Circulating Interleukins-33 and -37 and Their Associations with Metabolic Syndrome in Arab Adults.

Interleukins (ILs) are a group of cytokines known to have immunomodulatory effects; they include ILs-33 and -37 whose emerging roles in the pathogenesis of metabolic syndrome (MetS) remain under investigated. In this study, we compared circulating IL-33 and IL-37 in Arab adults with and without MetS to determine its associations with MetS components. A total of 417 Saudi participants (151 males, 266 females; mean age ± SD 41.3 ± 9.0 years; mean body mass index ± SD 30.7 ± 6.3 kg/m2) were enrolled and screened for MetS using the ATP III criteria. Anthropometrics and fasting blood samples were taken for the assessment of fasting glucose and lipids. Circulating levels of IL-33 and IL-37 were measured using commercially available assays. The results showed higher levels of serum IL-33 and IL-37 in participants with MetS than those without (IL-33, 3.34 3.42 (2.3-3.9) vs. (1-3.9), p = 0.057; IL-37, 5.1 (2.2-8.3) vs. 2.9 (2.1-6.1), p = 0.01). Additionally, having elevated levels of IL-33 was a risk factor for hypertension, low HDL-c, and hypertriglyceridemia. A stratification of the participants according to sex showed that males had higher IL-33 levels than females [3.7 (3.0-4.1) vs. 3.15 (1.4-3.8), p < 0.001], while females had higher levels of IL-37 than males [3.01 (2.2-7.0) vs. 2.9 (2.1-5.6), p = 0.06]. In conclusion, the presence of MetS substantially alters the expression of ILs-33 and -37. IL-33 in particular can be potentially used as a therapeutic target to prevent MetS progression. Longitudinal and interventional studies are warranted to confirm present findings.

Vitamin D Knowledge and Awareness Is Associated with Physical Activity among Adults: A Cross-Sectional Survey.

The relation between knowledge and awareness of vitamin D (VD) and physical activity in adults has not been well studied. The present cross-sectional study aims to demonstrate this relation among adults living in Saudi Arabia. A total of 774 adults participated and were stratified based on self-reports of whether they were physically active (PA group, N = 562) or not (non-PA, N = 212). The prevalence of VD awareness and its health effects were significantly higher in the PA group compared with their counterparts (97 vs. 93.4%; p = 0.02 and 92.3 vs. 81.6%; p < 0.001, respectively). Sunlight was the preferred overall source of VD among the PA group (91.1%) followed by food, supplements, and fortified foods. Sardine, salmon, oily fish (63.7%) and eggs (54.6%) were reported as good dietary sources. Other positive attitudes, represented by taking supplement or multivitamins (51.2%), high sun exposure (33.1%), and daily duration of exposure to sunlight (15−30 min; 53.4%) were higher in the PA than the non-PA group (p values < 0.05). The body parts exposed to the sun among the PA group were arms (67.1%), hands (64.1%), face and hands (62.5%), legs (58.5%), and face (53.2%), while sunscreen cream (47.2%) was their preferred sun-protection method. High levels of knowledge and positive attitudes were reported by the PA group compared with the non-PA group in regard to walking outdoors for sun exposure (80.6 vs. 62.7%; p < 0.001). Information about good dietary sources, the role of VD in human health, associated diseases, positive attitudes to sun exposure, and the use of supplements or multivitamins were among the determinants of VD knowledge and awareness. In conclusion, VD knowledge and awareness are positively associated with self-reported physical activity in adults. Further objective classifications of PA may strengthen the results of the present investigation.

Hepatokines fetuin A and fetuin B status in women with/without gestational diabetes mellitus.

OBJECTIVES: To assess circulating fetuin A and fetuin B levels in participants with and without Gestational Diabetes Mellitus (GDM) and to find out their correlations with other different parameters relating to gestational diabetes in Saudi women. METHODS: A total of 123 Saudi pregnant women (N: 46 GDM and N: 77 healthy control) were included in this observational study. Fasting blood samples were collected to assess serum lipids, insulin and fetuin A and fetuin B. Serum fetuin A and fetuin B were quantified by commercially available kits. RESULTS: The median value of fetuin A was slight lower in GDM patients [2003 pg/ml (866-3369)] than in the control group [2015 pg/ml (1060-2951)] without significant difference (P=0.95). The median value of fetuin B was also slight lower in GDM patients [3292 ng/ml (782-6740)] than the control group [3514 ng/ml (364-14854)] but without significant difference (P=0.564). There was a significant inverse correlation between fetuin B and total cholesterol in control group. CONCLUSIONS: The present study did not find a significant association between fetuins A and B with GDM or insulin resistance, but there was a significant inverse correlation between fetuin B and total cholesterol in the control group, reflecting good glucose control and adequate use of lipids in the nutrition of the fetus. Further research is required in the future to understand fetuin's role in the progression of GDM in Saudi women.

Sex-Specific Cut-Offs of Single Point Insulin Sensitivity Estimator (SPISE) in Predicting Metabolic Syndrome in the Arab Adolescents.

The Single Point Insulin Sensitivity Estimator (SPISE) is a novel surrogate marker for insulin sensitivity and was found comparable to the gold standard clamp test as well as for predicting the Metabolic Syndrome (MetS) in several populations. The present study aimed to assess for the first time, the validity of SPISE in predicting MetS among Arab adolescents. In this cross-sectional study, 951 Saudi adolescents aged 10−17 years were randomly recruited from different schools across Riyadh, Saudi Arabia. Anthropometrics were measured and fasting blood samples were collected for the assessment of glucose, lipid profile, adipokines, C-reactive protein and 25 hydroxyvitamin (OH) D. MetS was defined using the National Cholesterol Education Program's (NCEP) criteria with age-specific thresholds for adolescents. The SPISE as well as insulin resistance (HOMA-IR) indices were calculated. The over-all prevalence of MetS was 8.6% (82 out of 951). SPISE index was significantly lower in MetS than non-MetS participants in both sexes (5.5 ± 2.5 vs. 9.4 ± 3.2, p < 0.001 in boys and 4.4 ± 1.4 vs. 8.6 ± 3.2, p < 0.001 in girls). The SPISE index showed a significant inverse correlation with resistin, leptin, and C-reactive protein, and a significant positive correlation with adiponectin and 25(OH) D. Areas under the curve (AUC) revealed fair and good accuracy for predicting MetS 84.1% and 90.3% in boys and girls, respectively. The sex-specific cut-off proposed was SPISE index ≤6.1 (sensitivity 72.2% and specificity 83.9%) for boys and ≤6.46 (sensitivity 96.3% and specificity 73.4%), for girls. This study suggests that the SPISE index is a simple and promising diagnostic marker of insulin sensitivity and MetS in Arab adolescents.

Sex-Specific Cut-Offs of Seven Adiposity Indicators and Their Performance in Predicting Metabolic Syndrome in Arab Adults.

This study aimed to assess several indicators of adiposity and their effectiveness in predicting metabolic syndrome (MetS) and identify their cut-off values among general Saudi adults. Consequently, 833 participants (49% male and 51% female) aged 42.2 ± 11.9 years (408 MetS and 425 as controls) were enrolled into this cross-sectional study. Information on demographics, anthropometrics and biochemical results was retrieved from a registry. MetS was defined according to the National Cholesterol Education Program's (NCEP III) criteria. Overall, the lipid accumulation product (LAP) and waist-TG index (WTI) had the highest discriminatory ability for MetS (area under the curve (AUC): 0.857 and 0.831), respectively, followed by the visceral adiposity index (VAI) and dysfunctional adiposity index (DAI) (AUC: 0.819 and 0.804), respectively. Based on gender, the LAP and WTI were the best indicators for discriminating MetS and presented the highest Youden index values, with cut-off values of 49.8 (sensitivity 68.5%, specificity 82.4%), and 8.7 (sensitivity 70.7%, specificity 81.9%), respectively, in females and 46.2 (sensitivity 85.6%, specificity 76.3%) and 8.9 (sensitivity 73.9%, specificity 84.8%), respectively, in males. The LAP and WTI performed well in both genders with a superior ability to identify MetS in males and could be used to predict MetS in Saudi adults.

General Public's Knowledge of Diabetes and Physical Activity in Saudi Arabia over Time: The Need to Refresh Awareness Campaigns.

Diabetes mellitus (DM) is a major health issue in Saudi Arabia. Prevention of DM and its complications requires an understanding of the disease and modifiable behaviors (e.g., physical activity-PA). The purpose of this study was to examine the trends in knowledge of the general population regarding DM to better understand the shortcomings in the current awareness programs. This article presents a cross-sectional series study where a survey was distributed to a total of 3493 participants over four years, from 2017 till 2020, to assess general knowledge about DM, including information about PA. The mean percentage of correct responses of DM general knowledge was 63.8 ± 19.0 in 2017, which decreased to 61.3 ± 18.7 in 2020 with a significant beta coefficient of -0.8 ± 0.2 (p < 0.001). Participants' awareness about PA remained constantly high for four years: the mean percentage of correct responses was 82.1 ± 23.6 in 2017 and 82.0 ± 23.1 in 2020, and the beta coefficient was -0.5 ± 0.3 (p = 0.147). Furthermore, stratification by demographics showed that the majority of the subgroups (age, sex, educational status, marital status, having relative with DM, nationality) reported a significant declining trend in general DM knowledge. In addition, some of the subgroups also showed a declining trend in PA awareness. Future prevention efforts should assess the community's DM knowledge regularly to tailor awareness efforts to the population segments that need heightened educational interventions.

Patterns of essential trace elements (Cr, Mn, Ni, and Se) in Saudi patients with type 2 diabetes mellitus.

OBJECTIVES: Type 2 diabetes mellitus (T2DM) outcomes were observed to be influenced by circulating trace elements' status. The differences and correlations between serum levels of chromium (Cr), manganese (Mn), nickel (Ni), and selenium (Se) in Saudi patients with and without T2DM as well as those with prediabetes (pre-DM) were examined in this retrospective cross-sectional study. METHODS: Anthropometrics and fasting blood samples were collected from 119 patients with T2DM (aged 41-64 years), 95 non-T2DM (aged 27-55 years), and 80 with pre-DM (aged 35-57 years). An inductively coupled plasma-mass spectrometer was used to measure trace minerals in the blood. RESULTS: T2DM patients had significantly lower Mn serum concentrations than controls. There was no difference in Cr and Ni levels between groups. Serum Mn and Ni levels were lower in pre-DM subjects than controls. Serum Se concentrations were higher in pre-DM and T2DM patients than controls. In T2DM patients, serum Cr and Mn levels were inversely correlated with glucose, while Ni and Se levels were positively correlated with glucose in the T2DM group. CONCLUSIONS: Because of their roles in glucose metabolism, impaired trace element status may also play a role in T2DM pathogenesis. Appropriate dietary control and mineral supplementation are recommended.