Triglycerides and leptin soluble receptor: Which one is the target to protect ß-cells in patients with type 2 diabetes?

Objectives: to study the relationships of leptin and leptin SR with adiposity indices, and glycemic indices in patients with type 2 diabetes mellitus (T2DM) compared to healthy subjects. Methods: This cross-sectional study involved 65 patients with T2DM and 63 healthy controls. Fasting plasma levels of leptin, leptin SR, insulin and lipid profile were measured by enzyme linked immunosorbent essay, basal insulin resistance and beta-cell function were assessed using the homeostasis model assessment. Results: leptin SR level was significantly higher in T2DM patients than in controls (5.8 ± 1.6 and 4.8 ± 1.3 respectively; p= 0.001). In patients with T2DM, leptin SR was negatively correlated with homeostasis model of ß-cell function and body fat mass while it has a significant positive correlation with glycosylated hemoglobin (HbA1c). The independent predictors for leptin SR in patients with T2DM were triglycerides (TG) and HbA1c. Conclusions: elevated serum leptin SR level in patients with T2DM was positively correlated with TG and abnormal glucose metabolism which indicate that it plays a role in pathophysiology of T2DM. The association of elevated leptin SR level with high TG and deterioration of ß-cell function indicate that in some individuals, particularly non-obese, dyslipidemia might be a cause rather than a complication of diabetes.

The Attitude of King Saud University Medical Students Toward Online Distance Learning During the COVID-19 Pandemic.

Objective: To explore the attitudes of medical students at King Saud University (KSU) toward online distance learning during the COVID-19 pandemic and to examine the effects of gender, academic year and level of computer skills on student attitudes toward distance learning. Methods: A previously validated questionnaire was distributed to participants via WhatsApp using a stratified random sampling method. Data were analyzed using SPSS version 26.0 statistical software. Means and standard deviations were used to examine quantitative variables, while frequencies and percentages were used to examine qualitative variables. Results: Our study included 533 students; 71.9% of participants were satisfied with online classes, while 59.6% struggled to receive explanations due to limitations to face-to-face interactions. Two-thirds of participants thought that online classes were more convenient because of their flexibility with respect to location. A similar proportion (65.3%) believed that in situations of distance learning, it was difficult to meet and work with friends. The majority (88.7%) of participants agreed that distance learning saved time and effort spent traveling to campus. Finally, most participants 355 (66.6%), favored blended learning, while only 111 (20.8%) of participants preferred in-class learning. Students in preclinical years had more negative attitudes regarding face-to-face interactions (66.5% vs 54.9%, P=0.027) and meeting with friends (69.3% vs 58.7%, P=0.026) than did students in clinical years. Gender and level of computer skills did not affect students' attitudes toward distance learning (P > 0.05). Conclusion: The majority of student participants felt that online distance learning was an effective option during the pandemic, but they preferred to preserve face-to-face teaching as a concurrent option. Attitudes toward certain aspects of distance learning were more negative among students in preclinical years than among students in clinical years. We did not find any effects of gender or level of computer skills on student attitudes toward distance learning.

Knowledge, Attitudes, and Use of Protein Supplements among Saudi Adults: Gender Differences.

Saudi Arabia has witnessed recent reforms and positive socio-political changes that have led to increased opportunities for women to participate in fitness centers. This study investigated protein supplement consumption among Saudi females compared with that among males and examined the knowledge and attitudes of the participants toward protein supplement use. A cross-sectional study was conducted in Riyadh using a previously validated, self-administered online survey. The questionnaire included items related to the prevalence, knowledge, attitudes, and practice of protein supplementation. The participants were 354 adults (58.2% were females). The results showed that over 47% of the participants attended fitness centers with more male (80.3%) than female (41%) attendees. Nearly 50% of the participants consumed protein supplements, with males (68.7%) using significantly (p < 0.001) more protein supplements than females (35.6%). The powdered form was most commonly consumed. The percentage of gym attendees (67.8%) who used protein supplements was higher than that among non-gym attendees (32.2%). Gaining muscles (56.1%) followed by compensating for protein deficiency (28.6%) were the reasons for taking protein supplements, with a significant gender difference (p < 0.001). Coaches provided the most information on protein supplements. The participants appeared to be knowledgeable about protein supplements. Although over 68% of protein supplement users suffered from various symptoms, only 20% of the participants thought that there was no risk in taking protein supplements, with significant gender differences. It was concluded that Saudi male participants are twice more likely to attend the gym and consume protein supplements compared with females. Of both genders, those attending the gym consumed more protein supplements than non-gym attendees.

Evaluation of a Multidisciplinary Extracurricular Event Using Kolb's Experiential Learning Theory: A Qualitative Study.

Background and Purpose: Although health science programs run parallel to each other and comprise of shared core subjects between the different disciplines, students of the different disciplines rarely mix or interact with each other during their undergraduate studies. Extracurricular activities are a big part of university students' life, through which students have an opportunity to express themselves and enhance their soft skills in a safe and relaxed environment. Recently, King Saud University (KSU), Saudi Arabia, launched a multi-disciplinary event aimed at raising public's awareness of their rights and responsibilities in the healthcare system. Although the event was designed to educate the public about their rights and responsibilities in the healthcare system, it has proven to be a good opportunity to promote interprofessional education among participating students. This study aims to review and assess the impact of this multi-disciplinary public awareness event on the acquisition of core interprofessional competencies by participating students from the health sciences using Kolb's experiential learning theory as a framework. Patients and Methods: This qualitative study used semi-structured Zoom interviews in Nov 2020 with health science students who participated in the event. The research team used a pre-designed topic guide based on Kolb's experiential learning theory (KELT) for the interview questions. The interviews were recorded, transcribed, coded, and analysed using thematic analysis. Results: Twenty-one students, representing four health science colleges at KSU participated in three focus groups. The main themes identified were participants' attitudes towards the event, the types of knowledge and skills acquired from the event, and how they practically applied the knowledge acquired. These themes were aligned to KELT as this study's framework. Conclusion: The event covered the most important concepts of interprofessional education and could be a potential tool to educate students from multiple disciplines.

Interprofessional Education Competition During the COVID-19 Pandemic at King Saud University: Benefits and Challenges.

BACKGROUND: The objective of this qualitative study was to explore the value of virtual IPE competition that involved a COVID-19 case among healthcare students and the lessons that can be learned to improve this experience in the future. METHODS: The 27 senior students from the colleges of medicine, pharmacy, nursing, and paramedics were invited to two focus groups that followed the IPE competition and lasted 60 minutes each. A semi-structured focus group discussion guide was used in the focus group discussion to explore the benefits and limitations of the virtual IPE experience. Verbatim transcription of the two video-recorded sessions was conducted, and inductive thematic analysis was performed to uncover different emerging themes. RESULTS: The number of students who consented to participate was 16 (59.26%). The IPE virtual competition was perceived favorably by all students; however, multiple organization and communication barriers were reported. Although the participants liked the IPE virtual competition, they clearly stated their preference for an in-person IPE competition over the virtual one. Managing a COVID-19 case was not perceived favorably by some participants due to the absence of evidence-based clinical guidelines supporting certain treatment protocols over others. Thus, some participants preferred a non-COVID-19 case where clear and evidence-based guidelines exist. CONCLUSION: The use of different IPE strategies to enhance healthcare students' collaboration and understanding of their roles in the multidisciplinary healthcare team, especially during pandemic times, such as COVID-19, is possible. Future studies should examine new and innovative IPE strategies that address the identified limitations of virtual IPE.

Disparity among Endocrinologists and Gynaecologists in the Diagnosis of Polycystic Ovarian Syndrome.

OBJECTIVES: This study aimed to compare endocrinologists' versus gynaecologists' approaches in using the Rotterdam criteria to diagnose polycystic ovarian syndrome (PCOS). METHODS: This cross-sectional study was conducted at Physiology Department, King Saud University, Riyadh, Saudi Arabia, between December 2017 and April 2018. A validated self-administered questionnaire in English was used to obtain information from endocrinologists and gynaecologists regarding their approaches to diagnosing PCOS. Each group's diagnostic use of the Rotterdam criteria, association between years of experience and clinical decision-making, clinical features leading to diagnosis and considerations in the diagnosis of biochemical parameters that define hyperandrogenism were evaluated. RESULTS: A total of 132 physicians were included in this study (response rate: 27%); 77 (58.3%) were endocrinologists and 55 (41.7%) were gynaecologists. Most of the respondents (79.5%) had ≤20 years of experience. A statistically significant difference was detected between the endocrinologists and gynaecologists (98.7% versus 81.8%; P = 0.001) in their consideration of hyperandrogenism in the diagnosis. The gynaecologists relied more on ovarian morphology than the endocrinologists did (76.4% versus 45.5%, P <0.0001). Physicians with more experience used ovarian ultrasonography more compared to those with less experience (P = 0.006). CONCLUSION: There was disparity in the diagnostic approaches of endocrinologists, who rely more on androgen levels for diagnosis of PCOS versus gynaecologists, who more frequently use an ovarian morphology assessment. Increased years of experience increased the rate of ultrasonography use for PCOS diagnosis in both groups.

Medical students' readiness and perceptions about Interprofessional Education: A cross sectional study.

OBJECTIVES: Interprofessional Education (IPE) provides an environment where learners demonstrate the knowledge, skills and attitude required to manage the complex clinical scenarios in a collaborative and interprofessional manner. The actual sphere of influence of Interprofessional Education in many medical schools has been limited. Therefore, the present study aim was to evaluate the medical students' readiness and perception of Interprofessional Education in a medical college in Saudi Arabia. METHODS: This questionnaire based cross sectional study was executed in the Department of Physiology, College of Medicine, King Saud University during the period September 2016 to December 2017, using the 19-item Readiness for Interprofessional Learning Scale (RIPLS) with four subscales teamwork and collaboration, negative professional identity, positive professional identity and roles and responsibilities. The questionnaire was e-mailed to 1411 medical students and responses were analyzed using 5-point Likert scale. RESULTS: A total of 158 medical students and trainees responded to the survey, 69 (43.6%) were males and 89 (56.4%) were females. The majority of participants 122-148 (77-94%) acknowledged the positive impact of IPE on teamwork and collaboration, more than two thirds 105 (64.45%) disagreed with negative attitude and 110-126 (70-80%) showed positive professional identity. CONCLUSIONS: Medical students showed a positive perception and ready to adopt the Interprofessional Educational allied activities in medical schools. The shared academic events would improve in clarifying the roles and responsibilities of medical students in health care professions.

Elevated Serum TNF-α Is Related to Obesity in Type 2 Diabetes Mellitus and Is Associated with Glycemic Control and Insulin Resistance.

Background: Diabetes and obesity are very common associated metabolic disorders that are linked to chronic inflammation. Leptin is one of the important adipokines released from adipocytes, and its level increases with increasing body mass index (BMI). Tumor necrosis factor alpha (TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-Methodology. This is a cross-sectional study involving 63 healthy volunteers and 65 patients with T2DM. Body composition was measured, and fasting venous blood samples were analyzed for blood glucose, glycosylated hemoglobin (HbA1c), basal insulin, leptin, and TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF. Results: Our study showed a significantly higher level of TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-p=0.008). In obese diabetic patients, the serum level of TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-p=0.008). In obese diabetic patients, the serum level of TNF-p=0.008). In obese diabetic patients, the serum level of TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-r = 0.361, p=0.008). In obese diabetic patients, the serum level of TNF-r = 0.361, p=0.008). In obese diabetic patients, the serum level of TNF. Conclusion: TNF-α is associated with concurrent obesity and T2DM and correlates with HbA1c. This suggests that TNF-α needs further investigation to explore if it has a role in monitoring the effectiveness of management in individuals with obesity and T2DM.α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF-α) is a cytokine that is released by adipocytes and inflammatory cells in response to chronic inflammation. Type 2 diabetes mellitus (T2DM) is believed to be associated with low-grade chronic inflammation. The current study aims to investigate the involvement of leptin and TNF.

A Profile of Physical Activity, Sedentary Behaviors, Sleep, and Dietary Habits of Saudi College Female Students.

BACKGROUND: Few studies have reported valid comprehensive data on lifestyle habits of Saudi college females. In addition, studies on sedentary behaviors (SBs) and the duration of sleep of Saudi college students are rare. Saudi females appear to be less physically active and therefore, at a higher risk of noncommunicable diseases (NCDs). Therefore, the purpose of this study was to investigate lifestyle patterns of Saudi college females, including physical activity (PA), SBs, duration of sleep, and dietary habits. MATERIALS AND METHODS: A cross-sectional study was conducted among females attending health science colleges of King Saud University, using multistage stratified cluster sample (n = 456). Weight, height, PA, SB, sleep, and dietary habits were all assessed using a previously validated questionnaire. RESULTS: Nearly half of the college females were physically inactive. Females exercised mostly at home or alone at no specific time of day. Their activity was for health reasons (43.4%) for weight loss (28.7%); lack of time (71.2%) was the primary reason for inactivity. The majority (>85%) of females spent more time in sedentary activity (>3 h/day) while 95% of females had insufficient sleep (<8 h/night). Over 40% of the participants consumed breakfast or vegetables 5 days or more per week, whereas the corresponding proportions for fruit and milk/dairy products intake were 19.4% and 58.4%, respectively. The proportions of college females who consumed less healthy foods for 3+ days/week were fairly variable, ranging from 21.1% for French fries to 60.4% for chocolates/candy. The predictors of total PA time were increased the duration of sleep and reduced intake of French fries/potato chips. CONCLUSIONS: Unhealthy lifestyle habit appears prevalent among Saudi college females. Efforts toward promoting PA, decreasing SB, and insufficient sleep and improving dietary habits in Saudi females are needed to reduce future risks of NCDs.

Physical Fitness and Its Relationship to Plasma Leptin, Leptin Soluble Receptor, and Free Leptin Index in a Saudi Population: A Comparison Between Diabetic and Non-Diabetic Individuals.

BACKGROUND Low physical activity is considered to be a risk factor for type 2 diabetes mellitus (T2DM). One theory suggest that leptin resistance is involved in the pathophysiology of impaired glucose metabolism. In this study we aimed to assess the correlation of physical fitness scores (PFS) with serum total leptin (TL), serum leptin soluble receptor (LSR), and free leptin index (FLI) in a group of Saudi patients with T2DM. MATERIAL AND METHODS This cross-sectional study involved 115 subjects: 52 healthy control subjects and 63 patients with T2DM. All subjects underwent body composition analysis. Blood samples were analyzed for fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), serum total leptin (TL), and serum leptin soluble receptor (LSR). Based on ideal body composition and our previous studies, physical fitness scores (PFS) were recorded for each subject. RESULTS In patients with T2DM, levels of LSR were positively correlated with PFS (r=0.281, p=0.025), while the levels of TL (r=-0.425, p=0.001) and FLI (r=-0.439, p=0.001) were negatively correlated with PFS. In control subjects, TL and FLI levels were negatively correlated (r=-0.612, p=0.001and r=-0.543, p=0.001 respectively) with PFS. In linear regression analysis, after adjustment for age and BMI, TL and FLI were independent predictors of PFS. CONCLUSIONS Serum TL and FLI were negatively correlated while LSR was positively correlated with PFS in patients with T2DM. Therefore, they may be important biomarkers for predicting the outcomes of physical fitness and exercise programs.

Lifestyle Habits in Relation to Overweight and Obesity among Saudi Women Attending Health Science Colleges.

The study examined the associations between lifestyle habits and overweight/obesity among Saudi females attending health science colleges. A total of 454 female students were randomly recruited from five health science colleges at King Saud University, using a multistage stratified cluster sampling technique. Body weight and height were measured, and body mass index was calculated. All participants answered a validated questionnaire to assess physical activity (PA), sedentary behaviors (SB), sleep duration, and dietary habits. Results showed that the prevalence of overweight (21.4%) plus obesity (8.1%) among female participants was 29.5%. There was no significant difference between overweight/obese and nonoverweight/nonobese females in PA, screen time, sleep duration, or dietary habits. Overall, 50.4% of the participants were physically inactive (activity energy expenditure was <600 metabolic equivalent minutes per week). Active females showed significantly (p < 0.01) higher intakes of vegetables and fruits, lower chocolate/candy consumption (p = 0.05), and higher proportion of sufficient sleeping duration (>8 hours per night) (p < 0.001). It was concluded that half of the Saudi females in this study were physically inactive. Although PA positively impacted some of the lifestyle habits of college females, overweight/obesity was not associated with PA, SB, sleeping time, or dietary habits among the participants. Future research should attempt to elucidate the key factors involved in such relationship.

Expression of the prostaglandin F synthase AKR1B1 and the prostaglandin transporter SLCO2A1 in human fetal membranes in relation to spontaneous term and preterm labor.

BACKGROUND: Human labor is a complex series of cellular and molecular events that occur at the materno-fetal and uterine levels. Many hypotheses have been proposed for the initiation of human labor, one hypothesis suggests that maturation of the fetus releases a signal in the amniotic fluid that will be transmitted to myometrium via the fetal membranes and initiate uterine contractions. There is strong evidence that prostaglandins (PGs) play a central role in initiation and progression of human labor. OBJECTIVES: In this study we intended to investigate the expression of prostaglandin F synthase and the prostaglandin transporter in the human fetal membranes and to explore the relationship between cytokines and PGs in the mechanism of human labor. METHODS: We used fetal membranes obtained before labor at term and after spontaneous labor at term or preterm to identify the changes in prostaglandin F synthase (AKR1B1) and human prostaglandin transporter (SLCO2A1) proteins in relation to parturition. Using fetal membranes explants we tested the effect of cytokines (interleukin-1 and tumor necrosis factor alpha) on PG production and the concomitant changes in cyclooxygenase-2 (PTGS2), AKR1B1 and SLCO2A1 expression. RESULTS: Expression of PTGS2 and AKR1B1 was upregulated in the fetal membranes in association with term labor while SLCO2A1 was downregulated with advancing gestation and during term labor. Before labor, IL-1 increased the expression of PTGS2, however during labor TNF upregulated PTGS2 and AKR1B1 proteins. CONCLUSIONS: The prostaglandin F synthase AKR1B1 is upregulated while prostaglandin transporter is downregulated during term labor. The amnion is more responsive than choriodecidua to stimulation with pro-inflammatory cytokines. The mechanisms of term and preterm labor are different.