Diabetes tipo II. A terapia periodontal não cirúrgica pode favorecer o controle glicêmico do paciente? / Type II Diabetes. Does nonsurgical periodontal therapy improve glycemic control in patientes? / Diabetes tipo II. ¿Puede la terapia periodontal no quirúrgica mejorar el control glicémico del paciente?

Introdução:A doença periodontal corresponde àcondição que acomete os tecidos de proteção e/ou suporte do dente através de uma inflamação crônica causadapor patógenos.Estacondição pode ser modificada ou associada às doenças sistêmicas, como por exemplo, o diabetes mellitus tipo II (DM2).Objetivo:Avaliar quais os efeitos da terapia periodontal não cirúrgica sobre o controle glicêmico de pacientes diagnosticados com DM2.Metodologia:Revisão integrativa elaborada a partir de pesquisas clínicas randomizadas indexadas nas bases de dados Pubmed, Embase, Cochrane, Web of Science e BVS, na qual foram utilizados os descritores "periodontal diseases treatment", "glycemic control" e "metabolic control".Resultados:Dos trabalhos avaliados, seis foram selecionados para compor a revisão, tendo em vista os critérios de inclusão e exclusão estabelecidos. Logo, é notório que a terapia periodontal básica indica melhora no controle glicêmico dos pacientes com DM2, de acordo comanálise da HbA1c e PCR,portanto, com base nos resultados dessa pesquisa, o tratamento periodontal não cirúrgico parece contribuir para o controle metabólico. Apesar disso, alguns estudos se opõem aoresultadodo controle glicêmicodesses pacientes, reforçando a existência de variáveis que interferem nos resultados da pesquisa, como os níveis de hemoglobina, estágio da doença periodontal, amostra, dietae atividade física dos pacientes.Conclusões:O resultado deverá ser avaliado com maior cautela, tendo em vista as possibilidades de variáveis presentes nesse tipo de pesquisa. Por fim, ensaios controlados devem ser realizados para alcançar um maior esclarecimento a respeito dos efeitos da terapia periodontal não cirúrgica no controle glicêmico de pacientes com DM2 (AU).

Introduction:Periodontal disease is a condition in which protective or supportive tissues of the tooth are affected by chronic inflammation caused by pathogens. This condition may be modified or associated with systemic diseases such as type 2 diabetes mellitus (T2DM).Objective:To evaluate the effects of nonsurgical periodontal therapy on glycemic control in patients diagnosed with T2DM. Methodology:An integrative review was performed using randomized clinical trials indexed in PubMed, Embase, Cochrane, Web of Science, and BVS databases. The descriptors "periodontal disease treatment," "glycemic control," and "metabolic control" were used. Results:From the reviewed studies, six were selected for the review considering the established inclusion and exclusion criteria.Basic periodontal therapy improves glycemic control in patients with T2DM, as evidenced by analysis of glycated hemoglobin (HbA1c) and polymerase chain reaction (PCR). Therefore, based on the results of this research, nonsurgical periodontal treatment contributes to metabolic control. However, some studies contradict the effect of glycemic control in these patients, reinforcing the presence of variables that interfere with research results, such as hemoglobin levels, stage of periodontal disease, sample, dietand physical activity of patients. Conclusions:The results should be evaluated with more caution considering the potential variables present in this type of research. Finally, controlled trials should be conducted to understand better the effects of nonsurgical periodontal therapy on glycemic control in patients with T2DM (AU).

Introducción: La enfermedad periodontal es una condición en la cual los tejidos protectores o de soportedel diente se ven afectados por una inflamación crónica causada por patógenos. Esta condición puede modificarse o asociarse a enfermedades sistémicas como la diabetes mellitus tipo 2 (DM2). Objetivo: Evaluar los efectos de la terapia periodontal no quirúrgica en el control glucémico en pacientes diagnosticados con DM2. Metodología: Se realizó una revisión integradora utilizando ensayos clínicos aleatorizados indexados en las bases de datos de PubMed, Embase, Cochrane, Web of Science y BVS. Se utilizaron los descriptores "tratamiento de enfermedades periodontales", "control glucémico" y "control metabólico". Resultados: De los estudios revisados, se seleccionaron seis para la revisión, considerando los criterios de inclusión y exclusión establecidos. La terapia periodontal básica mejora el control glucémico en pacientes con DM2, como se evidencia en el análisis de la hemoglobina glicosilada (HbA1c) y la reacción en cadena de la polimerasa (PCR). Por lo tanto, basándose en los resultados de esta investigación, el tratamiento periodontal no quirúrgico contribuye al control metabólico. Sin embargo, algunos estudios contradicen el efecto del control glucémico en estos pacientes, lo que refuerza la presencia de variables que interfieren en los resultados de la investigación, como los niveles de hemoglobina, el estadio de la enfermedad periodontal, la muestra, la dieta y la actividad física de los pacientes. Conclusiones: Los resultados deben evaluarse con mayor precaución, considerando las posibles variables presentes en este tipo de investigación. Por último, se deben realizar ensayos controlados para comprender mejor los efectos de la terapia periodontal no quirúrgica en el control glucémico en pacientes con DM2 (AU).

Calidad de los Carbohidratos en la dieta de la población urbana costarricense / Carbohydrate Quality in the diet of the Costa Rican urban population

Introducción. La calidad de los carbohidratos consumidos juega un papel importante en la prevención de las enfermedades crónicas no transmisibles (ECNT). Objetivo. Analizar el índice de calidad de los carbohidratos (ICC) en la población urbana costarricense y su relación con las variables sociodemográficas, antropométricas y la calidad y la diversidad de la dieta. Materiales y métodos. Los datos provienen del Estudio Latinoamericano de Nutrición y Salud, en una muestra representativa de 798 personas entre 15 y 65 años que residen en zonas urbanas de Costa Rica (2014- 2015). En una visita domiciliaria se administró un cuestionario para recolectar los datos sociodemográficos y se pesó y midió a los participantes. El consumo dietético se obtuvo mediante dos recordatorios de 24 horas en días no consecutivos. El ICC se calculó mediante el consumo de fibra, el índice glicémico, la relación carbohidratos sólidos/líquidos y la relación granos enteros/granos totales. Se comparó el ICC según el sexo, el grupo de edad, el nivel socioeconómico, el estado nutricional, la circunferencia de cintura y la calidad y diversidad de la dieta de los participantes. Resultados. El ICC se asoció positivamente con un mayor consumo de energía, carbohidratos totales, proteínas, grasas, colesterol, frutas, vegetales y leguminosas (p<0,001). Un mayor ICC se asoció positivamente con un mayor porcentaje de adecuación de micronutrientes y mayor índice de diversidad y calidad de la dieta (p<0,001), así como con un menor índice de masa corporal y una menor circunferencia de cintura al ajustar por sexo y edad (p<0,005). Conclusiones. El presente estudio demostró que un mayor ICC se asocia significativamente con mejores indicadores dietéticos e índice de masa corporal, por lo que resulta fundamental establecer en Costa Rica pautas dietéticas que permitan aumentar la calidad de los carbohidratos de la dieta con el fin de contribuir en la prevención de las ECNT(AU)

Introduction. The carbohydrate quality index (CQI) plays an important role in the prevention of chronic non-communicable diseases (NCD) and adequate macro and micronutrient intake. Objective. To analyze the carbohydrate quality index (CCI) in the Costa Rican urban population and its relationship with sociodemographic and anthropometric variables and the quality and diversity of the diet. Materials and methods. Data come from the Latin American Nutrition and Health Study (ELANS), in a representative sample of 798 people between 15 and 65 years of age who reside in urban areas of Costa Rica (2014-2015). During a home visit, a questionnaire was administered to collect sociodemographic data, and participants were measured and weighed. Dietary intake was obtained through two 24-hour recalls in non- consecutive days. The CQI was calculated using fiber intake, glycemic index, liquid/solid carbohydrate ratio, and whole grain/total grains. CCI was then compared according to sex, age-group, socioeconomic level, nutritional status and diet quality and diet diversity. Results. The CQI was positively associated with energy intake, total carbohydrates, proteins, fats, cholesterol, fruits, vegetables, and legumes (p<0,001). Also, CQI was associated with a higher percentage of micronutrient adequacy and diet quality and diversity (p<0,001), as well as with a lower body mass index and lower waist circumference when adjusting for sex and age (p<0,005). Conclusions. The present study showed that higher CQI is associated with better dietary and body mass index, which shows that it is essential to establish dietary guidelines for public health in Costa Rica that allows increasing the quality of carbohydrates in the diet to contribute to the prevention of chronic NCD(AU)

Cantidad, estabilidad y digestibilidad de hidratos de carbono tras el proceso de extrusión: Impacto sobre el índice glicémico de harinas de consumo habitual en Chile

Las harinas de trigo, maíz, lentejas y arroz son elementales para la formulación de distintos alimentos de alto consumo en la población chilena. El proceso de extrusión es ampliamente utilizado por la industria alimentaria para generar propiedades que permitan la reconstitución instantánea de harinas. Sin embargo, dicho proceso tecnológico; afecta la cantidad, la estabilidad y la digestibilidad de los hidratos de carbono (CHO) del ingrediente alimentario. Estas propiedades nutricionales impactan directamente en la respuesta glicémica de los individuos y en el índice glicémico (IG) de los alimentos. La presente revisión analiza el efecto de la extrusión sobre las propiedades nutricionales de los CHO de alimentos elaborados a partir de harinas de consumo habitual en Chile. Factores como la temperatura, y en menor grado, la humedad y velocidad utilizadas en el proceso de extrusión, junto con el origen del grano utilizado, determinan las propiedades nutricionales de CHO presente en harinas extruidas. El estudio, control y estandarización de estas variables operacionales permitiría estandarizar la elaboración industrial de productos extruidos, impactando favorablemente; sobre la velocidad de hidrólisis de almidón y el IG de harinas de trigo, maíz, lentejas o arroz; y de alimentos formulados a partir de ellas.

Flours from wheat, corn, lentils, and rice are essential for the formulation of various high-consumption foods in the Chilean population. The extrusion process is widely used by the food industry to generate properties that allow for the instant reconstitution of flours. However, this technological process affects the nutritional properties of the carbohydrates (CHO) in the food ingredient, including quantity, stability, and digestibility; characteristics that directly impact the glycemic response of individuals and the glycemic index of foods. This review analyzes the effect of extrusion on the nutritional properties of CHO in foods made from commonly consumed flours in Chile. Factors such as temperature, and to a lesser extent, humidity, and speed used in the extrusion process, along with the origin of the grain used, determine the healthy properties of CHO in extruded flours. The utility of adjusting the mentioned variables in the extrusion process would allow for the standardization of industrial scaling in the production of extruded foods that would positively impact the starch hydrolysis rate and glycemic index of wheat, corn, lentil, or rice flours, and foods formulated from them.

Application of low glycemic index treatment in children with refractory epilepsy / 中华实用儿科临床杂志

Ketogenic diet (KD) has been applied to the treatment of epilepsy for the last century, although it has been underestimated due to the complicated preparation for beginners and the emergence of antiepileptic drugs.Due to the limitations of the mechanism of drug treatment of epilepsy, and the pathogenesis of epilepsy is complex, the incidence of drug-resistant epilepsy has not improved with the development of drugs over the years.KD plays an anti-epileptic and neuroprotective role through a variety of mechanisms, which is also effective to refractory epilepsy.As a result, KD has been emphasized again.Classical KD has high fat content and complicated operation.When the training is not fine enough, many patients cannot understand and qualify the operation.To overcome the disadvantages of the conventional KD, a modified KD has been developed that is closer to a normal diet structure and has a good tolerance, namely the low glycemic index treatment (LGIT). LGIT is featured by a slightly higher intake of carbohydrates, simplified meal preparation, improved taste and tolerance.This review aims to describe the mechanism, clinical outcomes and indications of LGIT in children with refractory epilepsy.

The effect of fruit consumption time on glucose regulation in pregnancy with gestational diabetes / O efeito do tempo de consumo de fruta na regulação da glicose na gravidez com diabetes gestacional

ABSTRACT Objective This study aims to determine the effect of fruit consumption time on blood glucose regulation in pregnant women with gestational diabetes. Methods The study was carried out with 64 volunteer participants diagnosed with gestational diabetes. Participants who were directed to the Department of Nutrition and Dietetics were divided into two groups according to the order of application; Group 1 was included in the nutrition treatment program for a week, consuming fruit for the main meal and Group 2 for the snack. During this process, the participants were applied a personalized nutrition plan that was adjusted equally for macronutrients of all meals containing isocaloric 3 main and 4 snacks. In this process, blood glucose values were measured six times a day by the participants and the blood glucose results of both groups before starting the nutrition therapy and on the seventh day after starting the medical nutrition therapy were compared. Results The mean age of the women participating in the study was 33.50±4.95 years and 32.28±5.18 years for the 1st and 2nd groups, respectively, and the groups were similar in terms of anthropometric measurements. The post-diet average of postprandial blood glucose levels in the morning within each group dropped from 180mg/d to 115mg/dL (p<0,001) for Group 1 and from 185mg/dL to 110mg/dL (p<0,001) for Group 2. There was a decrease in the fasting plasma glucose and postprandial blood glucose levels measured in the morning, noon and evening before and after the medical nutrition therapy of the groups, but no statistically significant difference was found between the groups (p>0.05). All participants on the gestational diabetes diet had normal blood sugar levels without the need for insulin. A statistically significant decrease was observed in the postprandial blood glucose-fasting plasma glucose difference levels of the pregnant women in the group that consumed fruit for snacks (Group 2) on the seventh day of the study (p<0,001). There was no significant difference in the pre-diet and post-diet morning fasting plasma glucose values of both groups (p>0,05). Conclusion This study found that medical nutrition therapy in pregnant women with gestational diabetes led to a decrease in blood glucose levels, but consuming fruits as a snack or at the main meal did not make a significant difference on fasting plasma glucose and postprandial blood glucose. It was concluded that the type and amount of carbohydrates consumed daily in gestational diabetes are determinative on blood glucose level.

RESUMO Objetivo O objetivo deste estudo é determinar o efeito do tempo de consumo de fruta na regulação da glucose no sangue em mulheres grávidas com diabetes gestacional. Métodos Este estudo foi realizado com 64 participantes voluntários diagnosticados com diabetes gestacional. Os participantes que foram encaminhados para o Departamento de Nutrição e Dietética foram divididos em dois grupos, de acordo com a ordem da sua aplicação. O grupo 1 foi incluído no programa de tratamento médico nutricional durante uma semana, consumindo fruta para a refeição principal e o grupo 2 para os lanches. Neste processo, foi aplicado aos participantes um plano de nutrição personalizado, com isocalórico, 3 refeições principais e 4 lanches, os macronutrientes de todas as refeições foram ajustados igualmente. Neste processo, os valores de glicemia foram medidos seis vezes por dia pelos participantes, e foram comparados os resultados da glicemia de ambos os grupos antes de se iniciar a terapia nutricional médica e no sétimo dia após o início da terapia nutricional médica. Resultados A idade média das mulheres que participaram no estudo foi de 33,50±4,95 e 32,28±5,18 anos para o 1º e 2º grupos, respetivamente, e não houve diferença entre os grupos em termos de medidas antropométricas. A glicemia média pós-prandial de manhã após terapia nutricional médica dentro dos grupos variou entre 180mg/d a 115mg/dL (p<0,001) para o Grupo 1, e de 185mg/dL a 110mg/dL para o Grupo 2 (p<0,001). Houve uma diminuição nos níveis de glicemia em jejum e glicemia média pós-prandial medidos de manhã, meio-dia e noite antes e depois da terapia nutricional médica dos grupos, mas não houve diferença estatisticamente significativa entre os grupos (p>0,05). Os níveis de açúcar no sangue de todos os participantes na dieta diabetes gestacional baixaram para níveis normais sem necessidade de terapia com insulina. Uma diminuição estatisticamente significativa foi observada no sétimo dia do estudo nos níveis de diferença do glicemia média pós-prandial-glicemia em jejum das mulheres grávidas do grupo que consumiram fruta como aperitivo (Grupo 2). (p<0.001). Não houve diferença significativa nos valores de glicemia em jejum matinal de ambos os grupos antes e depois da dieta (p>0,05). Conclusão Como resultado deste estudo, verificou-se que a terapia nutricional levou a uma diminuição do açúcar no sangue em mulheres grávidas com diabetes gestacional, mas o consumo de fruta como lanche ou refeição principal não fez uma diferença significativa no jejum e na glucose do sangue pós-prandial. Concluiu-se que o tipo e a quantidade de hidratos de carbono consumidos diariamente na diabetes gestacional são determinantes para o nível de glicose no sangue.

Association between carbohydrate quality index and dietary patterns, sleep quality, anxiety level, and depression symptoms: A cross-sectional study

Aim: This study was conducted to determine the relationship between carbohydrate quality and sleep quality, depression, anxiety, stress and anthropometric measurements. Methods: The carbohydrate quality was calculated using the total fiber intake, ratio of whole grains to total grains, the ratio of solid carbohydrates to total carbohydrates, and the glycemic index. Sleep status was determined using the Pittsburgh Sleep Quality Index (PSQI) and nutritional status was determined by taking a 1-day food consumption record and food consumption frequency. Results: It was found that 20% of the participants with the highest carbohydrate quality had the highest sleep quality and the lowest body mass index. Conclusion: Adults should be informed that the quality of carbohydrates that they consume, was associated with better sleep quality and some micronutrients (potassium, magnesium, vitamin A-D-K-C-B1-B6, Folate) but no significant correlation was found between anxiety, depression, and stress scores

Objetivos: Este estudio se realizó para determinar la relación entre la calidad de los carbohidratos y la calidad del sueño, la depresión, la ansiedad, el estrés y las medidas antropométricas. Métodos: La calidad de los carbohidratos se calculó utilizando la ingesta total de fibra, la proporción de granos integrales a granos totales, la proporción de carbohidratos sólidos a carbohidratos totales y el índice glucémico. El estado del sueño se determinó utilizando el índice de calidad del sueño de Pittsburgh (PSQI) y el estado nutricional se determinó tomando un registro de consumo de alimentos de un día y la frecuencia de consumo de alimentos. Resultados: Se encontró que el 20% de los participantes con la mayor calidad de carbohidratos tenían la mejor calidad de sueño y el índice de masa corporal más bajo. Conclusión: Se debe informar a los adultos que la calidad de los carbohidratos que consumen, se asoció con una mejor calidad del sueño y algunos micronutrientes (potasio, magnesio, vitamina A-D-K-C-B1-B6, folato), pero no se encontró una correlación significativa entre las puntuaciones de ansiedad, depresión y estrés.

Índice glicemico y carga glicémica de Galletas de Chuño / Glycemic index and glucemic load of Chuño biscuits

INTRODUCCION. El índice glicémico (IG) es la forma numérica que representa la rapidez de la absorción de los carbohidratos de un alimento, este índice multiplicado por la cantidad de carbohidratos en gramos dividido entre 100 es la carga glicémica (CG), ambos indicadores permiten la selección y uso de alimentos en dietas para controlar los niveles de glucosa sanguínea repercutiendo sobre el estado y restitución de la salud. La Galleta de Chuño es un alimento de repostería a base de fécula de papa que ha ampliado su mercado de consumo a las ciudades bolivianas, es fuente de carbohidratos y es consumido como sustituto del pan y galletas. OBJETIVOS. Determinar el índice glicémico y la carga glicémica de Galletas de Chuño en estudiantes del CETAL La Paz. MATERIALES Y MÉTODOS. Se realizó un estudio observacional, prospectivo, transversal y descriptivo seleccionando 10 estudiantes que cumplieron con criterios de selección. Se evaluó la respuesta glucémica a los 0, 15, 30, 45, 60, 90 y 120 min tras la ingesta de una solución con 50 g de glucosa y tras el consumo de 72,14 g de Galletas de Chuño, siguiendo procedimientos recomendados por la FAO/WHO para posteriormente calcular el índice glucémico y la carga glucémica. RESULTADOS. El valor promedio del IG de las Galletas de Chuño fue de 65,5 ± 4,8. La CG fue 13,6 para una ración de 30 g de las Galletas de Chuño. CONCLUSIONES. La Galleta de Chuño es un alimento de índice glucémico medio y de carga glicémica media, por lo que es recomendado para el consumo de la población en general, pero con moderación en su ingesta frecuente.

INTRODUCTION. The glycemic index (GI) is the numerical form that represents the rate of the carbohydrate absorption after a meal. This index multiplied by the amount of carbohydrates in grams divided by 100 is the glycemic load (CG). Both indicators allow selection and use of food in diets to control blood glucose levels, affecting the state and restitution of health. Chuño biscuits is a pastry food based on potato starch that has expanded its consumer market to Bolivian cities, it is a source of carbohydrates, and it is consumed as a substitute for bread and cookies. OBJECTIVES. To determine the glycemic index and the glycemic load of Chuño biscuits in students of Centro de Estudios Técnicos Acelerados Loreto (CETAL) in La Paz city. MATERIALS AND METHODS. This observational, prospective, cross-sectional and descriptive study included ten students who met the selection criteria. The glycemic response was evaluated at 0, 15, 30, 45, 60, 90, and 120 min after ingesting a solution with 50 g of glucose and after consuming 72.14 g of Chuño biscuits, following procedures recommended by FAO / WHO to calculate the glycemic index and glycemic load subsequently. RESULTS. The average GI value of Chuño biscuits was 65.5 ± 4.8. The CG was 13.6 for a serving of 30 g of the Galletas de Chuño. CONCLUSIONS. Chuño biscuits are a food with a medium glycemic index and a medium glycemic load, so it is recommended for consumption by the general population, however, when its intake is frequent, it should be consumed in moderation.

Análisis comparativo de la respuesta e índice glicémico, carga glicémica y saciedad de leche alta en proteínas y leche sin lactosa en sujetos sanos

RESUMEN Objetivo: Determinar el efecto del consumo de 3 tipos de leche de vaca (sin lactosa, alta en proteínas y estándar) sobre carga glicémica (CG), respuesta glicémica (RG) e índice glicémico (IG) y el nivel de saciedad en adultos sanos. Metodología: En 11 sujetos sanos se aplicó la metodología propuesta por la norma ISO 26642 para determinar índice glicémico. Se obtuvo muestra de sangre capilar a los 0, 30, 45, 60, 90 y 120 minutos. Se evaluó el nivel de hambre, saciedad y plenitud mediante escala visual análoga (EVA). El análisis estadístico se hizo mediante Test de Friedman, Wilcoxon, ajustado por Bonferroni o ANOVA de medidas repetidas. Significancia estadística con valor p0,05). Conclusión: Si bien la leche sin lactosa presentó un alto índice glicémico, ésta no afectó el nivel de saciedad. Por otro lado, la leche alta en proteínas y estándar tienen un bajo índice glicémico.

ABSTRACT Objective: To determine the effect of consumption of 3 types of cow's milk (lactose free, high in protein, and standard) on glycemic load (GL), glycemic response (GR) and glycemic index (GI) and the level of satiety in healthy adults. Methodology: Eleven healthy subjects participated. The methodology proposed by the ISO 26642 standard was applied to determine GI. Capillary blood sample was obtained at 0, 30, 45, 60, 90 and 120 minutes. The level of hunger, satiety and fullness were evaluated using a visual analog scale (VAS). Statistical analysis was done using the Friedman, Wilcoxon test, adjusted by Bonferroni or repeated measures ANOVA. Statistical significance was set as p0.05). Conclusion: Although lactose-free milk had a high GI, it did not affect satiety. On the other hand, high protein and standard milk have a low GI.

DEVELOPMENT OF APPLICATION ENCOMPASSING DATABASE OF GLYCEMIC INDEX, FUNCTIONAL FOODS AND CARB COUNTING OF INDIAN FOODS

Smartphone apps may be an innovative medium for delivering individual health behaviour change intervention en masse. This study aims to develop a mobile application containing the database of glycemic index (GI) values of Indian foods and functional foods and to aid patients with type 1 diabetes to count their carbohydrates for intake. This application was developed with the help of a computer science expert. The development process started by electing the platform with samples, then collecting and sorting the required data followed by its demonstration to the faculty members and students. This application is also useful for the general public to choose functional foods with potential health bene?ts. This app is useful for patients having type-1 diabetes to adjust their rapid acting insulin dosage by counting the carbohydrates. It was concluded that smartphone apps can be an innovative medium for treating certain medical condition of patients, delivering important health information and giving education to the general population.

Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting

Abstract Introduction: High leuko-glycaemic index (LGI) (> 2000) has been associated with poor prognosis in many critical care settings. However, there is no evidence of LGI's prognostic value in the postoperative period of coronary artery bypass grafting (CABG). This study aims to analyze the prognostic value of LGI in the postoperative period of CABG. Methods: Single-center retrospective analysis of prospectively collected data was performed. Consecutive adult patients undergoing CABG between 2007 and 2019 were included. Blood glucose levels and white blood cells count were evaluated in the immediate postoperative period. LGI was calculated by multiplying both values and dividing them by 1,000 and analyzed in quartiles. Receiver operating characteristic curve was used to determine the best cutoff value. The primary combined endpoint was in-hospital mortality, low cardiac output (LCO), or acute kidney injury (AKI). Secondary endpoints included in-hospital death, AKI, atrial fibrillation, and LCO. Results: The study evaluated 3,813 patients undergoing CABG (88.5% male, 89.8% off-pump surgery, aged 64.6 years [standard deviation 9.6]). The median of LGI was 2,035. Presence of primary endpoint significantly increased per LGI quartile (9.2%, 9.7%, 11.8%, and 15%; P<0.001). High LGI was associated with increased occurrence of in-hospital mortality, LCO, AKI, and atrial fibrillation. The best prognostic cutoff value for primary endpoint was 2,000. In a multivariate logistic regression model, high LGI was independently associated with in-hospital death, LCO, or AKI. Conclusion: High LGI was an independent predictor of in-hospital mortality, LCO, or AKI in postoperative period of CABG. It was also associated with higher in-hospital death.

GlucoSTRESS - Projeto de otimização do controle glicêmico em uma unidade de cuidados intensivos portuguesa nível C (III) / GlucoSTRESS - A project to optimize glycemic control in a level C (III) Portuguese intensive care unit

RESUMO Objetivo: Duplicar a percentagem de tempo no intervalo glicêmico 100 - 180mg/dL nos primeiros 3 meses após implementação faseada de um programa de educação formal e, posteriormente, de um protocolo de insulinoterapia, sem condicionar um aumento da frequência de hipoglicemia. Métodos: Foi feita a avaliação retrospetiva do controle glicêmico pré-intervenção. Foram realizados: implementação de um programa formal de educação; distribuição de algoritmos manuais de insulinoterapia endovenosa - otimizados pelos utilizadores, a partir do protocolo de Yale modificado - e formação informal da equipe de enfermagem. Foi dado apoio à utilização dos sistemas eletrônicos de controle glicêmico e do registo prospetivo dos resultados. Resultados: A primeira fase do programa (educação formal) melhorou o tempo no intervalo euglicêmico (28% para 37%). A segunda fase permitiu atingir 66% do tempo de euglicemia, com diminuição das hipoglicemias. A percentagem de doentes sob perfusão endovenosa de insulina às 48 horas de internamento aumentou (6% para 35%). Conclusão: A implementação faseada de um programa formal de educação que favoreceu a aplicação de protocolos de insulinoterapia eletrônicos e manuais dinâmicos demonstrou ter aderência e ser segura e eficaz no controle glicêmico no doente crítico, com diminuição concomitante das hipoglicemias.

ABSTRACT Objective: To double the percentage of time within the 100 - 180mg/dL blood glucose range in the first three months following a phased implementation of a formal education program, and then, of an insulin therapy protocol, without entailing an increased incidence of hypoglycemia. Methods: The pre-intervention glycemic control was assessed retrospectively. Next, were carried out the implementation of a formal education program, distribution of manual algorithms for intravenous insulin therapy - optimized by the users, based on the modified Yale protocol - and informal training of the nursing staff. The use of electronic blood glucose control systems was supported, and the results were recorded prospectively. Results: The first phase of the program (formal education) lead to improvement of the time within the euglycemic interval (28% to 37%). In the second phase, euglycemia was achieved 66% of the time, and the incidence of hypoglycemia was decreased. The percentage of patients on intravenous insulin infusion at 48 hours from admission increased from 6% to 35%. Conclusion: The phased implementation of a formal education program, fostering the use of electronic insulin therapy protocols and dynamic manuals, received good adherence and has shown to be safe and effective for blood glucose control in critically ill patients, with a concomitant decrease in hypoglycemia.

The effects of kefir in mixed meals on appetite and food intake: a randomized cross-over trial / Os efeitos do quefir em refeições mistas sobre o apetite e a ingestão de alimentos: um estudo randomizado cruzado

ABSTRACT Objective The natural probiotic kefir is fermented milk, and may have effects on satiety and voluntary energy intake. This randomized crossover trial aimed to determine whether kefir, consumed with low- or high-glycemic index meals, affects appetite and subsequent food intake. Methods Twenty four healthy females aged 21-24 years, were recruited from Erciyes University and the surrounding community. The participants were submitted to three different breakfasts: a low glycemic index accompanied by milk, a low glycemic index with kefir, and a high glycemic index with kefir, with a 1-week washout period between meals. At 0, 15, 30, 60, 90, 120, 150, and 180 minutes after the meal, appetite ratings were measured by the visual analog scale, and then ad libitum lunch was served. Results No differences in appetite scores and voluntary energy intake were detected between the test meals. Furthermore, palatability ratings were similar between test meals, except for the higher score of high glycemic index kefir for overall palatability. Conclusion This study demonstrated that adding kefir to a high glycemic index meal may prevent increases in appetite and food intake, resulting in postprandial responses similar to those of a low glycemic index meal. These findings might enable the development of novel dietary strategies based on appetite regulation to treat or prevent obesity, particularly for Western societies. This trial was registered at ClinicalTrials.gov under the process NCT03636217.

RESUMO Objetivo O quefir probiótico natural é um leite fermentado, e pode ter alguns efeitos sobre a saciedade e a ingestão voluntária de energia. Este ensaio cruzado randomizado teve como objetivo determinar se o quefir consumido com uma refeição de baixo ou alto índice glicêmico teria afetado o apetite e a ingestão de alimentos subsequente. Métodos Vinte e quatro mulheres saudáveis, com idades entre 21 e 24 anos, foram recrutadas na Universidade de Erciyes e na comunidade circundante. Todas as participantes foram submetidas a três cafés da manhã diferentes: um baixo índice glicêmico e leite, um baixo índice glicêmico e quefir, e um alto índice glicêmico e quefir, com um período de lavagem de 1 semana entre as refeições. Aos 0, 15, 30, 60, 90, 120, 150 e 180 minutos após a refeição, as classificações de apetite foram medidas por escala analógica visual e, em seguida, o almoço ad libitum foi servido. Resultados Não foram detectadas diferenças nos escores do apetite e na ingestão voluntária de energia entre as refeições do teste. Além disso, as classificações de palatabilidade foram semelhantes entre as refeições de teste, exceto o maior escore de alto índice glicêmico quefir para palatabilidade geral. Conclusão Este estudo demonstrou que a adição de quefir a uma refeição com alto teor de índice glicêmico pode impedir o aumento do apetite e da ingestão de alimentos, resultando em respostas pós-prandiais semelhantes a uma refeição com baixo teor de índice glicêmico. Esses achados poderiam permitir o desenvolvimento de novas estratégias dietéticas baseadas na regulação do apetite para tratar ou prevenir a obesidade, particularmente para a sociedade ocidental. Esse julgamento foi registado na ClinicalTrials.gov como NCT03636217.

Correlation between pre-delivery glycated hemoglobin Alc level and pregnancy outcome in patients with gestational diabetes mellitus / 中国基层医药

Objective:To investigate the relationship between pre-delivery glycated hemoglobin A1c (HbA1c) level and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:A total of 200 GDM patients who received treatment in Zhuji Maternal and Child Health Hospital, China between April 2018 and April 2020 were included in this study. All patients were subjected to health education, medical nutrition therapy, exercise intervention and necessary drug treatment. These patients were divided into GDM-1 (HbA1c > 7.0%, n = 30), GDM-2 (HbA1c 5.5%-7.0%, n = 30) and GDM-3 (HbA1c < 5.5%, n = 106) groups according to HbA1c levels within pre-delivery 1-3 days. An additional 400 healthy pregnant women who concurrently received health examination were included in the healthy control group (NC group). HbA1c level was compared between GDM patients and healthy controls. Pregnancy outcome was compared among patients with different HbA1c levels. Results:The incidences of pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery were significantly higher than those in the NC group ( χ2 = 4.59, 8.11, 9.19, 7.42, 10.05, 11.52, 35.75, 21.12, all P < 0.05). The incidences of pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery in the GDM-1 group were 10.00% (3/30), 30.00% (9/30), 33.33% (10/30), 26.67% (8/30), 30.00% (9/30), 36.67% (11/30), 50.00% (15/30), 30.00% (9/30), respectively, and they were 4.69% (3/64), 14.06% (9/64), 28.13% (18/64), 14.06% (9/64), 18.75% (12/64), 18.75% (12/64), 39.06% (25/64), 15.63% (10/64), respectively in the GDM-2 group, and 0.94% (1/106), 6.60% (7/106), 14.15% (15/106), 9.43% (10/106), 4.72% (5/106), 4.72% (5/106), 18.87% (20/106), 9.43% (10/106), respectively in the GDM-3 group. There were significant differences in these indexes among the three groups ( χ2= 6.07, 11.91, 7.56, 5.97, 15.97, 21.59, 14.47, 8.07, all P < 0.05). Conclusion:Pre-delivery HbA1c level in GDM patients is related to pregnancy outcomes such as pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery. Strict control of blood glucose is of great significance to improve the outcomes of pregnant patients with GDM and their newborns.

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study / 生物医学与环境科学（英文）

Objective@#The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.@*Methods@#The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.@*Results@#A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).@*Conclusion@#An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.

Dieta Cetogénica en el paciente con epilepsia refractaria / Ketogenic Diet in patients with refractory epilepsy

INTRODUCCIÓN: La epilepsia afecta a 0,5% a 1% de la población, iniciándose en la infancia en el 60% de los casos. El 25% de los niños que la presentan, tienen epilepsia refractaria (ER) a fármacos antiepilépticos (FAE) y en ellos la dieta cetogénica (DC) surge como un tratamiento no farmacológico efectivo. OBJETIVO: Evaluar el impacto de la DC en el número de crisis, en la calidad de vida y bienestar del paciente y su entorno. PACIENTES Y MÉTODO: Se revisaron los registros médicos de los pacientes con diagnóstico de ER que recibieron DC entre los años 2008 y 2018 registrando variables: edad, diagnóstico, número de crisis, número de FAE, respuesta y complicaciones. La DC se inició en todos los casos con el paciente hospitalizado durante un período no mayor a siete días, en el cual se realizó evaluación nutricional antropométrica con medición de peso y talla según condición clínica. RESULTADOS: Se analizaron 35 DC. La mediana de edad al inicio fue 4,8 años con rango intercuartil (RIC) de 2,3-6,8 años. Se utilizó DC clásica en 49% de los pacientes, Dieta Atkins Modificada en 37% y Dieta de Bajo Índice Glicémico en 14%. Su promedio de duración fue 13 meses + 11 DS meses. Luego de tres meses de iniciada la DC, la reducción de al menos un 50% de las crisis se observó en 82% de los casos, de los cuales 22,8% presentaron reducción de más de 90% y 20% quedó libre de crisis. Se registraron efectos secundarios en 21 pacientes, la mayoría gastrointestinales (62%) y dislipidemia (14%). Todos los efectos secundarios se resolvieron con manejo médico. CONCLUSIONES: La DC es un tratamiento efectivo en pacientes pediátricos con ER y las complicaciones asociadas fueron fácilmente controla das por un equipo multidisciplinario.

INTRODUCTION: Epilepsy affects 0.5 to 1% of the population. 25% of pediatric patients have drug-resistant epilepsy (DRE). Ketogenic Diet (KD) emerges as an effective, non-pharmacological treatment in this group. OBJECTIVE: To describe the effect of KD on seizure control and nutritional status in children whit DRE. PATIENTS AND METHOD: We reviewed the medical records of patients with DRE treated with KD, between 2008 and 2018, evaluating age, diagnosis, number of seizures, number of antiepileptic drugs used, clinical outcomes, and complications. The KD was initiated in all patients hospitalized for a period no longer than seven days, who were evaluated for their nutritional and anthropometric sta tus, with weight and height measurements according to the clinical condition. RESULTS: We analyzed 35 KD in 33 cases. The median age of KD initiation was 4.8 years with an interquartile range (IQR) of 2-3 to 6.8 years. Classical KD was used in 49% of patients, Modified Atkins Diet (MAD) in 37%, and Low-Glycemic Index Treatment (LGIT) in 14% of cases. The average duration was 13 months (SD 11 months). After three months of using KD, we observed at least 50% reduction of seizures in 82% (27/33) of the patients, out of these, 22.8% presented 90% or more reduction of seizures, and 20% ended up seizure-free. Adverse events were observed in 21 patients, mainly gastrointestinal (62%) and dyslipidemia (14%), without effect on height. All side effects resolved with medical ma nagement. CONCLUSIONS: KD is a useful treatment in pediatric patients with DRE without nutritional impact. The adverse events were easily controlled if the patients are evaluated by a multidisciplinary team, according to international guidelines.

Efectos de la terapia periodontal no quirúrgica sobre el control glucémico de la Diabetes Mellitus Tipo 2: Revisión de literatura / Effects of non-surgical periodontal therapy on glycemic control of Type 2 Diabetes Mellitus: A literature review

Resumen Objetivo: Conocer la relación entre la enfermedad periodontal y la diabetes mellitus tipo 2, en el control de la glucemia. Diseño y métodos de investigación: Se realizó una búsqueda bibliográfica utilizando una base de datos (PubMed) con restricción del idioma inglés, buscando las investigaciones más recientes y con el mayor número de sujetos de investigación. Resultados: Los artículos revisados coinciden en que el tratamiento de la enfermedad periodontal mejora el control glucémico en pacientes con diabetes mellitus tipo 2, con una disminución promedio de 0,69% en el nivel de hemoglobina glucosilada (HbA1c). Conclusiones: El tratamiento periodontal mejora el control de la glucemia en pacientes con Diabetes Mellitus Tipo 2, debido a que disminuye el estado de inflamación sistémica y por lo tanto, también la cantidad de células inflamatorias (como IL6 y TNF- α) que provocan alteraciones en la actividad de la insulina.

Abstract Objective: To know the relationship between periodontal disease and type 2 diabetes mellitus in the control of blood glucose. Design and research methods: A bibliographic search was conducted using a database (PubMed) with english language restriction, looking for the most recent research and with the largest number of research subjects. Results: The articles reviewed coincide in the treatment of periodontal disease improves glycemic control in patients with diabetes mellitus type 2, with an average of 0.69% in the level of glycosylated hemoglobin (HbA1c). Conclusions: Periodontal treatment improves glycemic control in patients with Type 2 Diabetes Mellitus, as well as the number of inflammatory cells (such as IL6 and TNF-α) that cause alterations in insulin activity.

Maternal nutritional status in diabetes mellitus and neonatal characteristics at birth / Estado nutricional materno en diabetes mellitus y características neonatales al nacimiento / Estado nutricional materno no diabetes mellitus e características neonatais ao nascimento

ABSTRACT Objectives: to analyze the nutritional status of women with diagnosis of Diabetes mellitus in pregnancy and the newborns' characteristics in relation to health conditions at birth. Methods: transversal study with data from 394 electronic medical charts (197 newborn and 197 mothers), between 2017 and 2018. Descriptive and analytical statistics. Results: there was prevalence of women with Gestational Diabetes (78.2%), followed by Type II Diabetes (13.7%) and Type I Diabetes (8.1%), and of term births (85.3%) and cesarean deliveries (54.8%). Type I Diabetes was associated to earlier gestational age at birth (p>0.001) and obesity during pregnancy was associated to higher birth weight of newborns (p=0.024). Clinical complications occurred in 37.6% of newborns. Among complications, Type I Diabetes was associated with respiratory disorder (p=0.005), and prematurity was associated with mother's overweight/obesity (p=0.010). Conclusions: we strongly advise about the need of metabolic and nutritional control during gestations that course with Diabetes mellitus, due occurrence of negative consequences to the newborn´s health at birth.

RESUMEN Objetivos: analizar el estado nutricional de las mujeres diagnosticadas con Diabetes mellitus durante el embarazo y las características neonatales relacionadas con las condiciones de nacimiento. Métodos: investigación transversal con datos de registros computarizados de 394 registros médicos (197 de madres y 197 de sus recién nacidos), entre 2017 y 2018. Estadísticas descriptivas y analíticas. Resultados: prevalencia de mujeres con Diabetes Gestacional (78.2%) seguido de Diabetes Tipo II (13.7%) y Diabetes Tipo I (8.1%), y recién nacidos a término (85.3%) nacidos por cesárea (54,8%). Diabetes Tipo I se asoció con una menor edad gestacional (EG) al nacer (p<0.001) y mujeres embarazadas obesas con mayor peso al nacer (p=0.024). Las complicaciones clínicas ocurrieron en el 37.6% de los recién nacidos. Entre las complicaciones, Diabetes Tipo I se asoció con trastorno respiratorio (p=0.005) y sobrepeso/obesidad materna en la prematuridad (p=0.010). Conclusiones: se reitera la necesidad del control metabólico y nutricional durante el embarazo con Diabetes mellitus, debido aparición de consecuencias negativas en el recién nacido.

RESUMO Objetivos: analisar o estado nutricional de mulheres com diagnóstico de Diabetes mellitus na gestação e as características neonatais referentes às condições de nascimento. Métodos: estudo transversal, com dados de registros informatizados de 394 prontuários (197 de mães e 197 de seus neonatos), entre os anos de 2017 e 2018. Estatística descritiva e analítica. Resultados: prevalência de mulheres com Diabetes Gestacional (78,2%), seguido por Diabetes Tipo II (13,7%) e Diabetes Tipo I (8,1%), e de neonatos a termo (85,3%) nascidos por cesariana (54,8%). Diabetes Tipo I foi associado a menor idade gestacional ao nascimento (p<0,001) e gestantes obesas ao maior peso de nascimento (p=0,024). Complicações clínicas ocorreram em 37,6% dos neonatos. Dentre as complicações, Diabetes Tipo I foi associado a distúrbio respiratório (p=0,005), e sobrepeso/obesidade maternos, à prematuridade (p=0,010). Conclusões: reitera-se a necessidade do controle metabólico e nutricional na gestação com Diabetes mellitus, devido ocorrência de consequências negativas no neonato.

Maternal nutritional status in diabetes mellitus and neonatal characteristics at birth / Estado nutricional materno en diabetes mellitus y características neonatales al nacimiento / Estado nutricional materno no diabetes mellitus e características neonatais ao nascimento

ABSTRACT Objectives: to analyze the nutritional status of women with diagnosis of Diabetes mellitus in pregnancy and the newborns' characteristics in relation to health conditions at birth. Methods: transversal study with data from 394 electronic medical charts (197 newborn and 197 mothers), between 2017 and 2018. Descriptive and analytical statistics. Results: there was prevalence of women with Gestational Diabetes (78.2%), followed by Type II Diabetes (13.7%) and Type I Diabetes (8.1%), and of term births (85.3%) and cesarean deliveries (54.8%). Type I Diabetes was associated to earlier gestational age at birth (p>0.001) and obesity during pregnancy was associated to higher birth weight of newborns (p=0.024). Clinical complications occurred in 37.6% of newborns. Among complications, Type I Diabetes was associated with respiratory disorder (p=0.005), and prematurity was associated with mother's overweight/obesity (p=0.010). Conclusions: we strongly advise about the need of metabolic and nutritional control during gestations that course with Diabetes mellitus, due occurrence of negative consequences to the newborn´s health at birth.

RESUMEN Objetivos: analizar el estado nutricional de las mujeres diagnosticadas con Diabetes mellitus durante el embarazo y las características neonatales relacionadas con las condiciones de nacimiento. Métodos: investigación transversal con datos de registros computarizados de 394 registros médicos (197 de madres y 197 de sus recién nacidos), entre 2017 y 2018. Estadísticas descriptivas y analíticas. Resultados: prevalencia de mujeres con Diabetes Gestacional (78.2%) seguido de Diabetes Tipo II (13.7%) y Diabetes Tipo I (8.1%), y recién nacidos a término (85.3%) nacidos por cesárea (54,8%). Diabetes Tipo I se asoció con una menor edad gestacional (EG) al nacer (p<0.001) y mujeres embarazadas obesas con mayor peso al nacer (p=0.024). Las complicaciones clínicas ocurrieron en el 37.6% de los recién nacidos. Entre las complicaciones, Diabetes Tipo I se asoció con trastorno respiratorio (p=0.005) y sobrepeso/obesidad materna en la prematuridad (p=0.010). Conclusiones: se reitera la necesidad del control metabólico y nutricional durante el embarazo con Diabetes mellitus, debido aparición de consecuencias negativas en el recién nacido.

RESUMO Objetivos: analisar o estado nutricional de mulheres com diagnóstico de Diabetes mellitus na gestação e as características neonatais referentes às condições de nascimento. Métodos: estudo transversal, com dados de registros informatizados de 394 prontuários (197 de mães e 197 de seus neonatos), entre os anos de 2017 e 2018. Estatística descritiva e analítica. Resultados: prevalência de mulheres com Diabetes Gestacional (78,2%), seguido por Diabetes Tipo II (13,7%) e Diabetes Tipo I (8,1%), e de neonatos a termo (85,3%) nascidos por cesariana (54,8%). Diabetes Tipo I foi associado a menor idade gestacional ao nascimento (p<0,001) e gestantes obesas ao maior peso de nascimento (p=0,024). Complicações clínicas ocorreram em 37,6% dos neonatos. Dentre as complicações, Diabetes Tipo I foi associado a distúrbio respiratório (p=0,005), e sobrepeso/obesidade maternos, à prematuridade (p=0,010). Conclusões: reitera-se a necessidade do controle metabólico e nutricional na gestação com Diabetes mellitus, devido ocorrência de consequências negativas no neonato.

A Fuzzy Approach for Diabetes Mellitus Type 2 Classification

Abstract This paper proposes an automatic fuzzy classification system for glycemic index, which indicates the level of Diabetes Mellitus type 2. Diabetes is a chronic disease occurred when there is deficiency in insulin production or in its action, or both, causing complications. Neuro-fuzzy systems and Decision Trees are used to obtain, respectively, the numerical parameters of the membership functions and the linguistic based rules of the fuzzy classification system. The results goal to categorize the glycemic index into 4 classes: decrease a lot, decrease, stable and increase. Real database from [1] is used and the input attributes of the system are defined. In addition, the proposed automatic fuzzy classification system is compared with an "expert" fuzzy classification system, which is totally modeled using expert knowledge. From linguistic based rules obtained from fuzzy inference process, new scenarios are simulated in order to obtain a larger data set which provides a better evaluation of the classification systems. Results are promising, since they indicate the best treatment - intervention or comparative - for each patient, assisting in the decision-making process of the health care professional.

Research progress on the relationship between carbohydrate, glycemic index, glycemic load and the incidence of ovarian cancer / 公共卫生与预防医学

Abstract: Ovarian cancer is a gynecological malignant tumor with the highest fatality rate. It is characterized by concealed onset and poor prognosis. Recent studies have found that carbohydrate intake, food glycemic index and food glycemic load are closely related to the incidence of ovarian cancer. In this article, we summarize the current progress of the above-mentioned research and provide references for the prevention and future research of ovarian cancer.