Research progress of adipokines and diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Diabetic retinopathy(DR)is one of the common microangiopathy in diabetes and the main cause of blindness in adults. It can be seen that it is very important to find the specific target of DR prevention and treatment. Adipose tissue is not only an energy storage tissue, but also an active endocrine organ, which can release a variety of cytokines, called adipokines. Studies have shown that adipokines play an important role in the occurrence and development of DR. Adipokines can not only directly act on vascular endothelium through blood circulation, but also indirectly affect vascular endothelial function by affecting the activity of sympathetic nervous system and insulin sensitivity, which leads to dysfunction of vascular endothelial cells, increased retinal vascular permeability, neurodegeneration and neovascularization, and finally leads to the destruction of blood-retinal barrier. In recent years, the role of some new adipokines in DR has been paid more and more attention. This paper reviews the related research of several new adipokines in DR.

Effects of dulaglutide combined with metformin on body metabolism, body fat composition and serum adipokines in obese patients with type 2 diabetes mellitus / 药学实践与服务

Objective To explore the clinical efficacy of dulaglutide combined with metformin in the treatment of obese patients with type 2 diabetes mellitus（T2DM）. Methods A total of 200 obese patients with T2DM who were treated in Shanghai Jiading District Anting Hospital from January 2021 to January 2023 were randomly divided into liraglutide group（n=100）and dulaglutide group（n= 100）. The liraglutide group was treated with liraglutide combined with metformin, and the dulaglutide group was treated with dulaglutide combined with metformin. Both groups were treated for 3 months. The body metabolic indexes [fasting blood glucose（FBG）, 2 h postprandial blood glucose（2 h PBG）, hemoglobin（HbA1 c）, total cholesterol（TC）, triglyceride（TG）], body fat composition [body fat rate, body mass index, subcutaneous fat rate of limbs, visceral fat index] and serum adipokines（adiponectin, neuropeptide Q（NPQ）, asprosin, irisin）levels were compared before treatment and 3 months after treatment. The clinical efficacy and adverse reactions of the two groups were observed. Results After 3 months of treatment, FBG, 2 h PBG, HbAlc, TC, TG, body fat rate, body mass index, subcutaneous fat rate of limbs, visceral fat index and asprosin in the two groups were lower than those before treatment, and those in the dulaglutide group were lower than those in the liraglutide group（P<0.05）. After 3 months of treatment, the levels of serum adiponectin, NPQ and irisin in the two groups were higher than those before treatment, and the increase in the dulaglutide group was greater than that in the liraglutide group（P<0.05）. The effective rate of dulaglutide group（98.00%）was higher than that of liraglutide group（91.00 %）（P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（11.00%, 14.00%）（P>0.05）. Conclusion Dulaglutide combined with metformin could improve the metabolic status of obese T2 DM patients, regulate body fat composition and serum adipokines, with significant clinical efficacy and safety.

Serum levels and gestational curve of adiponectin and leptin during adolescent pregnancy

SUMMARY OBJECTIVE: This study aimed to develop a curve of weekly serum levels of adiponectin and leptin among pregnant adolescents. In addition, pregestational body mass index and weight gain were assessed and correlated with the serum concentration of these molecules. METHODS: This was a prospective cohort study, including only pregnant adolescents with eutrophic pre-gestational body mass index who were weekly followed during the evolution of gestation. The serum concentrations of adipokines were determined using commercial ELISA kits and were correlated to pre-gestational body mass index and pregnancy weight gain. A total of 157 pregnant women participated in this study. RESULTS: Adiponectin levels showed a significant decrease among the trimesters (p=0.0004). However, we did not observe significant differences among its levels when compared weekly, neither of which was between adiponectin concentration and pre-gestational body mass index or weight gain (p=0.36 and p=0.10, respectively). In contrast, we detected a significant increase in weekly serum leptin levels (p<0.0001), positively correlated to both pre-gestational body mass index and weight gain (p=0.003 and p=0.0007, respectively). CONCLUSION: These adipokines present a different profile throughout adolescent pregnancy.

Mechanism of lipid metabolism mediated by hepatokines and adipokines in nonalcoholic fatty liver disease / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) has been renamed as metabolic-associated fatty liver disease, and systemic metabolic dysfunction has become one of the concerns of this disease. NAFLD is a metabolic disease based on dyslipidemia in the liver, which is closely associated with adipose tissue. Hepatokines and adipokines secreted by the liver and adipose tissue play an important role in regulating liver lipid metabolism. This article summarizes the hepatokines and adipokines that can promote or inhibit lipid metabolism, focusing on the mechanism of lipid metabolism mediated by hepatokines and adipokines in NAFLD, so as to provides ideas and a theoretical basis for clinical prevention and treatment.

Therapeutic effects of Tiaojing Xiaozhi Decoction combined with auricular acupoint embedding acupuncture on polycystic ovary syndrome in 40 obese cases / 中国基层医药

Objective:To investigate the therapeutic effects of Tiaojing Xiaozhi Decoction combined with auricular acupoint embedding acupuncture on polycystic ovary syndrome in obese patients. Methods:A total of 120 obese cases of polycystic ovary syndrome (spleen and kidney deficiency syndrome) treated in Ningbo Municipal Hospital of Traditional Chinese Medicine from July 2020 to June 2021 were included in this study. They were randomly assigned to undergo treatment with either Tiaojing Xiaozhi Decoction (Chinese medicine group, n = 40), auricular acupoint embedding acupuncture (ear acupuncture group, n = 40), or Tiaojing Xiaozhi Decoction and auricular acupoint embedding acupuncture (combined therapy group, n = 40). Traditional Chinese medicine (TCM) syndrome integral, body mass index, waist circumference, hip circumference, waist- to-hip ratio, testosterone, luteinizing hormone, follicle-stimulating hormone, luteinizing hormone/follicle-stimulating hormone, estradiol, prolactin, recombinant human leptin, adiponectin, tumor necrosis factor α, interleukin-6, and clinical efficacy were compared among groups before and after treatment. Results:Total response rate in the combined therapy group was 87.5%, which was slightly but not significantly, higher than 77.5% in the Chinese medicine group and 80.0% in the ear acupuncture group, and there was no significant difference in total response rate among the three groups (all P > 0.05). After treatment, TCM syndrome integral in the combined therapy was (10.40 ± 2.38) points, which was significantly lower than (12.35 ± 3.32) points in the Chinese medicine group and (14.18 ± 3.51) points in the ear acupuncture group ( F = 14.78, P < 0.05). The body mass index, waist circumference, hip circumference, and waist-to-hip ratio in the combined therapy group were superior to those in the Chinese medicine and ear acupuncture groups ( F = 4.11, 18.59, 3.62, 13.33, all P < 0.05). Luteinizing hormone and luteinizing hormone/follicle-stimulating hormone in the combined therapy group were superior to those in the Chinese medicine and ear acupuncture groups (all P < 0.05). After treatment, recombinant human leptin and adiponectin in the combined therapy and Chinese medicine groups were superior to those measured before treatment (both P < 0.05). After treatment, only adiponectin was significantly increased in the early acupuncture group compared with before treatment ( P < 0.05). After treatment, tumor necrosis factor α and interleukin-6 in the combined therapy group were (4.12 ± 1.54) μg/L and (3.09 ± 1.41) ng/L respectively, which were significantly decreased compared with before treatment ( t = 21.66, 10.42, both P < 0.05). Conclusion:Tiaojing Xiaozhi Decoction combined with auricular acupoint embedding acupuncture can decrease body mass index, fat factor, and inflammatory factor levels, which can help decrease sex hormone levels and TCM syndrome integral, and has an obvious therapeutic effect on polycystic ovary syndrome.

A Meta-analysis of the association between adipokines and bone nutrition of senile osteoporosis in China / 中华临床营养杂志

Objective:Through meta-analysis, the association of three common adipokines (leptin, adiponectin, and chemerin) with bone nutrition of senile osteoporosis (SOP) in China was systematically evaluated.Methods:CNKI, CBM, VIP, Wanfang, PubMed, Web of Science, Embase, Cochrane Library, and other databases were searched for articles published from the establishment of the database to July 30, 2022. After literature screening, data extraction, and quality evaluation of the included studies were independently conducted by two researchers, a meta-analysis was performed using RevMan5.4 and Stata17.0 softwares.Results:A total of 13 studies in the Chinese population were included, including 897 patients with SOP and 673 elderly with normal bone mineral density . The results of the meta-analysis showed that compared with the control group, the serum leptin levels were significantly lower ( MD -2.64, 95% CI -4.04 to -1.23, P < 0.001), chemerin levels were significantly higher ( MD 25.23, 95% CI 14.57 to 35.90, P < 0.001), and adiponectin levels were not significantly different ( MD -0.55, 95% CI -2.26 to 1.17, P > 0.05) in SOP patients. After subgroup analysis according to the measurement method, leptin levels remained lower in SOP patients than in the control group. Conclusions:Compared with the control group, leptin levels were lower and chemerin levels were higher in SOP patients. Therefore, dysregulation of adipokines may play an important role in the occurrence and development of SOP, and regulation of adipokine levels and functions may play a role in the treatment of SOP and the improvement of bone nutrition as a nutritional intervention.

Progress of adipokines in cancer treatment / 肿瘤研究与临床

Obesity is a well-known high-risk factor for many kinds of neoplasms. Adipokines secreted by adipose tissue play an important role in the process of obesity promoting tumorigenesis and development, and different adipokines play a role in promoting or suppressing cancer via different signaling pathways. Currently, lifestyle modification to control weight and targeted therapy of adipokines and their receptors are major research directions of cancer treatment, but most of the studies are still in the stage of basic and pre-clinical research. Therefore, the molecular mechanisms of adipokines in promoting or suppressing cancer should be further explored, and the dual inhibitors as well as combined therapy are the key research strategies for adipokines in cancer treatment in the future.

Pathogenic mechanism and research progress of adipocytokines in endometrial cancer / 中国临床药理学与治疗学

Endometrial carcinoma (EC) is one of the most common gynecologic tumors, and its incidence and mortality are increasing.The prognosis is usually favorable when the disease is diagnosed at an early stage. However, the prognosis for patients with recurrence and metastasis is relatively poor. As one of the risk factors for EC, the complex and widespread oncogenic role of obesity in EC has been validated, then the oncogenic and pro-carcinogenic mechanisms of adipocytokines secreted by adipose tissue in EC have attracted continuous attention. This review highly summarizes and concludes the previous relevant literature on the role of adipocytokines in endometrial cancer and the progress of research，and elucidates the correlation between adipocytokines and the occurrence risk, stage grading, and long-term prognosis of EC, as well as their signaling pathways and mechanisms of action in the development of EC. All this information will likely contribute to the development of novel molecular markers in EC, the discovery of new therapeutic targets, and the study of related targeted drugs, which may in turn break the current dilemma of early screening, early diagnosis, and treatment of recurrent and metastatic patients in EC in the future, resulting in an improvement of the long-term prognosis of patients with EC.

Pathophysiology of obesity and its associated diseases

The occurrence of obesity has increased across the whole world. Many epidemiological studies have indicated that obesity strongly contributes to the development of cancer, cardiovascular diseases, type 2 diabetes, liver diseases and other disorders, accounting for a heavy burden on the public and on health-care systems every year. Excess energy uptake induces adipocyte hypertrophy, hyperplasia and formation of visceral fat in other non-adipose tissues to evoke cardiovascular disease, liver diseases. Adipose tissue can also secrete adipokines and inflammatory cytokines to affect the local microenvironment, induce insulin resistance, hyperglycemia, and activate associated inflammatory signaling pathways. This further exacerbates the development and progression of obesity-associated diseases. Although some progress in the treatment of obesity has been achieved in preclinical and clinical studies, the progression and pathogenesis of obesity-induced diseases are complex and unclear. We still need to understand their links to better guide the treatment of obesity and associated diseases. In this review, we review the links between obesity and other diseases, with a view to improve the future management and treatment of obesity and its co-morbidities.

Aerobic physical training impact on adipokines in women with polycystic ovary syndrome - Effects of body fat percentage

ABSTRACT Objective: We investigated the effects of aerobic training on adipokine concentrations in women with polycystic ovary syndrome (PCOS). Subjects and methods: 120 women, including 60 with PCOS and 60 without PCOS, were divided into six groups (n = 20) based on body fat percentages of 22%-27%, 28%-32%, and 33%-37%. All groups were submitted the same evaluations before and after 16 weeks of aerobic training. These included anthropometric and hemodynamic analyses, cardiopulmonary tests, and laboratory tests. Two-way analysis of variance was performed to evaluate the differences between women with and without PCOS, effect of the body fat percentage, and effect of aerobic training. Results: Body fat and PCOS were associated with high values of blood glucose, insulin, and testosterone. Body fat also reduced adiponectin levels and increased leptin, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). In contrast, the PCOS increased only TNF-α and IL-6 levels. In the PCOS group, aerobic training reduced insulin, triglycerides, leptin, and IL-6 levels. It also promoted an increase in adiponectin and high-density lipoprotein levels. However, aerobic training did not alter TNF-α concentrations. Conclusion: The body fat potentiates metabolic impairments that may be harmful to women with PCOS. Aerobic training appears to promote an important beneficial effect on the metabolic regulation of adipokines, except TNF-α.

Modified Linggui Zhugan Decoction () Ameliorates Glycolipid Metabolism and Inflammation via PI3K-Akt/mTOR-S6K1/AMPK-PGC-1 α Signaling Pathways in Obese Type 2 Diabetic Rats / 中国结合医学杂志

OBJECTIVE@#To investigate the protective effects of modified Linggui Zhugan Decoction (, MLZD), a traditional Chinese medicine formula, on obese type 2 diabetes mellitus (T2DM) rats.@*METHODS@#Fifty Sprague-Dawley rats were randomly divided into 5 groups by a random number table, including normal, obese T2DM (ob-T2DM), MLZD low-dose [MLDZ-L, 4.625 g/(kg·d)], MLZD middle-dose [MLD-M, 9.25 g/(kg·d) ] and MLZD high-dose [MLD-H, 18.5 g/(kg·d)] groups, 10 rats in each group. After 4-week intervention, blood samples and liver, pancreas, muscle tissues were collected to assess the insulin resistance (IR), blood lipid, adipokines and inflammation cytokines. The alteration of phosphatidylinositol 3 kinase (PI3K)-protein kinase B (PKB or Akt)/the mammalian target of rapamycin (mTOR)-ribosome protein subunit 6 kinase 1 (S6K1 )/AMP-activated protein kinase (AMPK)-peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1 α) pathways were also studied.@*RESULTS@#MLZD dose-dependently reduced fasting blood glucose, fasting insulin, homeostasis model of assessment for IR index and increased insulin sensitive index compared with ob-T2DM rats (P<0.05). Similarly, total cholesterol, triglyceride, low-density lipoprotein cholesterol and free fatty acids were also decreased compared with ob-T2DM rats after 4-week treatment (P<0.05 or P<0.01). Improvements in adipokines and inflammatory cytokines were observed with a raised level of adiponectin and a reduced level of leptin, resistin, tumor necrosis factor-α and interleukin-6 (P<0.05 or P<0.01). MLZD regulated the PI3K-Akt/mTOR-S6K1/AMPK-PGC-1 α pathways and restored the tissue structure of liver and pancreas (P<0.05 or P<0.01).@*CONCLUSIONS@#MLZD ameliorated glycolipid metabolism and inflammation, which may be attributed to the regulation of PI3K-Akt/mTOR-S6K1/AMPK-PGC-1 α pathways.

Protective Roles of Shilajit in Modulating Resistin, Adiponectin, and Cytokines in Rats with Non-alcoholic Fatty Liver Disease / 中国结合医学杂志

OBJECTIVE@#To evaluate the effect of Shilajit, a medicine of Ayurveda, on the serum changes in cytokines and adipokines caused by non-alcoholic fatty liver disease (NAFLD).@*METHODS@#After establishing fatty liver models by feeding a high-fat diet (HFD) for 12 weeks, 35 Wistar male rats were randomly divided into 5 groups, including control (standard diet), Veh (HFD + vehicle), high-dose Shilajit [H-Sh, HFD + 250 mg/(kg·d) Shilajit], low-dose Shilajit [L-Sh, HFD + 150 mg/(kg·d) Shilajit], and pioglitazone [HFD + 10 mg/(kg·d) pioglitazone] groups, 7 rats in each group. After 2-week of gavage administration, serum levels of glucose, insulin, interleukin 1beta (IL-1β), IL-6, IL-10, tumor necrosis factor-alpha (TNF-α), adiponectin, and resistin were measured, and insulin resistance index (HOMA-IR) was calculated.@*RESULTS@#After NAFLD induction, the serum level of IL-10 significantly increased and serum IL-1β, TNF-α levels significantly decreased by injection of both doses of Shilajit and pioglitazone (P<0.05). Increases in serum glucose level and homeostasis model of HOMA-IR were reduced by L-Sh and H-Sh treatment in NAFLD rats (P<0.05). Both doses of Shilajit increased adiponectin and decreased serum resistin levels (P<0.05).@*CONCLUSION@#The probable protective role of Shilajit in NAFLD model rats may be via modulating the serum levels of IL-1β, TNF-α, IL-10, adipokine and resistin, and reducing of HOMA-IR.

Consumption of osmo-dehydrated Andean Berry (Vaccinium meridionale Swartz) decreases levels of pro-inflammatory biomarkers of overweight and obese adults / Consumo de agraz osmodeshidratado (Vaccinium meridionale Swartz) disminuye los niveles de biomarcadores proinflamatorios de adultos con sobrepeso y obesidad

Background: A Body Mass Index (BMI) greater than 24.9 Kg/m2 promotes chronic inflammation due to increased secretion of pro-inflammatory adipokines. Consuming fruits rich in bioactive compounds such as berries is a promising strategy to counteract this effect. Objectives: Determine the effect of osmo-dehydrated Andean Berry consumption on inflammatory biomarkers (TNF-α, IL- 6, IL-1ß, and adiponectin) and plasma antioxidant capacity in overweight and obese adults after 21 days. Methods: Andean Berry was osmo-dehydrated in 70% sucrose syrup. Antioxidant activity, proximal composition, phenolic content, microbiological analysis, and sensory analysis of the product were determined. Twenty-five obese and overweight subjects consumed 35g of osmo-dehydrated berry for 21 days. Inflammatory biomarkers and antioxidant capacity in plasma were evaluated at the beginning and end of the study. Results: Osmo-dehydrated Andean Berry presented a total phenolic content of 692.7 ± 47.4 mg Gallic Acid Equivalents/100 g. All biomarkers evaluated in the subjects showed statistically significant differences (p> 0.05), except for CRP, before and after the study. IL-6 presented the more significant reduction among all pro-inflammatory adipokines with an effect size of 18.4 Conclusions: Regular consumption of osmo-dehydrated Andean Berry contributes to decreasing pro-inflammatory biomarkers and improves the plasma antioxidant capacity of overweight and obese adults

Antecedentes: un índice de masa corporal (IMC) superior a 24.9 kg/m2 promueve la inflamación crónica debido al aumento en la secreción de adipocinas proinflamatorias. El consumo de frutas ricas en compuestos bioactivos como las bayas es una estrategia prometedora para contrarrestar este efecto. Objetivo: Determinar el efecto del consumo de agraz osmodeshidratado en biomarcadores inflamatorios (TNF-α, IL- 6, IL-1ß y adiponectina) y capacidad antioxidante plasmática de adultos con sobrepeso y obesidad después de 21 días. Métodos: El agraz fue osmo-deshidratado en jarabe de sacarosa al 70%. Se determinó la actividad antioxidante, composición proximal, contenido fenólico, análisis microbiológico y análisis sensorial del producto. Veinticinco sujetos obesos y con sobrepeso consumieron 35 g de agraz osmodeshidratado durante 21 días. Se evaluaron biomarcadores inflamatorios y capacidad antioxidante en plasma al inicio y al final del estudio. Resultados: El agraz osmodeshidratado presentó un contenido fenólico total de 692.7 ± 47.4 mg GAE / 100 g. Todos los biomarcadores evaluados en los sujetos mostraron diferencias estadísticamente significativas (p> 0.05), a excepción de la PCR, antes y después del estudio. La IL-6 presentó la mayor reducción entre todas las adipocinas proinflamatorias con un tamaño del efecto de 18.4 Conclusiones: El consumo regular de agraz osmodeshidratado contribuye a disminuir los biomarcadores proinflamatorios y mejora la capacidad antioxidante plasmática de adultos con sobrepeso y obesidad

Hueso: alteraciones relacionadas con obesidad / Bone: Obesity-Related Disorders

Resumen: El tejido óseo, anteriormente considerado como una estructura mecánica de soporte y movimiento, ha mostrado una participación importante en la homeostasis del organismo, incluyendo al metabolismo energético y el tejido adiposo. En la actualidad se considera un órgano endócrino que sintetiza moléculas reguladoras del metabolismo denominadas osteocinas. A su vez, el tejido adiposo, considerado como una glándula de secreción interna, ayuda a mantener la reserva energética del organismo y produce proteínas y moléculas como las adipocinas, algunas de las cuales afectan directamente al hueso. El análisis del ciclo resorción/formación ósea, muestra que la masa ósea es reflejo del balance entre ambas. Cuando se pierde este balance y hay reducción de la masa ósea con aumento de la fragilidad, aparece la osteoporosis lo que incrementa el riesgo de fractura. Una de cada 3 mujeres y 1 de cada 5 hombres mayores de 50 años presenta una fractura por osteoporosis. La interacción entre tejido adiposo y hueso está mediada por citocinas, osteocinas y adipocinas. La obesidad puede incidir en el hueso por varios mecanismos entre los cuales se encuentran los inflamatorios y los inducidos por citocinas derivadas de los adipocitos como la leptina y la adiponectina que pueden modificar el metabolismo óseo. Evidencias apoyan el efecto negativo de la obesidad sobre la salud del hueso, aunque estudios al respecto aún son contradictorios.

Abstract: The bone tissue, previously considered as a mechanical support for structure and movement, has shown an important participation in the homeostasis of the body, including energy metabolism and adipose tissue. Currently, it is considered an endocrine organ that synthesizes regulatory molecules of metabolism called osteokines. At the same time, the adipose tissue, considered as an internal secretion gland, helps to maintain the body energy and produces proteins and mol ecules such as adipokines, some of which affect the bone directly. The analysis of bone resorption/formation cycle shows that bone mass is a reflection of the balance between both. When this balance is lost and there is a reduction of bone mass with increased fragility, osteoporosis appears and increases the risk of fracture. One in three women and one in five men over 50 years old have a fracture due to osteoporosis. The interaction between adipose tissue and bone is mediated by cytokines, osteokines and adipokines. Obesity may affect the bone by several mechanisms, among which the inflammatory is included and those induced by cytokines secreted by adipocytes such as leptin and adiponectin which can modify bone metabolism. Evidence supports the negative effect of obesity on bone health, although studies about it are still contradictory.

Clinical Study on Addition and Subtraction Treatment to Renshen Maidong San to Gestational Diabetes Mellitus of Deficiency of Both Qi and Yin / 中国实验方剂学杂志

Objective:This study aims to investigate the effect of addition and subtraction treatment to Renshen Maidongsan on metabolism of glucose， lipid and pregnancy outcome when used to gestational diabetes mellitus （GDM） with deficiency of both Qi and Yin. Method:In this study， 108 patients with GDM were randomly divided into observation group with 54 cases and control group with 54 cases. Patients in control group took Yuquan wan orally， 6 g/time， 4 times/day ， and patients in observation group were prescribed addition and subtraction treatment to Renshen Maidongsan， 1 dose/day. The course of treatment for both groups was 4 weeks. Oral glucose tolerance test （OGTT） was performed before and after treatment. Fasting blood glucose （FBG） ， 1 h our plasma glucose （1 h PG）， 2 h our plasma glucose （2 h PG）， glycosylated hemoglobin （HbA1c） and other indicators were detected to record the pregnancy outcome. Also， the levels of total cholesterol （TC）， triglyceride （TG）， high density lipoprotein cholesterol （HDL-C）， low density lipoprotein cholesterol （LDL-C）， adiponectin， serum amyloid A （SAA）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， resistin， interleukin-1<italic>β</italic> （IL-1<italic>β</italic>） and interleukin-6 （IL-6） were detected before and after treatment. Then the safety evalution was carried out. Result:The levels of insulin resistance index （HOMA-IR）， FBG， 1 h PG， 2 h PG， HbA1c， TC， LDL-C， TG， IL-6， IL-1<italic>β</italic>， TNF-<italic>α</italic>， SAA， leptin and resistin in observation group were lower than the data checked in control group （<italic>P</italic><0.01）， and the levels of HOMA-<italic>β</italic>， insulin sensitivity index （InISI） and adiponectin were higher than the standards of from control group （<italic>P</italic><0.01）. Then the incidence of medical cesarean section， pregnancy induced hypertension， polyhydramnios， premature rupture of membranes， premature delivery and adverse pregnancy outcomes were lower than those in control group （<italic>P</italic><0.01）. Conclusion:Addition and subtraction treatment to Renshen Maidongsan can improve insulin sensitivity and islet <italic>β</italic>-cell function， regulate inflammatory factors and adipokines， improve insulin resistance （IR）， effectively regulate glucose and lipid metabolism， improve maternal and infant adverse pregnancy outcomes when used on patients with GDM and deficiency of Qi and Yin， and it was safe to use in clinic.

Carga respiratória em obesos e jovens asmáticos: um estudo da cinética diafragmática / Respiratory burden in obese and young asthmatics: a study of diaphragmatic kinetics

RESUMO Objetivo O objetivo deste estudo foi avaliar a cinética diafragmática, a função respiratória e a dosagem sérica de leptina e citocinas inflamatórias (IL-6 e TNF-α) em três grupos clínicos: obeso, asmático e saudável. Métodos Estudo clínico-exploratório realizado com 73 jovens (12-24 anos, sendo 42,5% do sexo masculino) alocados em três grupos: obesidade (GO, n = 33), índice de massa corporal (IMC z-score) ≥ + 2 e asmáticos leves controlados (GA, n = 26), classificados pela GINA, e grupo controle saudável (GC, n = 14). Os participantes foram submetidos à ultrassonografia diafragmática, espirometria, pressão respiratória máxima, níveis séricos de leptina e níveis de IL-6 e TNF-α em hemocultura total. Resultados A espessura do diafragma foi maior no GO em comparação ao GA e GC (2,0 ± 0,4 vs 1,7 ± 0,5 e 1,6 ± 0,2, respectivamente, com p < 0,05). A ventilação voluntária máxima (VVM) foi significativamente menor no GO e GA em relação ao GC (82,8 ± 21,4 e 72,5 ± 21,2 vs 102,8 ± 27,3, respectivamente, com p < 0,05). O GO tem a maior taxa de leptina entre todos os grupos (com os outros dois grupos, p < 0,05). Os três grupos tinham níveis semelhantes de TNF-α e IL-6. Conclusão A hipertrofia muscular encontrada no diafragma de indivíduos obesos pode ser justificada pelo aumento do trabalho respiratório imposto pela condição crônica da doença. Esse aumento de espessura não ocorreu em asmáticos leves controlados. Os marcadores IL-6 e TNF-α não detectaram evidências de inflamação muscular, embora fosse esperado que a leptina estivesse alterada em indivíduos obesos. Pacientes obesos e asmáticos apresentaram menor resistência pulmonar do que os saudáveis.

ABSTRACT Objective The aim of this study was to assess the diaphragm kinetics, respiratory function, and serum dosage of leptin and inflammatory cytokines (IL-6 and TNF-α) in three clinical groups: obese, asthmatic, and healthy. Methods This is a clinical exploratory study performed on 73 youths (12-24 years of age, 42.5% male) allocated into three groups: obesity (OG, n=33), body mass index (BMIz-score) ≥ +2, asthmatic (AG, n=26) controlled mild asthmatics, classified by GINA, and Healthy Control Group (CG, n=14). The participants were subjected to diaphragmatic ultrasound, spirometry, maximal respiratory pressure, serum leptin levels, and IL-6 and TNF-α whole blood cell culture levels. Results Diaphragm thickness was higher in OG in comparison to AG and CG (2.0±0.4 vs 1.7±0.5 and 1.6±0.2, both with p<0.05). Maximal voluntary ventilation (MVV) was significantly lower in OG and AG in relation to the CG (82.8±21.4 and 72.5±21.2 vs 102.8±27.3, both with p<0.05). OG has the highest leptin rate among the groups (with the other two groups had p<0.05). All groups had similar TNF-α and IL-6 levels. Conclusion The muscular hypertrophy found in the diaphragm of the obese individuals can be justified by the increase in respiratory work imposed by the chronic condition of the disease. Such increase in thickness did not occur in controlled mild asthmatics. The IL-6 and TNF-α markers detected no evidence of muscle inflammation, even though leptin was expected to be altered in obese individuals. Both obese and asthmatic patients had lower pulmonary resistance than the healthy ones.

Association between visceral/subcutaneous adipose tissue ratio and plasma inflammatory markers and score for cardiovascular risk prediction in a Brazilian cohort: Pró-Saúde Study

Visceral adipose tissue (VAT) is associated with various metabolic disorders, and adipokines, secreted by adipose tissue, are involved in their pathogenesis. This study investigated associations between VAT/subcutaneous adipose tissue (SAT) ratio, inflammatory markers, and cardiovascular (CV) risk-score in adults. Plasma levels of adipokines, plasma lipid profile, blood pressure, and body composition (using dual-emission x-ray absorptiometry) were determined. CV risk-score based on the American College of Cardiology and the American Heart Association (ACC/AHA) score was calculated in a sample of 309 Brazilian civil servants aged <60 years. Participants' VAT/SAT ratio were categorized into quartiles. Among males, plasma leptin (2.8 ng/mL) and C reactive protein (CRP) (0.2 mg/dL) (P<0.05) levels were higher at P75 and P50 than P5, and the highest calculated CV risk-score was observed at P75 (7.1%). Among females, higher plasma adiponectin levels were observed at P25 (54.3 ng/mL) compared with P75 (36 ng/mL) (P<0.05). Higher plasma CRP levels were observed at P75 (0.4 mg/dL) compared with P5 (0.1 mg/dL) (P<0.05). Higher CV risk-score was observed at P75 (2.0%) compared with P5 (0.7%). In both sexes, VAT and VAT/SAT ratio were directly associated with plasma leptin, CRP, and CV risk-score, and inversely associated with adiponectin; SAT was directly associated with plasma leptin and CRP (P<0.01); interleukin (IL)-10 and CRP were directly associated with adiponectin and leptin, respectively (P<0.05). Among men only, IL-10 (inversely) and CRP (directly) were associated with CV risk-score (P=0.02). Our results strengthened the relevance of the VAT/SAT ratio in cardiovascular risk.

Adipokines: mediators of immunity and inflammation

White adipose tissue has emerged as a highly dynamic organ that releases a plethora of immune and inflammatory mediators that are involved in obesity, metabolic syndrome and immune mediated diseases. Adipokines have complex role in various physiological and pathological processes by exerting potent modulatory actions on target tissues In this Review, In this review, we explore the effects of different adipokines, focusing primarily on leptin, adiponectin, visfatin and resistin in causing immune-mediated and/or inflammatory diseases.

Responses of plasma adipokines to high intensity interval training: systematic review / Respostas das adipocinas plasmáticas ao treino intervalado de alta intensidade: revisão sistemática / Respuestas de las adipocinas plasmáticas al entrenamiento por intervalos de alta intensidad: revisión sistemática

ABSTRACT Introduction Obesity is one of the major diseases of modern times. However, the explanation for its pathophysiology is recent and has not yet been fully elucidated. White adipose tissue synthesizes and secretes adipokines that affect several pathologies related to obesity. Excessive growth of this tissue results in increased levels of pro-inflammatory adipokines and a consequent decrease in anti-inflammatory adipokines. Nevertheless, most studies use moderate intensity training, limiting the understanding of high intensity interval training in these proteins. Objective To verify the latest information on the effects of HIIT in improving the profile of circulating adipokines. Methods A search was performed on the databases PUBMED, Lilacs, HighWire, BVS and the Cochrane Database of Systematic Reviews, with the following keywords: HIIT adipokines, HIIT leptin, HIIT adiponectin. Eleven studies were selected, published in English and Portuguese between 2013 and 2017. Results HIIT proved to be effective in increasing adiponectin in the adolescent population and in Olympic athletes, but this depended on a good prescription parameter and exercise intensity. However, maximum or supramaximal intensities were superior to low and moderate intensities. In turn, leptin presented a significant decrease in response to HIIT due to the reduction of adipose tissue, demonstrating a directly proportional relation. Other adipokines, such as omentin-1 and interleukin-10, also responded positively to HIIT, resulting in improved anti-inflammatory status. Conclusion HIIT proved to be an efficient method to reduce inflammation due to obesity, as well as inducing an improvement in sports performance. However, the effects depend on training volume, intensity and prescription method. Level of evidence I; Therapeutic study-Investigating the results of treatment.

RESUMO Introdução A obesidade é uma das principais doenças dos tempos modernos. Entretanto, a explicação da sua fisiopatologia é recente e ainda não foi totalmente esclarecida. O tecido adiposo branco sintetiza e secreta adipocinas que acometem diversas patologias relacionadas à obesidade. O aumento excessivo desse tecido resulta no aumento dos níveis de adipocinas pró-inflamatórias e na consequente diminuição de adipocinas anti-inflamatórias. Entretanto, a maioria dos estudos utiliza o treinamento de intensidade moderada, limitando o entendimento do treinamento intervalado de alta intensidade nessas proteínas. Objetivo Verificar as mais recentes informações sobre os efeitos do HIIT na melhoria do perfil das adipocinas circulantes. Métodos Foi realizada uma pesquisa nos bancos de dados PUBMED, Scielo, Lilacs, HighWire, BVS e Cochrane Database of Systematic Reviews com as seguintes palavras chaves: HIIT adipokines, HIIT leptin, HIIT adiponectin. Onze estudos foram selecionados, publicados em inglês e em português, entre os anos de 2013 e 2017. Resultados O HIIT mostrou-se eficiente para aumentar a adiponectina na população adolescente e em atletas olímpicos, mas isso depende de um bom parâmetro de prescrição e da intensidade do exercício. Entretanto, as intensidades máximas ou supramáximas se mostraram superiores às intensidades baixas e moderadas. Por sua vez, a leptina apresentou significativa diminuição em resposta ao HIIT devido à redução do tecido adiposo, demonstrando uma relação diretamente proporcional. Outras adipocinas, como a omentina-1 e a Iiterleucina-10, também responderam de forma positiva ao HIIT, resultando em um melhor estado anti-inflamatório. Conclusão O HIIT demonstrou ser um método eficiente para diminuir a inflamação decorrente da obesidade, assim como induzir uma melhora no rendimento esportivo. Entretanto, os efeitos dependem do volume de treino, intensidade e método de prescrição. Nível de evidência I; Estudo terapêutico-Investigação dos resultados do tratamento.

RESUMEN Introducción La obesidad es una de las principales enfermedades de los tiempos modernos. Entretanto, la explicación de su fisiopatología es reciente y aún no se ha dilucidado completamente. El tejido adiposo blanco sintetiza y secreta adipocinas que afectan diversas patologías relacionadas a la obesidad. El aumento excesivo de este tejido resulta en el aumento de los niveles de adipocinas proinflamatorias y la consiguiente disminución de las adipocinas antiinflamatorias. Entretanto, la mayoría de los estudios usa el entrenamiento de intensidad moderada, limitando el entendimiento del entrenamiento por intervalos de alta intensidad en estas proteínas. Objetivo Verificar las más recientes informaciones sobre los efectos de HIIT en la mejora del perfil de las adipocinas circulantes. Métodos Se realizó una búsqueda en los bancos de datos PUBMED, Lilacs, HighWire, BVS y Cochrane Database of Systematic Reviews con las siguientes palabras llave: HIIT adipokines, HIIT leptin, HIIT adiponectin. Se seleccionaron 11 estudios, publicados en inglés y portugués entre 2013 y 2017. Resultados El HIIT se mostró eficiente para aumentar la adiponectina en la población adolescente y en atletas olímpicos, pero eso depende de un buen parámetro de prescripción e intensidad del ejercicio. Entretanto, las intensidades máximas o supramáximas se mostraron superiores a las intensidades bajas y moderadas. A su vez, la leptina present ó disminución significativa en respuesta al HIIT debido a la reducción del tejido adiposo, demostrando una relación directamente proporcional. Otras adipocinas, como omentina-1 e interleucina-10, también respondieron positivamente al HIIT, resultando en un mejor estado antiinflamatorio. Conclusión El HIIT demostró ser un método eficiente para disminuir la inflamación proveniente de la obesidad, así como inducir una mejora en el rendimiento deportivo. Entretanto, los efectos dependen del volumen de entrenamiento, la intensidad y el método de prescripción. Nivel de evidencia I, Estudio terapéutico - Investigación de los resultados del tratamiento.

Analysis of the chemerin and resistin adipokines in children and adolescents

SUMMARY OBJECTIVES To compare the serum concentrations of adipokines resistin and chemerin in children and adolescents with eutrophic and overweight and to evaluate their relationship with anthropometric, biochemical, and blood pressure variables. METHODS a cross-sectional epidemiological study was conducted with 234 students enrolled in public elementary schools in the city of Juiz de Fora / MG. Anthropometric evaluation, biochemistry, and blood pressure measurement were performed. Statistical analyzes included the Student-t or Mann-Whitney tests, Pearson or Spearman correlation, used according to the distribution of the variables, and linear regression analysis, by means of the evaluation of the effect of the independent variables on the serum levels of chemerin and resistin, adjusted for age and sex. For the data analysis, SPSS® software version 21.0 and STATA® version 10.1 were used, assuming a significance level of 5%. RESULTS the concentrations of chemerin were higher in eutrophic individuals than in those with excess weight (p> 0.05). In contrast, levels of resistin were higher in the young with excess weight than in the eutrophic ones (p <0.05). In the multiple linear regression analysis, the levels of chemerin were associated with the values of resistin, systolic, and diastolic blood pressure. Resistance levels maintained association only with BMI and chemerin values. CONCLUSION the adipokines analyzed presented a distinct profile in the groups of children and adolescents with eutrophic and overweight.

RESUMO OBJETIVOS Comparar as concentrações séricas das adipocinas resistina e quemerina em crianças e adolescentes com eutrofia e excesso de peso e avaliar sua relação com as variáveis antropométricas, bioquímicas e a pressão arterial. MÉTODOS Estudo epidemiológico transversal realizado com 234 estudantes matriculados em escolas públicas do ensino fundamental no município de Juiz de Fora/MG. Realizou-se avaliação antropométrica, bioquímica e aferição da pressão arterial. As análises estatísticas compreenderam os testes t de Student ou Mann-Whitney, correlação de Pearson ou Spearman, utilizados de acordo com a distribuição das variáveis, e análise de regressão linear, realizada por meio da avaliação do efeito das variáveis independentes nos níveis séricos de quemerina e resistina, ajustado por idade e sexo. Para a análise dos dados foram utilizados os softwares SPSS® versão 21.0 e Stata® versão 10.1, admitindo-se nível de significância de 5%. RESULTADOS As concentrações de quemerina foram maiores nos indivíduos eutróficos do que nos com excesso de peso (p>0,05). Em contrapartida, os níveis de resistina estiveram maiores nos jovens com excesso ponderal do que nos eutróficos (p<0,05). Na análise de regressão linear múltipla, os níveis de quemerina apresentaram associação com os valores de resistina, pressão arterial sistólica e diastólica. Os níveis de resistina mantiveram associação apenas com os valores de IMC e quemerina. CONCLUSÃO As adipocinas analisadas apresentaram perfil distinto nos grupos de crianças e adolescentes com eutrofia e com excesso de peso.