Visceral adiposity index as a predictor of type 2 diabetes mellitus risk: A systematic review and dose-response meta-analysis.

AIMS: Considering the positive association between visceral adiposity index (VAI) and type 2 diabetes mellitus (T2DM), no comprehensive assessment on the summarized and dose-response relationship between VAI and T2DM has yet been reported. Therefore, we performed a meta-analysis, including dose-response analysis, to quantitively elucidate this association. DATA SYNTHESIS: MEDLINE via PubMed and Embase databases were searched for relevant articles up to December 14, 2021. Random-effects generalized least squares regression models were used to assess the quantitative association between VAI and T2DM risk across studies. Restricted cubic splines were used to model the dose-response association. A total of 9 prospective cohort studies and 5 cross sectional studies were included in our review. Based on the meta-analysis, the pooled RR of T2DM was 2.05 (95% CI 1.74-2.41) for the highest versus reference VAI category. We found that the risk of T2DM was increased by 44% (RR, 1.44; 95% CI, 1.23-1.68) with each 1-unit increment of VAI. While, we found no evidence of a nonlinear dose-response association of VAI and T2DM (Pnon-linearity = 0.428). With the linear cubic spline model, when compared to population with VAI at 0.6, for those with VAI at 2.0, the risk of T2DM was increased by 81% (RR, 1.81; 95% CI 1.55-2.12). CONCLUSIONS: Our meta-analysis provides quantitative data suggesting that VAI is associated with an increased risk of T2DM. Public health strategies focusing on weight loss among obesity, especially the people characterized by the thin-on-the-outside--fat-on-the-inside phenotype could possibly reduce a substantial risk of T2DM. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022372666.

Efficacy of the ketogenic diet in Chinese adults versus children with drug-resistant epilepsy: A pilot study.

OBJECTIVE: We compared the efficacy and safety of ketogenic diet (KD) therapy as a treatment for Chinese adults versus children with drug-resistant epilepsy. METHODS: The classic KD was initiated in 19 adults and 29 children with drug-resistant epilepsy. The KD ratio and the dosage of antiseizure medication (ASM) were delicately modulated by the ketogenic team. RESULTS: At 12 months after diet initiation, 11 adults (8 on a KD ratio of 3:1 and 3 on a ratio of 2:1) and 20 children (9 on a ketogenic diet ratio of 3:1 and 11 on a ratio of 2:1) remained on the diet. The retention rate for adult KD therapy recipients was 79.0% at 6 months and 57.9% at 12 months after diet initiation, which was not significantly different from the retention rate for children (82.8% at 6 months and 68.9% at 12 months; P > 0.05). The efficacy rate of KD therapy (seizure freedom or ≥50% reduction in seizure frequency) did not significantly differ between adults (63.2%) and children (75.8%, P = 0.517). Alleviation of seizure severity was observed in 68.4% of adults and 63.6% of children who were not seizure free on KD therapy. Antiseizure medication was reduced in 34 out of all 48 individuals at the final follow-up. CONCLUSION: Our study demonstrated that KD therapy is a safe and effective treatment for Chinese adults as well as children with drug-resistant epilepsy.

Effects of low-carbohydrate vs low-fat diets on weight loss and metabolic risk factors in obese/overweight individuals with impaired glucose regulation: A randomized controlled trial.

BACKGROUND AND OBJECTIVES: The aim of this study was to compare the effects of low-carbohydrate diet (LCD) versus low-fat diet (LFD) on weight loss, glycemic control and metabolic risk factors in individuals with impaired glucose regulation (IGR) after 10-week intervention. METHODS AND STUDY DESIGN: In this 10-week randomized controlled trial, 90 obese/overweight adults with IGR were randomly assigned to consume either low-carbohydrate diet (20%-25% energy from carbohydrates, 30%-45% energy from fat, 40%-45% en-ergy from protein), or low-fat diet (40%-55% energy from carbohydrates, 20%-30% energy from fat, 20%-30% energy from protein), or heath education (HE) group. The anthropometry and body composition were collected at baseline, week 4, week 8 and week 10. The glycemia and metabolic indicators were assessed at baseline and week 10. RESULTS: A total of 69 participants (mean±SE age: 39.2±1.0 years, 72.5% women) completed the intervention and were included in the final analysis. At week 10, all three groups presented similar mean reduction in weight (LCD: 5.80±0.6 kg; LFD: 6.36±0.57 kg; HE: 4.49±0.98 kg), and fasting blood glucose (LCD: 0.73±0.13 mmol/L; LFD: 0.84±0.17 mmol/L; HE: 0.58±0.14 mmol/L). Additionally, there were no differences in the improvements of TG and liver function markers between diets, the low-fat diet exhibited more favorable effects on TC level. CONCLUSIONS: Both diets achieved similar weight loss, fasting glucose, and insulin reduction in short-term, suggesting each diet pattern could be an effective strategy for the prediabetes management.

Effect of vitamin D supplementation on markers of cardiometabolic risk in children and adolescents: A meta-analysis of randomized clinical trials.

BACKGROUND AND AIMS: An increasing attention to the effect of vitamin D supplementation on cardiometabolic risk markers in children and adolescents has been gained recently. However, the results are inconsistent. Therefore, we conducted a meta-analysis to examine the effect of vitamin D supplementation on cardiometabolic risk markers in children and adolescents. METHODS AND RESULTS: Eligible randomized controlled trials (RCTs) were identified by searching PubMed, EMBASE and Web of Science. The results of this study are synthetized and reported in accordance with the PRISMA statement. GRADE system was used to assess the certainty of evidence. A total of 9 RCTs were identified and included in the meta-analysis. We found that vitamin D supplementation did not affect the changes of cardiometabolic risk markers including high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), body mass index (BMI), waist circumferences, systolic blood pressure (SDP) and diastolic blood pressure (DBP). However, vitamin D supplementation showed a beneficial effect on fasting glucose (MD, -1.54 mg/dl, 95% CI -2.98 to -0.10) and TG (MD, -24.76 mg/dl, 95% CI -37.66 to -11.86) in the sub-group analysis of total vitamin D supplementation ≥ 200,000 IU. CONCLUSIONS: Vitamin D supplementation appeared to have a beneficial effect on reducing fasting glucose and TG level when total vitamin D supplementation ≥200,000 IU but not HDL-C, LDL-C TC, blood pressure and waist circumferences levels in children and adolescents. Further studies are needed to address this issue.

The effect of aspartame on accelerating caspase-dependent apoptosis of pancreatic islet via ZIPK/STAT3/caspase 3 signaling pathway.

Aspartame (ASP) as an important sugar substitute is widely used in pharmaceutical and food processing. Here, we compared the effects of ASP and sucrose on mice pancreatic islet cells in vivo and observed that ASP with the condition of high concentration and long-term exposure (HASP) could cause insulin secretion (500 mg/kg for 1 month). Next, we conducted iTRAQ mass spectrometry to profile the global phosphoproteome and found that phosphorylation of zipper-interacting protein kinase (ZIPK) in murine pancreatic islet tissues were induced at Thr197, Thr242, Thr282, and Ser328 by high-sucrose (HS) treatment, but only induced at Thr197 and Ser328 by HASP treatment. Simultaneously, phosphorylation of STAT3 could be induced at Tyr705 and Ser727 by HS but not by HASP. Furthermore, presence of activated STAT3 accompanied with autophagy was observed in HS treatment. In turn, the inactivation of STAT3 as well as enhanced expression of caspase 3 was observed in HASP treatment. We generated Thr242APro and Thr282Pro on ZIPK using CRISPR-Cas9 in ß-TC3 cells and found the weakened interaction with STAT3 as well as the reduced phosphorylation of STAT3 even under HS stimulation. Finally, we observed that ankyrin repeat domain containing 11 (ANKRD11) could interact with ZIPK and play an inhibitory role in the phosphorylation of Thr242APro and Thr282Pro of ZIPK. However, HASP can induce the retention of ANKRD11 in the cytoplasm by phenylpyruvic acid (the metabolite of ASP). Taken together, this study determined that ASP with high concentration and long-term exposure could lead to caspase-dependent apoptosis of pancreatic islet cells through ANKRD11/ZIPK/STAT3 inhibition. Our results give evidence of adverse effects of aspartame on islet cells in some extreme conditions, which might help people to reconsider the biosafety of non-nutritive sweeteners.

Health economic evaluation of an artificial intelligence (AI)-based rapid nutritional diagnostic system for hospitalised patients: A multicentre, randomised controlled trial.

BACKGROUND & AIMS: Malnutrition is prevalent among hospitalised patients, and increases the morbidity, mortality, and medical costs; yet nutritional assessments on admission are not routine. This study assessed the clinical and economic benefits of using an artificial intelligence (AI)-based rapid nutritional diagnostic system for routine nutritional screening of hospitalised patients. METHODS: A nationwide multicentre randomised controlled trial was conducted at 11 centres in 10 provinces. Hospitalised patients were randomised to either receive an assessment using an AI-based rapid nutritional diagnostic system as part of routine care (experimental group), or not (control group). The overall medical resource costs were calculated for each participant and a decision-tree was generated based on an intention-to-treat analysis to analyse the cost-effectiveness of various treatment modalities. Subgroup analyses were performed according to clinical characteristics and a probabilistic sensitivity analysis was performed to evaluate the influence of parameter variations on the incremental cost-effectiveness ratio (ICER). RESULTS: In total, 5763 patients participated in the study, 2830 in the experimental arm and 2933 in the control arm. The experimental arm had a significantly higher cure rate than the control arm (23.24% versus 20.18%; p = 0.005). The experimental arm incurred an incremental cost of 276.52 CNY, leading to an additional 3.06 cures, yielding an ICER of 90.37 CNY. Sensitivity analysis revealed that the decision-tree model was relatively stable. CONCLUSION: The integration of the AI-based rapid nutritional diagnostic system into routine inpatient care substantially enhanced the cure rate among hospitalised patients and was cost-effective. REGISTRATION: NCT04776070 (https://clinicaltrials.gov/study/NCT04776070).

The role of dietary modification in the prevention and management of metabolic dysfunction-associated fatty liver disease: An international multidisciplinary expert consensus.

Metabolic dysfunction-associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD), has become the leading cause of chronic liver disease worldwide. Optimal dietary intervention strategies for MAFLD are not standardized. This study aimed to achieve consensus on prevention of MAFLD through dietary modification. A multidisciplinary panel of 55 international experts, including specialists in hepatology, gastroenterology, dietetics, endocrinology and other medical specialties from six continents collaborated in a Delphi-based consensus development process. The consensus statements covered aspects ranging from epidemiology to mechanisms, management, and dietary recommendations for MAFLD. The recommended dietary strategies emphasize adherence to a balanced diet with controlled energy intake and personalized nutritional interventions, such as calorie restriction, high-protein, or low-carbohydrate diets. Specific dietary advice encouraged increasing the consumption of whole grains, plant-based proteins, fish, seafood, low-fat or fat-free dairy products, liquid plant oils, and deeply colored fruits and vegetables. Concurrently, it advised reducing the intake of red and processed meats, saturated and trans fats, ultra-processed foods, added sugars, and alcohol. Additionally, maintaining the Mediterranean or DASH diet, minimizing sedentary behavior, and engaging in regular physical activity are recommended. These consensus statements lay the foundation for customized dietary guidelines and proposing avenues for further research on nutrition and MAFLD.

Functional foods and dietary supplements in the management of non-alcoholic fatty liver disease: A systematic review and meta-analysis.

Objective: In this systematic review and meta-analysis, we aimed to clarify the overall effects of functional foods and dietary supplements in non-alcoholic fatty liver disease (NAFLD) patients. Methods: Randomized controlled trials (RCTs) published in PubMed, ISI Web of Science, Cochrane library, and Embase from January 1, 2000 to January 31, 2022 were systematically searched to assess the effects of functional foods and dietary supplements in patients with NAFLD. The primary outcomes were liver-related measures, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and hepatic fibrosis and steatosis, while the secondary outcomes included body mass index (BMI), waist circumference (WC), triacylglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). These indexes were all continuous variables, so the mean difference (MD) was used for calculating the effect size. Random-effects or fixed-effects models were used to estimate the mean difference (MD). The risk of bias in all studies was assessed with guidance provided in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Twenty-nine articles investigating functional foods and dietary supplements [antioxidants (phytonutrients and coenzyme Q10) = 18, probiotics/symbiotic/prebiotic = 6, fatty acids = 3, vitamin D = 1, and whole grain = 1] met the eligibility criteria. Our results showed that antioxidants could significantly reduce WC (MD: -1.28 cm; 95% CI: -1.58, -0.99, P < 0.05), ALT (MD: -7.65 IU/L; 95% CI: -11.14, -4.16, P < 0.001), AST (MD: -4.26 IU/L; 95% CI: -5.76, -2.76, P < 0.001), and LDL-C (MD: -0.24 mg/dL; 95% CI: -0.46, -0.02, P < 0.05) increased in patients with NAFLD but had no effect on BMI, TG, and TC. Probiotic/symbiotic/prebiotic supplementation could decrease BMI (MD: -0.57 kg/m2; 95% CI: -0.72, -0.42, P < 0.05), ALT (MD: -3.96 IU/L; 95% CI: -5.24, -2.69, P < 0.001), and AST (MD: -2.76; 95% CI: -3.97, -1.56, P < 0.0001) levels but did not have beneficial effects on serum lipid levels compared to the control group. Moreover, the efficacy of fatty acids for treating NAFLD was full of discrepancies. Additionally, vitamin D had no significant effect on BMI, liver transaminase, and serum lipids, while whole grain could reduce ALT and AST but did not affect serum lipid levels. Conclusion: The current study suggests that antioxidant and probiotic/symbiotic/prebiotic supplements may be a promising regimen for NAFLD patients. However, the usage of fatty acids, vitamin D, and whole grain in clinical treatment is uncertain. Further exploration of the efficacy ranks of functional foods and dietary supplements is needed to provide a reliable basis for clinical application. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier: CRD42022351763.

Association of eating habits with health perception and diseases among Chinese physicians: a cross-sectional study.

Background: Some eating habits may be related to the development of gastrointestinal diseases, obesity, and related metabolic dysfunctions. Because of long working hours, and shift schedules, physicians are more likely to form such eating habits and have a high risk of developing these diseases. Objectives: We aimed to investigate the association between physicians' eating habits and their health perception and diseases. Methods: Between 24 June and 5 August 2020, we performed convenience sampling of in-service physicians in hospitals in mainland China. A questionnaire was administered to collect data pertaining to basic sociodemographic characteristics, eating habits, health-related information such as body mass index classification, and prevalence of common diseases. The associations among eating habits and perceived suboptimal health status, micronutrient deficiency-related diseases, obesity, and related metabolic diseases were analysed. Results: The prevalence of unhealthy eating habits was high: more eating out-of-home (53.4% in hospital canteens, 23.0% in restaurants and takeaways), fewer meals at home, irregular meals (30.5%), and eating too fast (the duration <10 min, 34.6%). Among those with the above eating habits, the prevalence rates of sub-optimal health and disease were higher than among those without the above eating habits. Conclusion: Eating habits such as frequent eating out-of-home, irregular meals, and eating too fast were common among physicians, and were significantly related to perceived sub-optimal health status and disease occurrence.

Increased risk of cancer in patients with type 2 diabetes mellitus: a retrospective cohort study in China.

BACKGROUND: Previous studies indicated that type 2 diabetes mellitus (T2DM) might be associated with the risk of cancer. The aim of this study was to investigate the association between T2DM and the risk of developing common cancers in a Chinese population. METHODS: A population-based retrospective cohort study was carried out in the Nan-Hu district of Jiaxing city, Zhejiang province, China. The incidence of cancer cases among type 2 diabetic patients were identified through record-linkage of the Diabetic Surveillance and Registry Database with the Cancer Database from January 2002 to June 2008. The standardized incidence ratio (SIR) and 95% confidence interval (CI) were estimated for the risk of cancer among the patients with type 2 diabetes. RESULTS: The overall incidence of cancer was 1083.6 per 10(5) subjects in male T2DM patients and 870.2 per 105 in females. Increased risk of developing cancer was found in both male and female T2DM patients with an SIR of 1.331 (95% CI = 1.143-1.518) and 1.737 (1.478-1.997), respectively. As for cancer subtypes, both male and female T2DM patients had a significantly increased risk of pancreatic cancer with the SIRs of 2.973 (1.73-4.21) and 2.687 (1.445-3.928), respectively. Elevated risk of liver and kidney cancers was only found in male T2DM patients with SIRs of 1.538 (1.005-2.072) and 4.091 (1.418-6.764), respectively. Increased risks of developing breast cancer [2.209 (1.487-2.93)] and leukemia SIR: [4.167 (1.584- 6.749) ] were found in female patients. CONCLUSIONS: These findings indicated that patients with T2DM have an increased risk of developing cancer. Additional cancer screening should be employed in the management of patients with T2DM.

Habitual Fish Oil Supplementation and Risk of Incident Inflammatory Bowel Diseases: A Prospective Population-Based Study.

Background: Inflammatory Bowel Diseases (IBDs) have been emerging in recent years with the advance of global industrialization and diet pattern transformation. Marine n-3 polyunsaturated fatty acids (n-3 PUFAs), enriched in fish oils, have well-known human health promotion. Evidence on the association of fish oil supplementation with the risk of developing IBDs was scarce. This study aimed to examine the association between the use of fish oil supplements and the risk of developing inflammatory bowel diseases (IBDs) among the general population. Methods: We conducted a prospective cohort study of 447,890 participants aged 40-69 years from the UK Biobank. A touch screen questionnaire was used to get the data about fish oil intake at baseline. Incident diagnoses of IBDs were ascertained by the International Classification of Diseases (ICD-9 and ICD-10) or self-report. Cox proportional hazards model was applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of developing IBDs and their subtypes. Results: We documented 1,646 incident cases of IBDs, including 533 incident cases of Crohn's disease (CD) and 1,185 incident cases of ulcerative colitis (UC) during an average of 8 years of follow-up. After multivariate adjustment, the use of fish oil was associated with a 12% lower risk of IBDs (HR: 0.88, 95% CI: 0.78-0.99, p = 0.03) compared with non-consumers. For subtypes of IBDs, fish oil supplementation was inversely associated with a 15% lower risk of UC (HR: 0.85, 95% CI: 0.75-0.99, p = 0.02) but was not correlated with the risk of CD (p = 0.22). Besides, fish oil supplementation showed a significant inverse correlation with baseline CRP levels (ß = -0.021, p < 0.001) and a positive association with baseline albumin levels (ß = 0.135, p < 0.001) after adjustment for multiple variates. Conclusion: Habitual intake of fish oil supplements was associated with a lower risk of IBDs and UC. Fish oil users tended to have lower baseline C-reactive protein levels and higher baseline albumin levels compared with non-users. It was concluded that fish oil supplement use may be recommended for the prevention and control of IBDs.

Poor Pre-operative Nutritional Status Is a Risk Factor of Post-operative Infections in Patients With Gastrointestinal Cancer-A Multicenter Prospective Cohort Study.

Objective: This study aimed to assess the prognostic value of the Nutritional Risk Score 2002 (NRS2002) and patient-generated subjective global assessment (PG-SGA) for post-operative infections in patients with gastric cancer (GC) and colorectal cancer (CRC) who underwent curative surgery. Methods: This prospective study included 1,493 GC patients and 879 CRC patients who underwent curative surgery at 18 hospitals in China between April 2017 and March 2020. The NRS2002 and PG-SGA were performed on the day of admission. The relationship between the nutritional status of patients before surgery and post-surgical incidence of infection was analyzed using univariate and multiple logistic regression analyses. Results: According to NRS2002, the prevalence of nutritional risk was 51.1% in GC patients and 63.9% in CRC patients. According to the PG-SGA, 38.9% of GC patients and 54.2% of CRC patients had malnutrition. Approximately 4.4% of the GC patients and 9.9% of the CRC patients developed infectious complications after surgery. The univariate and multiple logistic regression analyses showed that the risk of infections was significantly higher in GC patients with a high nutritional risk score (NRS2002 ≥5) than in those with a low score (NRS2002 <3), and the PG-SGA score was identified as a predictor of post-operative infection complications of CRC. Conclusion: The pre-operative nutritional status of patients with GC or CRC has an impact on post-operative infection occurrence. NRS2002 ≥5 was a risk factor for post-operative infection in patients with GC, and the PG-SGA B/C was a predictor of infections in patients with CRC.

Phospho­regulation of Cdc14A by polo­like kinase 1 is involved in ß­cell function and cell cycle regulation.

The objective of the present study was to investigate the effects of polo­like kinase 1 (PLK1) and the phosphorylation of human cell division cycle protein 14A (Cdc14A) by PLK1 on ß­cell function and cell cycle regulation. Mouse ß­TC3 cells were incubated with small interfering RNA (siRNA) to knock down the expression of PLK1. Cell cycle analysis was performed using flow cytometry, and cell proliferation and apoptosis was determined. Insulin secretion was evaluated by a radioimmunoassay under both low and high glucose conditions. Mouse ß­TC3 cells were transfected with a wild type or a non­phosphorylatable Cdc14A mutant (Cdc14AS351A/363A; Cdc14AAA) to investigate whether the phosphorylation of Cdc14A is involved in cellular regulation of PLK1 under high glucose conditions. It was found that PLK1 siRNA significantly promoted cellular apoptosis, inhibited cell proliferation, decreased insulin secretion and reduced Cdc14A expression under both low and high glucose conditions. Cdc14A overexpression promoted ß­TC3 cell proliferation and insulin secretion, while Cdc14AAA overexpression inhibited cell proliferation and insulin secretion under high glucose conditions. PLK1 siRNA partially reversed the proliferation­promoting effects of Cdc14A and further intensified the inhibition of proliferation by Cdc14AAA under high glucose conditions. Similarly, Cdc14A overexpression partially reversed the insulin­inhibiting effects of PLK1 siRNA, while Cdc14AAA overexpression showed a synergistic inhibitory effect on insulin secretion with PLK1 siRNA under high glucose conditions. In conclusion, PLK1 promoted cell proliferation and insulin secretion while inhibiting cellular apoptosis in ß­TC3 cell lines under both low and high glucose conditions. In addition, the phospho­regulation of Cdc14A by PLK1 may be involved in ß­TC3 cell cycle regulation and insulin secretion under high glucose conditions.

Food-drug interactions precipitated by fruit juices other than grapefruit juice: An update review.

This review addressed drug interactions precipitated by fruit juices other than grapefruit juice based on randomized controlled trials (RCTs). Literature was identified by searching PubMed, Cochrane Library, Scopus and Web of Science till December 30 2017. Among 46 finally included RCTs, six RCTs simply addressed pharmacodynamic interactions and 33 RCTs studied pharmacokinetic interactions, whereas seven RCTs investigated both pharmacokinetic and pharmacodynamic interactions. Twenty-two juice-drug combinations showed potential clinical relevance. The beneficial combinations included orange juice-ferrous fumarate, lemon juice-99mTc-tetrofosmin, pomegranate juice-intravenous iron during hemodialysis, cranberry juice-triple therapy medications for H. pylori, blueberry juice-etanercept, lime juice-antimalarials, and wheat grass juice-chemotherapy. The potential adverse interactions included decreased drug bioavailability (apple juice-fexofenadine, atenolol, aliskiren; orange juice-aliskiren, atenolol, celiprolol, montelukast, fluoroquinolones, alendronate; pomelo juice-sildenafil; grape juice-cyclosporine), increased bioavailability (Seville orange juice-felodipine, pomelo juice-cyclosporine, orange-aluminum containing antacids). Unlike furanocoumarin-rich grapefruit juice which could primarily precipitate drug interactions by strong inhibition of cytochrome P450 3A4 isoenzyme and P-glycoprotein and thus cause deadly outcomes due to co-ingestion with some medications, other fruit juices did not precipitate severely detrimental food-drug interaction despite of sporadic case reports. The extent of a juice-drug interaction may be associated with volume of drinking juice, fruit varieties, type of fruit, time between juice drinking and drug intake, genetic polymorphism in the enzymes or transporters and anthropometric variables. Pharmacists and health professionals should properly screen for and educate patients about potential adverse juice-drug interactions and help minimize their occurrence. Much attention should be paid to adolescents and the elderly who ingest medications with drinking fruit juices or consume fresh fruits during drug treatment. Meanwhile, more researches in this interesting issue should be conducted.

A comprehensive nutritional survey of hospitalized patients: Results from nutritionDay 2016 in China.

AIMS: Prevalence of malnutrition is a common and serious issue responsible for the morbidity and mortality rate among hospitalized patients. We aimed to provide an actual and comprehensive situation of the nutritional characteristics, nutritional support and the risk factors for malnutrition among hospitalized patients in China. METHODS: We analyzed the data from nutritionDay audit 2016 in China. The international daylong cross-sectional survey was performed on November 10th, 2016 via filling out several questionnaires regarding information on patients' illness, food intake history, weight change and nutritional care. Re-assessment of patients' outcome questionnaire was performed 30 days later. RESULTS: Total of 781 patients from 9 hospitals and 8 kinds of departments were enrolled in this report. Of these, malnutrition rate was 29.6%. Parenteral nutrition (251/344, 73.0%) was the primary nutrition support form in Chinese hospitals. However, 41.8% (136/325) of patients at nutritional risk or already diagnosed with malnutrition did not received any form of nutritional support, whereas 34.0% (155/456) well-nourished patients did. Patients with malnutrition had extended length of hospital stay and poor 30-day outcomes compared to well-nourished patients. Nutritional support could benefit nutritional risk or malnutrition patients, rather than well-nourished patients. Moreover, major lesion types, self-related health, food intake last week were independent risk factors of malnutrition (all p<0.05). CONCLUSIONS: Chinese hospital staff is generally lack of knowledge and awareness of malnutrition. Self-related health, major lesion types and food intake are associated with malnutrition.

Biological variations of hematologic parameters determined by UniCel DxH 800 hematology analyzer.

CONTEXT: The Coulter DxH 800 hematology analyzer can determine conventional hematologic parameters. It also provides many new hematologic parameters, some of which show potential clinical utility. OBJECTIVES: To study, for the first time, the biological variations of new hematologic parameters and reinvestigate the biological variations of conventional hematologic parameters using the newest Coulter hematology analyzer. DESIGN: Forty adult volunteers (21 women and 19 men) were included. All participants maintained their normal lifestyles. Blood samples were drawn in duplicate by a single experienced phlebotomist and analyzed within 2 hours using a single analyzer. Before each batch analysis, the instrument quality controls were performed using the same lots of reagents. RESULTS: Within-subject and between-subject biological variations for the conventional hematologic parameters were compatible with published data. The analytic variation of the DxH 800 for these parameters appeared smaller. Index of individuality (ratio of within-subject to between-subject biological variation) for all parameters was low. In addition, intraday and interday biological variations of most parameters studied are fairly constant among the population examined. CONCLUSIONS: These observations are clinically valuable. Data on within-subject biological variation and analytic precision may be used to generate objective delta-check values for use in quality management. Comparing within-subject and between-subject biological variation on new parameters may allow us to decide the utility of traditional population-based reference ranges. Furthermore, documentation of biological variations of new parameters is an essential prerequisite in the development of any clinical application in the future.

[Effect of total flavonoids from Chrysanthemun morifolium on learning and memory in aging mice].

OBJECTIVE: To investigate the effect of total fiavonoids from Chrysanthemun morifolium (TFCM) on learning and memory, and cholinergic system function in aging mice. METHODS: The aging mice model was established by subcutaneous injection of D-galactose. ICR mice were divided into five groups (n=10): contrA group, model group, and TFCM groups. Mice in TFCM groups were given TFCM (50,100 or 150 mg/kg) by gastric irrigation once a day. Learning and memory ability were evaluated by Morris water maze test. The MDA content, SOD and Ach E activity were also measured. RESULTS: Compared with control group, learning and memory ability declined in the D-galactose-induced aging mice; meanwhile MDA content and AchE activity increased, SOD activity decreased. Treatment with TFCM (100, 150 mg/kg) ameliorated the decrease in learning and memory ability of aging mice. Compared with model group, TFCM (100, 150 mg/kg) could also decrease MDA content and Ach E activity, and increase SOD activity in aging mice. CONCLUSION: TFCM may improve the learning and memory ability of aging mice. The mechanism is involved in its antioxidative characteristic and improvement of central cholinergic system function.

Diacylglycerol-induced improvement of whole-body insulin sensitivity in type 2 diabetes mellitus: a long-term randomized, double-blind controlled study.

BACKGROUND & AIMS: Diacylglycerol oil has been shown to lower postprandial and fasting serum triacylglycerol levels and reduce body fat. The aim of this study was to investigate the effect of diacylglycerol oil on risk factors of type 2 diabetes mellitus (DM) and cardiovascular disease in type 2 DM patients. METHODS: This was a double-blind controlled parallel study with 127 type 2 DM patients (aged 40-65) recruited in Hangzhou, China. All subjects consumed triacylglycerol oil in the lead-in period (14 days), then they were randomly divided into two groups and consumed diacylglycerol or triacylglycerol oil with a similar fatty acid composition (25 g/day) for 120 days. Blood samples were collected on days 0, 60 and 120 and risk factors of type 2 DM and cardiovascular disease and biochemical parameters were measured by standard methods. RESULTS: There were a total of 112 subjects who completed the study. Diet intake did not differ significantly between groups. Body weight, BMI, waist circumference, HOMA-IR, serum insulin and leptin levels were significantly reduced from baseline in the diacylglycerol oil group but not in the triacylglycerol oil group. Serum glucose was also significantly improved in patients with higher glucose levels at baseline (>7.00 mmol/L) in the diacylglycerol oil group. Parameters of liver and kidney functions and essential fatty acids in serum phospholipids did not differ between groups. CONCLUSIONS: Diacylglycerol oil consumption improved biomarkers and anthropometric parameters of type 2 DM compared with triacylglycerol oil. No adverse reactions were observed with diacylglycerol oil consumption for type 2 DM patients. Diacylglycerol oil has an equivalent bioavailability as triacylglycerol oil in relation to providing essential fatty acids.

Protection of myocardium in streptozotocin-induced diabetic rats by water extracts of Hsian-tsao (Mesona procumbens Hemsl.).

The myocardial protective effects of water extracts from Hsian-tsao (Mesona procumbens Hemsl.) on diabetic rats were investigated. Thirty Sprague-Dawley male rats were randomly divided into three groups, "control group" (n=10) with intraperitoneal saline injection, "diabetic group" (n=10) with 60 mg of intraperitoneal streptozotocin injection per kg of body weight and "Hsian-tsao group" (n=10) with intragastric administration of Hsian-tsao extracts every day for 4 weeks after intraperitoneal streptozotocin injection. Body weight and blood sugar concentrations were measured before and after model induction in the three groups. Thrombospondin-1 (TSP-1) expressions in the myocardium were monitored by immunohistochemistry and rt-RT-qPCR analysis. Myocardial ultrastructural changes were also analyzed by us-ing transmission electron microscopy. Our results demonstrated that diabetic myocardial ultrastructural changes included myofibrillar disarrangements, mitochondria disruption, and an increase in nuclear membrane invaginations. These damages were significantly less severe in the Hsian-tsao group compared with the diabetic group. A significant increase of the TSP-1 expression was also observed in the hearts of the diabetic rats (p<0.01), but it was relatively lower in the Hsian-tsao group than in the diabetic group (p<0.01). It suggested that Hsian-tsao treatment in the diabetic rats effectively prevented the pathological alterations in the myocardium and decreased TSP-1 expression.