' opinions, is lacking. This study's purposes were to analyze the growth trends of China's stem cell community and identify the knowledge and attitudes held by Chinese medical workers regarding stem cell research. We found that there are currently 13 high-quality stem cell research centers with more than 400 PhD-level researchers across Mainland China. These centers feature many high-caliber scientists from the stem cell research community. From 1997 through 2019, the National Natural Science Foundation of China allocated roughly $576 million to 8,050 stem cell programs at Chinese universities and research institutions. China's annual publications on stem cells increased from less than 0.6% of the world's total stem cell publications in 1999 to more than 14.1% in 2014. Our survey also revealed that most participants held positive attitudes toward stem cell research, supported further funding, and had high general awareness about stem cells.

The complete chloroplast genome and phylogenetic analysis of Saussurea wettsteiniana (Compositae).

Saussurea wettsteiniana is a medicinally important herb endemic to Hengduan Mountains. Here, we report and characterize the complete chloroplast genome sequence of S. wettsteiniana to provide genomic resources useful for future study. The complete chloroplast genome is 152,631 bp in length, consisting of a large single copy and a small single copy of 83,552 bp and 18,637 bp, which were separated by a pair of inverted repeats of 25,221 bp. Totally 133 genes were annotated, including 87 protein-coding genes, 36 tRNA genes, and eight rRNA genes. We also detected two pseudo-genes (ycf1 and rps19). The overall GC content of the whole genome is 37.7%. The phylogenetic tree based on 23 complete plastomes indicated that S. wettsteiniana was closely related to S. involucrata of Compositae.

Modeling in the Time of COVID-19: Statistical and Rule-based Mesoscale Models.

We present a new technique for the rapid modeling and construction of scientifically accurate mesoscale biological models. The resulting 3D models are based on a few 2D microscopy scans and the latest knowledge available about the biological entity, represented as a set of geometric relationships. Our new visual-programming technique is based on statistical and rule-based modeling approaches that are rapid to author, fast to construct, and easy to revise. From a few 2D microscopy scans, we determine the statistical properties of various structural aspects, such as the outer membrane shape, the spatial properties, and the distribution characteristics of the macromolecular elements on the membrane. This information is utilized in the construction of the 3D model. Once all the imaging evidence is incorporated into the model, additional information can be incorporated by interactively defining the rules that spatially characterize the rest of the biological entity, such as mutual interactions among macromolecules, and their distances and orientations relative to other structures. These rules are defined through an intuitive 3D interactive visualization as a visual-programming feedback loop. We demonstrate the applicability of our approach on a use case of the modeling procedure of the SARS-CoV-2 virion ultrastructure. This atomistic model, which we present here, can steer biological research to new promising directions in our efforts to fight the spread of the virus.

Decolorization and degradation of reactive dye during the dyed cotton fabric rinsing process.

Dyeing process of textile consumes large quantities of water, which results in huge amounts of colored wastewater. Most of the dye wastewater treating methods focused on the treatment of wastewater after the rinsing process of dyed textile. In this paper, tetraacetylethylenediamine/hydrogen peroxide (TAED/H2O2) active oxidation (AO) system was developed to rinse dyed textile and decolorize the rinsing wastewater simultaneously. The results indicated that the decolorization ratio of the rinse effluent obtained by AO method were in the range of 51.72%-84.15% according to different dyes and the COD value decreased more than 30% compared with that of traditional rinsing process. The decolorization kinetics investigation showed that the decolorization of dyes during AO rinsing process followed the law of pseudo-first order kinetics. The result of UV-Vis and UPLC-MS analysis demonstrated that the dye was degraded into colorless organic molecular fragments and partly mineralized during the AO rinsing process.

Design of a Low Noise Bio-Potential Recorder With High Tolerance to Power-Line Interference Under 0.8 V Power Supply.

A bio-potential recorder working under 0.8 V supply voltage with a tunable low-pass filter is proposed in this paper. The prototype is implemented in TSMC 180 nm CMOS technology, featuring a power consumption of 2.27  µW, while preserving a high tolerance of power-line interference (PLI) up to 600 m Vpp, a common-mode rejection ratio (CMRR) of higher than 100 dB, a THD of -65.5 dB, and a noise density of 50 nV/ √{Hz} by employing four new techniques, including 1) low noise chopper modulator, 2) feedback loop based common-mode cancellation loop (CMCL), 3) offset cancellation loop (OCL) with PMOS backgate control scheme, and 4) a very-lower transconductance (VLT) operational transconductance amplifier (OTA) using in the DC-servo-loop (DSL). The measured mid-band gain is 43.3 dB with a high-pass cut-off frequency of 1.2 Hz. The low-pass cut-off frequency can be configured from 650 Hz to 7.5 kHz. The measured input-referred integrated noise is 1.2 uVrms in the frequency band of 1-650 Hz and 4.1 uVrms in the 1 Hz-7.5 kHz frequency band, respectively, leading to a power efficiency factor (PEF) of 7.49 and 7.59.

Angiopoietin-like 8 Improves Insulin Resistance and Attenuates Adipose Tissue Inflammation in Diet-Induced Obese Mice.

Angiopoietin-like 8 (ANGPTL8) is closely linked to obesity-associated metabolic diseases and insulin resistance. The aim of the current study was to investigate the ability of ANGPTL8 to reverse insulin resistance in obese mice. The administration of ANGPTL8 reduced weight gain and improved glucose tolerance in mice with diet-induced obesity. In addition, ANGPTL8 administration modified macrophage infiltration, reduced monocyte chemoattractant protein-1 (MCP-1) and interleukin-1ß(IL-1ß) levels, and increased adiponectin gene expression in inguinal white adipose tissue (iWAT). Moreover, the exposure of a cultured peritoneal macrophage line to ANGPTL8 reduced the mRNA expression of M1 macrophage markers (TNF-α and IL-1ß) upon stimulation with lipopolysaccharides in a dose-dependent manner. By contrast, when incubated with IL-4, exposure of macrophages to ANGPTL8 increased the mRNA expression of M2 macrophage markers (Arg1 and Chi3l3) in a dose-dependent manner. Collectively, the results of the present study demonstrated that treatment with ANGPTL8 can attenuate adipose tissue inflammation through regulation of macrophage polarization, and thus, it could be useful for improving insulin resistance.