International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP).

INTRODUCTION AND HYPOTHESIS: This manuscript is the International Urogynecology Consultation (IUC) on pelvic organ prolapse (POP) chapter one, committee three, on the Pathophysiology of Pelvic Organ Prolapse assessing genetics, pregnancy, labor and delivery, age and menopause and animal models. MATERIALS AND METHODS: An international group of urogynecologists and basic scientists performed comprehensive literature searches using pre-specified terms in selected biomedical databases to summarize the current knowledge on the pathophysiology of the development of POP, exploring specifically factors including (1) genetics, (2) pregnancy, labor and delivery, (3) age and menopause and (4) non-genetic animal models. This manuscript represents the summary of three systematic reviews with meta-analyses and one narrative review, to which a basic scientific comment on the current understanding of pathophysiologic mechanisms was added. RESULTS: The original searches revealed over 15,000 manuscripts and abstracts which were screened, resulting in 202 manuscripts that were ultimately used. In the area of genetics the DNA polymorphisms rs2228480 at the ESR1 gene, rs12589592 at the FBLN5 gene, rs1036819 at the PGR gene and rs1800215 at the COL1A1 gene are significantly associated to POP. In the area of pregnancy, labor and delivery, the analysis confirmed a strong etiologic link between vaginal birth and symptoms of POP, with the first vaginal delivery (OR: 2.65; 95% CI: 1.81-3.88) and forceps delivery (OR: 2.51; 95% CI: 1.24-3.83) being the main determinants. Regarding age and menopause, only age was identified as a risk factor (OR : 1.102; 95% CI: 1.02-1.19) but current data do not identify postmenopausal status as being statistically associated with POP. In several animal models, there are measurable effects of pregnancy, delivery and iatrogenic menopause on the structure/function of vaginal support components, though not on the development of POP. CONCLUSIONS: Genetics, vaginal birth and age all have a strong etiologic link to the development of POP, to which other factors may add or protect against the risk.

Genetic Diversity and Population Structure of Psidium Species from Restinga: A Coastal and Disturbed Ecosystem of the Brazilian Atlantic Forest.

The Atlantic Forest is one of the most threatened biomes in the world. Here, we use a common set of microsatellite markers to assess the genetic diversity and population structure of three species from the genus Psidium (P. guajava, P. macahense, and P. guineense), located in a disturbed environment of the Atlantic Forest, the restinga, in Espírito Santo, Brazil. Psidium guajava populations presented the highest number of alleles (95) followed by P. guineense (81) and P. macahense (68). The genetic variability was high (P. guajava = 0.71; P. guineense = 0.74; P. macahense = 0.63), with greater variation within populations (72 to 84%) than among populations (15 to 27%), reflecting elevated values of genetic differentiation (P. guajava, FST: 0.15; P. macahense, ØST: 0.27; P. guineense, ØST: 0.21). The populations were clustered into two main groups and considered moderately structured. This is the first report of genetic studies and evidence of polyploidy to P. macahense. Our results may provide information that can be used in management and conservation strategies, to preserve the diversity of Psidium populations.

Genetic diversity and structure of landrace accessions, elite lineages and cultivars of common bean estimated with SSR and SNP markers.

Common bean (Phaseolus vulgaris L.) is an important source of proteins, fibers and minerals for humans, being grown mainly in developing countries and representing a source of income for small farmers. In this work, a set of 206 Brazilian landraces and 59 elite lineages and cultivars were genotyped with 23 SSR (Simple Sequence Repeats) and 251 SNPs (Single-Nucleotide Polymorphism) markers. The ideal number of groups, according to STRUCTURE, was K = 2 for both SNPs and SSRs. This could be expected considering the two original gene pools-Andean (AND) and Mesoamerican (MES). The matrices of genetic simple matching dissimilarity for SSRs and SNPs were highly correlated; therefore, the allelic data of the markers was combined and analyzed to understand the genetic relationships of the studied collection. The neighbor-joining analysis considering the genetic distance of simple matching grouped the 265 genotypes into 17 subgroups. The markers SSR and SNP presented high power to discriminate among the genotypes. The ample genetic diversity observed in the work collection makes it a valuable source for the conservation, sustainable management and exploration in breeding programs of the crop.

Culture of goat preantral follicles in situ associated with mesenchymal stem cell from bone marrow.

This study aims to develop an in vitro co-culture system of in situ goat preantral follicles with bone marrow-derived mesenchymal stem cells (BM-MSC), evaluating the influence of these cells on follicular growth, rate of activation and morphologically normal follicles. Fragments of ovarian cortex were cultured for 1 or 7 days in the presence of BM-MSC (BM-MSC+) and absence of BM-MSC (BM-MSC-). Histological sections of the fragments were analysed and data were obtained regarding morphological classification, survival rate of morphologically normal follicles and rate of follicular activation. Culture medium on days 1 and 7 was also sampled for nitrite concentration and reduced glutathione activity. There was a reduction (P < 0.05) in the percentage of morphologically normal follicles in the BM-MSC+ compared with the fresh control only on the seventh day of culture. When comparing treatments, on the seventh day of culture, a higher rate of morphologically normal preantral follicles was observed in BM-MSC+ (P < 0.05). In both treatments, primordial and developing follicle rates were similar to the fresh control (P > 0.05). When comparing treatments with each other, as well as with the fresh control, no differences were observed in follicular diameter (P > 0.05) or nitrite concentration (P > 0.05). The concentration of reduced glutathione was lower on the seventh day of co-culture in both treatments (P < 0.05). In conclusion, co-culture had no influence on follicular or oocyte development. However, it was critical to maintain the survival of preantral follicles during 7 days of culture.

Jaguar movement database: a GPS-based movement dataset of an apex predator in the Neotropics.

The field of movement ecology has rapidly grown during the last decade, with important advancements in tracking devices and analytical tools that have provided unprecedented insights into where, when, and why species move across a landscape. Although there has been an increasing emphasis on making animal movement data publicly available, there has also been a conspicuous dearth in the availability of such data on large carnivores. Globally, large predators are of conservation concern. However, due to their secretive behavior and low densities, obtaining movement data on apex predators is expensive and logistically challenging. Consequently, the relatively small sample sizes typical of large carnivore movement studies may limit insights into the ecology and behavior of these elusive predators. The aim of this initiative is to make available to the conservation-scientific community a dataset of 134,690 locations of jaguars (Panthera onca) collected from 117 individuals (54 males and 63 females) tracked by GPS technology. Individual jaguars were monitored in five different range countries representing a large portion of the species' distribution. This dataset may be used to answer a variety of ecological questions including but not limited to: improved models of connectivity from local to continental scales; the use of natural or human-modified landscapes by jaguars; movement behavior of jaguars in regions not represented in this dataset; intraspecific interactions; and predator-prey interactions. In making our dataset publicly available, we hope to motivate other research groups to do the same in the near future. Specifically, we aim to help inform a better understanding of jaguar movement ecology with applications towards effective decision making and maximizing long-term conservation efforts for this ecologically important species. There are no costs, copyright, or proprietary restrictions associated with this data set. When using this data set, please cite this article to recognize the effort involved in gathering and collating the data and the willingness of the authors to make it publicly available.

Emotional Symptoms and Risk Behaviors in Adolescents: Relationships With Cyberbullying and Implications on Well-Being.

Context: Cyberbullying is considered a public health problem with serious consequences on adolescents' health and well-being. Objective: To analyze the relationships between emotional symptoms and risk behaviors with cyberbullying and understand the role of these factors as predictors of well-being. Design: This is a cross-sectional study based on the 2014 Health Behaviour in School-Aged Children of the World Health Organization (HBSC/WHO) study. Results: More girls reported being involved in cyberbullying as cybervictims, whereas more boys reported being involved in cyberbullying as cyberbullies and cyberbully victims. Girls reported more emotional symptoms, especially fear and sadness; boys reported more risk behaviors, specifically drug use and involvement in fights, but a higher well-being when compared to girls. Cyberbullies and cyberbully victims reported higher alcohol consumption than cybervictims; cyberbullies also reported higher drugs consumption compared to cybervictims and cyberbully victims. Well-being was predicted by emotional symptoms and age, independently of gender; for girls, involvement in fights also predicted well-being. Conclusions: If boys and girls, as well as cybervictims, cyberbullies, and cyberbully victims, present different levels of well-being, emotional symptoms, and risk behaviors vary in function of cyberbullying, it is crucial to develop individual interventions focused on the specific needs of each group.

Symptoms of thyrotoxicosis, bone metabolism and occult atrial fibrillation in older women with mild endogenous subclinical hyperthyroidism.

OBJECTIVE: The objective of this study was to evaluate symptoms of thyrotoxicosis, bone turnover, bone mineral density (BMD) and occult atrial fibrillation (AF) in women ≥65 years with mild endogenous subclinical hyperthyroidism (SCH). DESIGN: Cross-sectional and case-control study. PATIENTS: Signs and symptoms of thyrotoxicosis, serum carboxyterminal telopeptide (CTx) and procollagen type I N-terminal propeptide (PINP), BMD, resting electrocardiogram (ECG) and 72-h ECG monitoring were evaluated in 180 women ≥65 years, including 90 with mild SCH (TSH between 0·1 and 0·4 mIU/l) and 90 euthyroid controls matched for age and body mass index. RESULTS: Symptom Rating Scale scores did not differ between patients and controls. None of the patients with SCH scored 20 points, a score compatible with clinical thyrotoxicosis. Eighty patients with SCH (89%) obtained seven or fewer points, a score compatible with euthyroidism. No difference in serum CTx or PINP concentrations was observed between patients and controls. There was also no correlation between these markers and TSH, free T4 or total T3 levels. Finally, no difference in femoral neck or lumbar spine BMD was observed between patients with SCH and controls. Three patients with SCH (3·3%) and two euthyroid women (2·2%) had known AF or AF in the resting ECG. ECG monitoring for 72 h revealed episodes of occult AF in 1/87 patients with SCH and in 1/88 euthyroid women (1·1%). CONCLUSIONS: Mild endogenous SCH (TSH between 0·1 and 0·4 mIU/l) was not associated with symptoms of thyrotoxicosis, altered bone metabolism or a higher prevalence of occult AF in women ≥65 years.

Natural history of subclinical hypothyroidism with TSH ≤10 mIU/l: a prospective study.

OBJECTIVE: The risk of progression of subclinical hypothyroidism (SCH) to clinical dysfunction is one of the factors considered in the decision to treat this condition. This study evaluated the natural history of SCH in women with TSH ≤10 mIU/l. DESIGN: This is a prospective study. PATIENTS: Two hundred and fifty-two women with SCH and TSH levels ranging from 4·5 to 10 mIU/l were followed up for a period of 5 years. RESULTS: Among the 241 patients followed up until the completion of the study, 46 (19%) required levothyroxine (L-T4) therapy, 55 (22·8%) had spontaneous normalization of serum TSH, and 140 (58·1%) continued to meet the criteria for mild SCH. In multivariate analysis, only initial TSH >8 mIU/l was a predictor of the need for L-T4. In contrast, initial TSH ≤8 mIU/l and the absence of thyroiditis [negative antithyroid peroxidase antibodies (TPOAb) and ultrasonography (US)] were predictors of TSH normalization. Of note, the natural history was similar in TPOAb-positive patients and patients with negative TPOAb but with positive US. CONCLUSIONS: Most women with mild elevation of serum TSH, ranging from 4·5 to 10 mIU/l, do not progress to overt hypothyroidism and even normalize their TSH. However, initial TSH seems to be a more important predictor of progression than the presence of antibodies or ultrasonographic appearance.

The Internalized Stigma of Mental Illness: Cross-Cultural Adaptation and Psychometric Properties of the Portuguese Version of the ISMI Scale.

This study examined the psychometric properties of the Portuguese version of the ISMI scale in a sample of 253 adult psychiatric outpatients. The exploratory factor analysis replicated the five factor structure of the scale. The results revealed good internal consistency. Criterion-related validity supported the variability in response to stigma across clinical diagnoses. Thus, the Portuguese version of the ISMI scale can be considered appropriate to measure and differentiate between stigmatization experiences. Also, in order to design more focused approaches aimed to reduce the negative effects of internalized stigma, its use in institutional and in community-based mental health services is recommended.

Prevalence and severity of asthma and related symptoms in 6- to 7-year-old schoolchildren of Rio de Janeiro using of the ISAAC questionnaire by telephone survey.

OBJECTIVE: To evaluate the prevalence and severity of asthma and its association with sex in 6- to 7-year-old schoolchildren from the city of Rio de Janeiro (RJ), obtained by a telephone survey. METHODS: A cross-sectional study using the International Study of Asthma and Allergies in Childhood (ISAAC) Written Questionnaire for Asthma adapted and validated by telephone interviews was conducted. The random sample was recruited systematically, without replacement, taking into account the proportion of school classes and students in each regional coordination of the Municipal Secretariat of Education, which supplied the students' telephone numbers. The data were collected by a polling company from May to July 2010. Prevalence ratios (PRs) and 95% confidence intervals (95% CI) were compared using the difference in proportions test suitable for large samples to analyze the association between asthma and sex. RESULTS: In total, 3216 interviews from parents/caregivers of children were analyzed; 51.4% of the children were males. Mothers were the primary respondents (71.9%). The prevalence rates of "wheezing ever" and "wheezing in the last 12 months" were 52.2% and 20.9%, respectively, and were significantly higher among boys (PR: 1.10, 95% CI: 1.03-1.18 and PR: 1.27, 95% CI: 1.10-1.45). The same pattern was observed for "asthma ever" (PR: 1.44, 95% CI: 1.12-1.85) and for "severe asthma" (PR: 1.42, 95% CI: 1.11-1.82). CONCLUSION: The prevalence of asthma was high among RJ's students. Most of the indicators of the disease were more prevalent among boys. Our results were similar to those observed in other Brazilian and international centers using the traditional ISAAC protocol. The use of this method can be an alternative for epidemiological studies of childhood asthma especially in areas where the telephone coverage is high.

Endocrine FGFs and their signaling in the brain: Relevance for energy homeostasis.

Since their discovery in 2000, there has been a continuous expansion of studies investigating the physiology, biochemistry, and pharmacology of endocrine fibroblast growth factors (FGFs). FGF19, FGF21, and FGF23 comprise a subfamily with attributes that distinguish them from typical FGFs, as they can act as hormones and are, therefore, referred to as endocrine FGFs. As they participate in a broad cross-organ endocrine signaling axis, endocrine FGFs are crucial lipidic, glycemic, and energetic metabolism regulators during energy availability fluctuations. They function as powerful metabolic signals in physiological responses induced by metabolic diseases, like type 2 diabetes and obesity. Pharmacologically, FGF19 and FGF21 cause body weight loss and ameliorate glucose homeostasis and energy expenditure in rodents and humans. In contrast, FGF23 expression in mice and humans has been linked with insulin resistance and obesity. Here, we discuss emerging concepts in endocrine FGF signaling in the brain and critically assess their putative role as therapeutic targets for treating metabolic disorders.

Positive Youth Development, Mental Stress and Life Satisfaction in Middle School and High School Students in Portugal: Outcomes on Stress, Anxiety and Depression.

The relation between positive youth development and stress, anxiety and depression was studied considering the mediator role of psychological symptoms and life satisfaction. A total of 3109 students included in the "Psychological Health and Well-being" study of the School Observatory participated, including 1618 females and 1491 males aged between 11 and 18 years old (M = 14.45; SD = 1.88), belonging to different school groups in different regions of the country. Adolescents with higher stress, depression and anxiety levels reported lower levels of competence, confidence and connection, as well as more psychological symptoms and lower life satisfaction. The results also showed that adolescents with higher levels of competence, confidence and connection reported less psychological symptoms and more life satisfaction. Two separate mediation analyses were performed to analyse the role of mental distress and life satisfaction on the relationship between positive youth development indicators and stress, anxiety and depression. These analyses confirmed the predicted relationships and partial mediations between mental distress and life satisfaction. These results should be taken into account in public policies concerning young people's health and education that should involve both targeted and indicated prevention strategies, including school and community-based interventions, in order to be effective.

Bibliometric analysis of water kefir and milk kefir in probiotic foods from 2013 to 2022: A critical review of recent applications and prospects.

Although milk kefir and water kefir have different physical, chemical and microbiological characteristics, several microbial species that make up kefir stand out with probiotic functions. Furthermore, because it is suitable for a variety of substrates, kefir and the species of probiotic microorganisms that make it up are seen as a promising alternative in the development of probiotic and health-promoting foods. The aim of this study was to carry out a bibliometric analysis of water kefir and milk kefir in probiotic foods and to critically analyze recent applications and prospects. Using the Scopus database, 202 documents published between 2013 and 2022 were identified and submitted to bibliometric analysis using the VOSviewer software. Regarding recent applications, 107 documents published between 2021 and June 2023 were identified. It was observed that, in the literature consulted, no study used bibliometric analysis to evaluate the use of water kefir and milk kefir in probiotic foods. Due to the presence of probiotic species, kefir has been listed as an alternative for the production of new probiotic food matrices that are beneficial to health. Recent applications show kefir's potential in the development of probiotic products based on fruit and fruit juice, whey beverages, fermented milks and derivatives, and alcoholic beverages such as beers.

Evaluation of sensory acceptance, purchase intention and color parameters of potentially probiotic mead with Saccharomyces boulardii.

Mead is a fermented alcoholic beverage produced by yeast action on a diluted solution of honey. In this study, for the first time, sensory acceptance, purchase intention and color parameters of potentially probiotic mead with Saccharomyces boulardii were evaluated. The mead with S. boulardii presented yeast counts higher than 106 CFU/mL, being considered potentially probiotic, and tended to be yellow in color. About 160 tasters participated in the sensory evaluation, and 69.38% knew mead, but only 35.62% had tried the beverage. In terms of acceptance, the mead were within the acceptable range (above 5), and F2 (with initial soluble solids of 30° Brix and S. boulardii concentration of 0.030 g/L) was the most accepted, with an overall average of 7.63 ± 1.42 on the nine-point hedonic scale. In addition, F2 presented the highest purchase intention. In conclusion, the mead showed a tendency towards the color yellow and good sensory acceptance.

Double-flanged polypropylene technique: 5-year results.

PURPOSE: To assess the long-term (5-year) results and complications of the double-flanged polypropylene technique in patients with capsular tension segment fixation, nonfoldable intraocular lens (IOL) scleral fixation, and foldable IOL scleral fixation. SETTING: Santa Casa de Belo Horizonte and Centro Oftalmológico de Minas Gerais. DESIGN: Prospective case series. METHODS: Eyes that underwent treatment using the double-flanged polypropylene technique between September 2016 to September 2021 were included. LogMAR visual acuity was recorded, as well as complications such as long-term polypropylene resistance, conjunctival erosion, conjunctival inflammation, flange exposure, internalization, endophthalmitis, retinal detachment, and cystoid macular edema. RESULTS: 71 eyes of 61 patients were evaluated. The mean follow-up period for these eyes was 28.2 ± 14.3 (min: 4; max: 60; median: 26) months. 173 flanges were performed. 13 cases with sub-Tenon flanges (7.5%) were observed. 5 exposed flanges (2.89%), presented after a mean of 1.8 weeks postoperatively, were observed. 1 patient with large flanges presented with conjunctival inflammation and hyperemia. 2 late internalized flanges (1.1%) and 2 recently internalized flanges (1.1%) were observed. 3 eyes (4.22%) had retinal detachment. Moreover, cystoid macular edema was detected in 3 eyes (4.22%). No cases of endophthalmitis were observed. CONCLUSIONS: The double-flanged technique was proven to be stable when the correct technical procedure was followed. However, complications can be observed, especially with short scleral tunnels and in eyes where the flanges were not buried inside the sclera.

Healthy Social Network Use and Well-Being during Adolescence: A Biopsychosocial Approach.

Screen time and the use of social networks is the most frequent form of leisure time occupation and socializing for adolescents. The present study is aimed at understanding and characterizing, from an ecological perspective, what distinguishes healthy and less healthy or even dependent use of social media in young people and the influence on adolescents' well-being. This paper is based on the Health Behaviour in School-aged Children (HBSC) from 2022, a survey carried out every 4 years, in collaboration with the World Health Organisation (WHO), following an international protocol. A total of 7643 students from the 6th, 8th, 10th, and 12th school grades responded, of which 53.9% were female, with an average age of 15.05 (SD = 2.36). The sample is representative of the school grades under study. The results allow us to study and identify similarities and differences between three groups related to the level of healthiness in the use of social networks and its relations to well-being from an ecological perspective. What distinguishes adolescents with less healthy use of social networks is that they are more often female, older, have more self-injurious behaviour, higher alcohol consumption, and a worse relationship with teachers. The adolescents with the highest level of dependence on social networks are those who have a higher perception of lack of safety at school and in their area of residence, as well as a higher use of screen time as a leisure activity. The well-being of adolescents using social media in a healthy way is explained by fewer psychological symptoms, better stress management strategies, better body awareness, more physical activity, less time online with friends, and better relationships with family and teachers. Technologies and social networks are important for the well-being of adolescents; it is essential to promote a healthy, critical and balanced use with other "screen-free" activities and to promote socio-emotional skills, a lack of which seems to be one of the biggest risk factors associated with the healthy use of technologies.

COVID-19, Wellness and Life Satisfaction in Adolescence: Individual and Contextual Issues.

During and in the aftermath of the COVID-19 pandemic, several works reflected on young people's physical and psychological health. The Dual Factor Model, which we refer to as the quadripartite model, is useful for understanding children's and adolescents' psychological health and differentiating them regarding their attitude toward the effects of the COVID-19 pandemic. In this investigation, students from the fifth to twelfth year of schooling enrolled in the DGEEC study "Psychological Health and Wellbeing in Portuguese schools" were considered. Four groups were created based on life satisfaction (low or high) and psychological distress (with or without symptoms). The study included 4444 students (M = 13.39 years ± 2.41), of whom 47.8% were male. Of the participants, 27.2% were in the second cycle of primary education, and 72.8% were in lower and upper secondary education. Differences in gender and education level (as a proxy for age) were observed. Additionally, when considering students' perceptions of changes in their lives following the COVID-19 pandemic (stayed the same, became worse, became better), these three groups were compared concerning personal and contextual variables, revealing significant differences at both the individual and contextual levels. Finally, the study discusses the influence of education and health professionals and the need for friendly public policies.

Growing conditions of Saccharomyces boulardii for the development of potentially probiotic mead: Fermentation kinetics, viable cell counts and bioactive compounds.

Mead is an alcoholic beverage produced by the fermentation of a diluted honey solution by the action of yeast. Recently, research has shown the potential of S. boulardii for brewing beer and in the development of probiotic alcoholic beverages and, to date, no research has examined for mead production. The aim of this study was to evaluate the growth conditions of S. boulardii for the development of potentially probiotic mead. The findings show that initial wort soluble solids conditions of 30°Brix and initial concentration of 0.030 g/L of S. boulardii obtain potentially probiotic mead with viable yeast cells of 6.53 Log10 CFU/mL, alcohol content of 5.05%, and has the presence of total phenolics (17.72 mg GAE/100 mL) and natural antioxidants (62.79 and 1.37 µmol TE/100 mL for ABTS and FRAP methods, respectively). In conclusion, S. boulardii has a potential for the development of probiotic mead.

Involvement of companions in patient safety in pediatric and neonatal units: scope review.

OBJECTIVES: to describe scientific evidence on the involvement of companions in patient safety, from their own perspective and health professionals' perspective in neonatal and pediatric units. METHODS: scoping review carried out according to The Joanna Briggs Institute's recommendations, in eight databases, following the Preferred Reporting Items checklist for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, between 2011 and 2021. RESULTS: the 13 studies included highlighted the importance of companions' involvement in patient safety and the prevention of adverse events. However, they pointed out failures in communication and weakness in the training of professionals, which were obstacles to their involvement. The strengthening of health education, multidisciplinary rounds and educational technologies were highlighted as strategies to expand the involvement of companions. FINAL CONSIDERATIONS: this study directs elements for health professionals and managers to rethink the companions' role in patient safety and development of collective strategies.

The bile acid TUDCA reduces age-related hyperinsulinemia in mice.

Aging is associated with glucose metabolism disturbances, such as insulin resistance and hyperinsulinemia, which contribute to the increased prevalence of type 2 diabetes (T2D) and its complications in the elderly population. In this sense, some bile acids have emerged as new therapeutic targets to treat TD2, as well as associated metabolic disorders. The taurine conjugated bile acid, tauroursodeoxycholic acid (TUDCA) improves glucose homeostasis in T2D, obesity, and Alzheimer's disease mice model. However, its effects in aged mice have not been explored yet. Here, we evaluated the actions of TUDCA upon glucose-insulin homeostasis in aged C57BL/6 male mice (18-month-old) treated with 300 mg/kg of TUDCA or its vehicle. TUDCA attenuated hyperinsulinemia and improved glucose homeostasis in aged mice, by enhancing liver insulin-degrading enzyme (IDE) expression and insulin clearance. Furthermore, the improvement in glucose-insulin homeostasis in these mice was accompanied by a reduction in adiposity, associated with adipocyte hypertrophy, and lipids accumulation in the liver. TUDCA-treated aged mice also displayed increased energy expenditure and metabolic flexibility, as well as a better cognitive ability. Taken together, our data highlight TUDCA as an interesting target for the attenuation of age-related hyperinsulinemia and its deleterious effects on metabolism.