Endoplasmic reticulum stress: bridging inflammation and obesity-associated adipose tissue.

Obesity presents a significant global health challenge, increasing the susceptibility to chronic conditions such as diabetes, cardiovascular disease, and hypertension. Within the context of obesity, lipid metabolism, adipose tissue formation, and inflammation are intricately linked to endoplasmic reticulum stress (ERS). ERS modulates metabolism, insulin signaling, inflammation, as well as cell proliferation and death through the unfolded protein response (UPR) pathway. Serving as a crucial nexus, ERS bridges the functionality of adipose tissue and the inflammatory response. In this review, we comprehensively elucidate the mechanisms by which ERS impacts adipose tissue function and inflammation in obesity, aiming to offer insights into targeting ERS for ameliorating metabolic dysregulation in obesity-associated chronic diseases such as hyperlipidemia, hypertension, fatty liver, and type 2 diabetes.

Effects and Mechanistic Role of Mulberry Leaves in Treating Diabetes and its Complications.

Diabetes mellitus (DM) has become a surge burden worldwide owing to its high prevalence and range of associated complications such as coronary artery disease, blindness, stroke, and renal failure. Accordingly, the treatment and management of DM have become a research hotspot. Mulberry leaves (Morus alba L.) have been used in Traditional Chinese Medicine for a long time, with the first record of its use published in Shennong Bencao Jing (Shennong's Classic of Materia Medica). Mulberry leaves (MLs) are considered highly valuable medicinal food homologs that contain polysaccharides, flavonoids, alkaloids, and other bioactive substances. Modern pharmacological studies have shown that MLs have multiple bioactive effects, including hypolipidemic, hypoglycemic, antioxidation, and anti-inflammatory properties, with the ability to protect islet [Formula: see text]-cells, alleviate insulin resistance, and regulate intestinal flora. However, the pharmacological mechanisms of MLs in DM have not been fully elucidated. In this review, we summarize the botanical characterization, traditional use, chemical constituents, pharmacokinetics, and toxicology of MLs, and highlight the mechanisms involved in treating DM and its complications. This review can provide a valuable reference for the further development and utilization of MLs in the prevention and treatment of DM.

Efficacy and safety of traditional Chinese medicines combined with conventional Western medicines in the treatment of type 2 diabetes mellitus: a network meta-analysis of randomized controlled trials.

Aims/hypothesis: Through a comprehensive analysis of the clinical randomized controlled trials of traditional Chinese medicine (TCM) combined with conventional western medicine (CWM) in treating type 2 diabetes(T2DM) in the past ten years, the clinical efficacy and safety of different TCMs combined with CWM were explored. This study aimed to provide specific suggestions for clinical guidance on treating T2DM. Methods: A literature search was conducted in CNKI, WanFang, VIP, CBM, PubMed, Embase, and Web of Science. The search time was limited from 2010 to the present time. The literature type was a controlled clinical trial study of TCM combined with CWM intervention in treating T2DM. The outcome indices of the efficacy evaluation included fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), adverse reactions, and clinical efficacy. Stata 15 and RevMan 5.4 software were used to conduct a network meta-analysis and a traditional meta-analysis. Results: The results showed that shenqi jiangtang granule combined with sulfonylurea, shenqi jiangtang granules combined with metformin and jinlida granules combined with insulin had significant effects on reductions in FBG, 2hPG and clinical efficacy compared with western medicines alone, which included fasting blood glucose [MD=-2.17, 95%CI=(-2.50, -1.85)], blood sugar at 2 hours after a meal [MD=-1.94, 95%CI=(-2.23, -1.65)], and clinical curative effect [OR= 1.73, 95%CI=(0.59, 2.87)]. Conclusions: TCM combined with CWM has a very significant effect on treating T2DM compared with CWM alone. According to the network meta-analysis, the best intervention measures of different TCMs for different outcome indicators were obtained. Systematic review registration: identifier 42022350372.

PDX-1: A Promising Therapeutic Target to Reverse Diabetes.

The pancreatic duodenum homeobox-1 (PDX-1) is a transcription factor encoded by a Hox-like homeodomain gene that plays a crucial role in pancreatic development, ß-cell differentiation, and the maintenance of mature ß-cell functions. Research on the relationship between PDX-1 and diabetes has gained much attention because of the increasing prevalence of diabetes melitus (DM). Recent studies have shown that the overexpression of PDX-1 regulates pancreatic development and promotes ß-cell differentiation and insulin secretion. It also plays a vital role in cell remodeling, gene editing, and drug development. Conversely, the absence of PDX-1 increases susceptibility to DM. Therefore, in this review, we summarized the role of PDX-1 in pancreatic development and the pathogenesis of DM. A better understanding of PDX-1 will deepen our knowledge of the pathophysiology of DM and provide a scientific basis for exploring PDX-1 as a potential target for treating diabetes.

The efficacy of Chinese patent medicine intervention on blood glucose and lipid in prediabetes: A meta-analysis.

Objective: The purpose of this study was to analyze the efficacy and safety of Chinese patent medicine in the treatment of blood glucose, blood lipid and insulin resistance in prediabetic patients through a meta-analysis of clinical trials. Methods: Randomized controlled trials of Chinese patent medicine in the treatment of prediabetes were searched in the databases of CNKI, WanFang, VIP, CBM, PubMed, Web of Science and Embase using the computer with the search deadline on June 2, 2022. The two researchers independently screened the literatures based on the inclusion and exclusion criteria, and the fasting blood glucose, postprandial blood glucose, glycated hemoglobin, insulin resistance index, blood lipids, prediabetes reversal rate and diabetes conversion rate were used as outcome indicators. The quality of the study was evaluated according to the Cochrane scale, and data were analyzed by RevMan software. Results: Sixteen clinical trial studies were eventually fitted into, and a meta-analysis was conducted on the included studies, and the final results showed as follows: Compared with conventional lifestyle intervention, the remedy of Chinese patent medicine intervention in prediabetes patients had significant effects on the outcome indicators, such as fasting blood glucose [MD = -0.36, 95%CI = (-0.45,-0.26), P < 0.00001], 2 h postprandial blood glucose [MD = -0.71, 95%CI = (-0.99,-0.42), P < 0.00001], glycated hemoglobin [MD = -0.33, 95%CI = (-0.48,-0.19), P < 0.00001], BMI [MD = -0.82, 95%CI = (-1.20,-0.44), P < 0.0001], insulin resistance index [MD = -0.20, 95%CI = (-0.29,-0.11), P < 0.00001], diabetes conversion rate [MD = 0.49, 95%CI = (0.34,0.70), P＜0.0001], and the differences were indicated as a statistically significant. However, the outcome indexes of TC, TG, HDL-C and LDL-C in blood lipid exhibited no significant effect, and no significant difference. Conclusions: The results indicated that Chinese patent medicine intervention could ameliorate the outcome indicators of prediabetes with significant efficacy and good safety. Its therapeutic effect was mainly manifested in blood glucose, insulin, body weight, and diabetes conversion rate. Chinese patent medicine maybe a promising avenue for prediabetes.