Effects of Dietary Carbohydrate Concentration and Glycemic Index on Blood Glucose Variability and Free Fatty Acids in Individuals with Type 1 Diabetes.

Monitoring glycemic control status is the cornerstone of diabetes management. This study aimed to reveal whether moderate-carbohydrate (CHO) diets increase the risk of free fatty acid (FFA) levels, and it presents the short-term effects of four different diet models on blood sugar, glycemic variability (GV), and FFA levels. This crossover study included 17 patients with type 1 diabetes mellitus to identify the effects of four diets with different CHO contents and glycemic index (GI) on GV and plasma FFA levels. Diet 1 (D1) contained 40% CHO with a low GI, diet 2 (D2) contained 40% CHO with a high GI, diet 3 (D3) contained 60% CHO with a low GI, and diet 4 (D4) contained 60% CHO with a high GI. Interventions were performed with sensor monitoring in four-day periods and completed in four weeks. No statistical difference was observed among the groups in terms of blood glucose area under the curve (p = 0.78), mean blood glucose levels (p = 0.28), GV (p = 0.59), and time in range (p = 0.567). FFA and total triglyceride levels were higher in the D1 group (p < 0.014 and p = 0.002, respectively). Different diets may increase the risk of cardiovascular diseases by affecting GI, FFA, and blood glucose levels.

Probiotics and Prebiotics Affecting Mental and Gut Health.

The effects of the gut microbiota on mental and intestinal health are an area of great interest. This study aimed to reveal the relationship between the intake of probiotic and prebiotic foods and mental and gut health. Data were obtained using an online survey from young adults (n = 538) enrolled at Afyonkarahisar Health Sciences University who agreed to participate in this study in the 2022-2023 academic year. This study included 538 participants, mostly (85.5%) females. Participants who never consumed yogurt had 7.614 times higher Gastrointestinal Symptom Rating Scale scores than those who consumed yogurt daily (p < 0.01). Similarly, the frequency of ayran consumption had a statistically significant effect on Bristol Stool Scale scores (p < 0.05). The ratio of normal defecation to constipation was 68.7% lower in participants who consumed ayran daily, whereas the ratio of diarrhea to constipation was 76.4% lower in participants who never consumed ayran. However, the frequency of prebiotic consumption did not have a significant effect on Bristol Stool Scale scores (p > 0.05). The consumption of probiotic and prebiotic foods exerted a significant effect on GSRS total scores and subfactors of the Depression Anxiety Stress Scale-42, namely depression, anxiety, and stress.

Do Mindful Eating and Intuitive Eating Affect Beverage Preferences? A Cross-Sectional Survey.

Intuitive eating involves following body signals to guide eating decisions and avoiding restrictive diets. Mindful eating is paying full attention to sensory experiences and fostering nonjudgmental awareness. We aimed to elucidate potential relationships between beverage intake and intuitive and mindful eating scores. This cross-sectional exploratory study (October 2021-December 2022) enrolled adult male and female participants who provided sociodemographic and health-related information and subsequently completed the Beverage Intake Questionnaire, the Mindful Eating Questionnaire (MEQ-30), and the Intuitive Eating Scale (IES-2). Bidirectional relationships were observed between beverage intake and intuitive and mindful eating scores. The total beverage intake of males was double compared with that of females, with the intake being mainly derived from sugar-sweetened beverages (p = 0.000). Increased total water intake was positively correlated with IES-2 and its subscale scores and was negatively correlated with MEQ-30 scores in both sexes (p < 0.05). Alcoholic beverage intake was associated with reductions in IES-2 and MEQ-30 scores, whereas unconditional permission to eat increased by 18.3% in males. In females, the consumption of milk-based beverages decreased the IES-2 scores. Understanding the complex relationships between beverage intake and intuitive and mindful eating may deepen our understanding of individual dietary behaviors and inform dietary interventions.

Evaluation of the effect of gluten-free diet and Mediterranean diet on autoimmune system in patients with Hashimoto's thyroiditis.

Hashimoto's thyroiditis is an autoimmune disease in which thyroid cells are attacked through cell-and antibody-mediated immune processes. A gluten-free diet reduces antibody concentration and regulates thyroid autoimmunization. Mediterranean diet reduces oxidative stress. This study evaluates the short-term effects of Mediterranean, gluten-free, and Mediterranean gluten-free dietary patterns on thyroid function and autoantibody levels of patients. The 40 patients with Hashimoto's thyroiditis included in the study were randomly divided into four groups (defined as gluten-free, Mediterranean, Mediterranean gluten-free, and controls) for 12 weeks. Thyroid function tests, autoantibody levels, and food consumption were recorded at the beginning and end of the study. There was no statistically significant difference in TSH levels of the groups before the intervention, but a statistically significant difference was found afterward (p < 0.05). Free T3 hormone levels showed a statistically significant difference across the groups before and after the intervention (p < 0.05). Free T3 hormone levels increased significantly in all intervention groups after the intervention, with the highest increase in the Mediterranean group (p < 0.05). In the intervention groups, anti-TPO and anti-Tg levels decreased after the intervention; however, this difference was not significant across groups (p > 0.05). In addition, body weight, body mass index, waist and hip circumference averages decreased significantly in all intervention groups compared with controls (p < 0.05). The study achieved an increase in Free T3 hormone levels in the intervention groups. The most marked difference was seen in the Mediterranean gluten-free diet model, which may be due to the anti-inflammatory effect of both Mediterranean and gluten-free diets and the loss of body weight as a result of the intervention.

Results from Türkiye: Which Factors Drive Consumers to Buy Organic Food?

The trend towards organic foods as an alternative has recently increased. Several individual, environmental, and behavioural factors can affect this situation. This study was conducted with 1417 participants to examine the factors affecting attitudes, purchase intention (PI), and actual purchasing behaviour towards organic foods. Consequently, a two-part questionnaire was used to query participants' sociodemographic information and their attitudes and preferences towards organic foods. Data were analysed using multiple regression analysis, Pearson's correlation, and structural equation modelling. Our findings confirmed that health consciousness, the knowledge of organic foods, subjective norms, perceived price, values (health and safety), nutritional content, naturalness, availability, monetary barriers, risk barriers, and trust affect attitudes towards organic products. These findings indicate that increasing consumers' knowledge and awareness about organic foods, encouraging their consumption by society, accessibility them in the food market and making them affordable can affect the attitude towards these products. Furthermore, we determined the direct effect of the attitude on actual buying behaviour with the mediating role of PI. Additionally, we noted that marital status, employment status, disease diagnosis in the last 12 months, and the presence of a baby at home affect actual buying behaviour. In conclusion, they can help food marketers target consumers to their sociodemographic status and develop new sales strategies.

Determination of the Viability of Lactic Acid Bacteria by Dynamic In Vitro Gastrointestinal Model in Household and Industrial-Type Kefir Samples.

This study presents results based on differences in the antioxidant activity and lactic acid bacteria counts in different parts of the digestive tract following simulated gastrointestinal digestion of kefir samples. Statistically significant differences were observed in Lactobacillus counts in different kefir types including industrial (IK), starter culture (SCK), and kefir grains (KG). These differences were observed between the initial and second min in the mouth region (T = 3.968; p < 0.05); and between the initial, 60th, and 120th min in the stomach region (R = 11.146; p < 0.05). Additionally, a statistically significant difference was noted in the initial Lactobacillus levels among the IK, SCK, and KG in the stomach region (H = 7.205; p < 0.05). Also, significant differences were identified between the Lactococcus counts of IK across 0, 60, and 120 min in the stomach region (R = 10.236; p < 0.05). Notably, a statistically significant difference was noted in the Lactococcus levels in the KG between the initial and second min in the mouth region (T = 3.101; p < 0.05) and between 0, 60, and 120 min in the stomach region (R = 25.771; p < 0.001). These findings highlight the differences between the physicochemical characteristics of different kefir types. A decrease in lactic acid bacteria counts in kefir samples was observed throughout the dynamic in vitro gastrointestinal tract to reveal the significance of the digestive process when determining probiotic product capacity.

Production of snack bar enriched with paraprobiotics grown in banana peel medium, nutritional, sensory and quality parameters.

Introduction: Objective: this research aims to develop a product with high sensory and nutritional quality to make paraprobiotics developed in banana peel consumable within the scope of waste evaluation. Methods: Lactobacillus plantarum and Lactobacillus casei probiotics were developed here by using banana peels as a medium, and paraprobiotics were obtained from these strains by the pasteurization method at 80 °C for 30 minutes. Two types of bars, with and without paraprobiotics, were produced, and the nutritional and sensory quality characteristics of the bars were examined. Results: bars with and without paraprobiotics showed similar properties in terms of energy, protein, carbohydrate, saturated fat, Ca, Mg, Zn, Fe, Na, and total sugar values and sensory criteria, but showed significantly different levels in terms of total fat, potassium, total fiber, total phenolic substance and antiradical activity values. Conclusion: bars with and without paraprobiotics are in the category of "protein added, protein source, or protein-containing", "high fiber", "low sodium" products.

Introducción: Objetivo: esta investigación tiene como objetivo desarrollar un producto con alta calidad sensorial y nutricional para hacer consumibles los paraprobióticos desarrollados a partir de la cáscara de plátano en el ámbito de la evaluación de residuos. Métodos: en este estudio, se desarrollaron probióticos Lactobacillus plantarum y Lactobacillus casei utilizando la cáscara de plátano como medio, y se obtuvieron paraprobióticos a partir de estas cepas mediante el método de pasteurización a 80 °C durante 30 minutos. Se produjeron dos tipos de barras, con y sin paraprobióticos, y se examinaron las características de calidad nutricional y sensorial de las barras. Resultados: las barras con y sin paraprobióticos mostraron propiedades similares en cuanto a energía, proteínas, carbohidratos, grasas saturadas, calcio, magnesio, zinc, hierro, sodio y valores totales de azúcar, así como criterios sensoriales, pero presentaron niveles significativamente diferentes en términos de grasa total, potasio, fibra total, sustancias fenólicas totales y valores de actividad antirradical. Conclusión: las barras con y sin paraprobióticos se encuentran en la categoría de productos "con agregado de proteínas, fuente de proteínas o con contenido de proteínas", "alto contenido de fibra" y "bajo contenido de sodio".

Effects of Ramadan intermittent fasting on gut microbiome: is the diet key?

Much research has been conducted regarding the impact of diet on the gut microbiota. However, the effects of dietary habits such as intermittent fasting are unclear. This study aimed to investigate the effect of intermittent fasting during Ramadan on the gut microbiota. The study was conducted on 12 healthy adult individuals who practiced fasting 17 h per day for 29 consecutive days during the month of Ramadan. To determine the dietary intake of individuals, a 3-day dietary record was kept at the beginning and end of the study. Reads that passed quality filtering were clustered, and custom-prepared 16S rRNA gene regions of bacteria associated with the human microbiome were used as a reference. Consensus sequences were created, and genus-level taxonomic annotations were determined using a sequence identity threshold of 95%. The correlations between the dietary intake measurements of the participants and the respective relative abundance of bacterial genera were investigated. The results showed that Firmicutes were higher in abundance in the gut microbiota before fasting among participants, while they were significantly lower in abundance at the end of Ramadan fasting (p < 0.05). Proteobacteria were significantly higher in abundance at the end of the month of Ramadan (p < 0.05). Fasting was associated with a significant decrease in levels of seven genera: Blautia, Coprococcus, Dorea, Faecalicatena, Fusicatenibacter, Lachnoclostridium, and Mediterraneibacter. Conversely, the abundances of two bacterial genera were enhanced at the end of the fasting month: Escherichia and Shigella. The results of the dietary intake analysis showed that a negative correlation was detected for three comparisons: Ihubacter and protein (rho = -0.54, p = 0.0068), Fusicatenibacter and vegetables (rho = -0.54, p = 0.0042), and Intestinibacter and nuts (rho = -0.54, p-value = 0.0065). The results suggest that even when the fasting period during Ramadan is consistent, the types of food consumed by individuals can affect the gut microbiota.

Efficacy of human C1 esterase inhibitor concentrate for treatment of ACE-inhibitor induced angioedema.

BACKGROUND: ACE inhibitor (ACEi) induced angioedema predominantly affects the upper aerodigestive tract. As ACEi induced angioedema is mediated by bradykinin, therapeutic response to antihistamines and glucocorticoids remains unsatisfactory. In bradykinin mediated hereditary angioedema, C1-esterase inhibitor (C1INH) is an effective and approved treatment since many years. Our aim was to evaluate the therapeutic effect of C1INH in ACEi induced angioedema. METHODS: We performed a double-blind, parallel-group, multicentre randomised placebo-controlled trial between December 2013 and September 2018. Eligible were adults with ACEi induced angioedema with airway obstruction. Participants were randomised 1:1 to single doses of either C1INH (20 IU/kg) or placebo (0.9% NaCl) i.v in addition to standard care (i.v. 500 mg prednisolone and 2.68 mg clemastine) i.v. Composite symptom scores were assessed at baseline and up to 48 h, at discharge and 1 week after discharge. Physician assessed time to complete oedema resolution (TCER) and time to onset of relief (TOR). RESULTS: 30 patients (16 C1INH, 14 placebo) were randomised and dosed. 25 (9 C1INH, 12 placebo) completed the study. TCER was 29.63 h ± 15.56 h in the C1INH and 17.29 h ± 10.40 h in the placebo arm (p = 0.0457). TORs were 4.13 h ± 3.38 h and 2.86 h ± 1.29 h for C1INH and placebo, respectively (p = 0.4443). There were no adverse events related to study medication. CONCLUSIONS: In the context of baseline application of steroids and antihistamines C1INH was inferior in the treatment of ACEi induced angioedema when compared to placebo with respect to time to complete resolution of symptoms. Eudra-CT Number: 2012-001670-28.

The effect of regular consumption of four low- or no-calorie sweeteners on glycemic response in healthy women: A randomized controlled trial.

OBJECTIVES: The aim of this study was to determine the effects of regular exposure to certain low- or no-calorie sweeteners (LNCS) on glucose tolerance and glucagon-like peptide 1 (GLP-1) release in healthy individuals. METHODS: It was designed as a randomized, single-blinded, controlled study. Healthy and normoglycemic adults who did not have regular consumption of LNCS were recruited. Participants underwent a 75-g oral glucose tolerance test (OGTT) at baseline and were randomly assigned to consume 330 mL water sweetened with saccharine, sucralose, or aspartame + acesulfame-K (Asp+Ace-K), or plain water for the control group, daily for 4 wk. Fasting plasma glucose, insulin, GLP-1, and glycated hemoglobin A1c (HbA1c) levels and 1-h, 2-h, and 3-h plasma glucose and insulin levels during OGTT were obtained at baseline. The change in insulin sensitivity was assessed by both the Homeostatic Model Assessment Insulin Resistance (HOMA-IR) Index and the Matsuda Index. Anthropometric measurements and dietary intakes were determined at baseline. Baseline measurements were repeated at week 4. RESULTS: Of the participants enrolled in the study, 42 (age, 21.24 ± 2.26 y; body mass index, 20.65 ± 2.88 kg/m2) completed the 4-wk intervention period. There were no differences for glucose, insulin, GLP-1, or HbA1c levels or HOMA-IR scores at baseline or at week 4 when compared with the control group. The area under the curve of mean glucose and insulin values during OGTT were also found to be similar between groups at baseline and week 4. There were also no effects of LNCS intake on body weight, body composition, and waist circumference. CONCLUSIONS: These results suggest that regular consumption of LNCS-sweetened water similar to doses consumed in daily life over 4 wk had no significant effect on glycemic response, insulin sensitivity, GLP-1 release, and body weight in healthy individuals. This trial was registered at www. CLINICALTRIALS: gov as NCT04904133.

Validation of the Dutch Eating Behaviour Questionnaire Children (DEBQ-C) version in Turkish preadolescence children.

BACKGROUND/OBJECTIVES: It is important to determine Dysfunctional eating behaviors such as dietary restraint and overeating tendencies in order to provide weight management and acquire the right habits in children. The purpose of this study was to test the reliability and validity of Dutch Eating Behaviour Questionnaire Children (DEBQ-C) with Turkish preadolescent children. MATERIALS/METHODS: This research included 440 preadolescents (9.3 ± 6.9 years and 235 girls, 205 boys). The instrument is divided into three subscales, each with 20 items. Emotional eating, restrained eating, and external eating are the three subscales. Confirmatory factor analysis (CFA) was used to assess the construct validity of the Turkish version of the DEBQ-C, and Cronbach α values were computed to evaluate the subscale reliabilities. There were 20 observable variables and three latent variables in the hypothesized model. RESULTS: Fit indices for the hypothesized model were good (×2/degree of freedom = 1.96; root mean square error of approximation = 0.05; comparative fit index = 0.95; goodness of fit index = 0.93). These findings revealed that the Turkish version of the DEBQ-C has a factor structure that was identical to the three-factor structure of the original scale. The Turkish version of the DEBQ-C subscales has internal consistency coefficients ranging from 0.72 (external eating) to 0.86. (emotional eating). CONCLUSIONS: The DEBQ-C Turkish version is a viable and reliable tool for measuring overeating tendencies in Turkish preadolescents, according to the findings.

Restrained, emotional eating and depression can be a risk factor for metabolic syndrome / La alimentación emocional y restrictiva, junto con la depresión, pueden ser un factor de riesgo para el síndrome metabólico

Introduction: metabolic syndrome (MetS) can have a bidirectional effect on emotional and restrained eating. Objectives: our aims are to find interrelations between MetS and emotional eating, restrained eating, additionally with depression. Methods: cross-sectional study. Participants aged between 18 and 63, and mostly were obese (n = 200). Eating Attitudes Test (EAT-26), Beck Depression Inventory (BDI) and Dutch Eating Behavior Questionnaire (DEBQ) were used to find associations between eating patterns and metabolic syndrome. Results: our study ensured evidences for physiological relations between restrained and emotional eating with MetS. Biochemical parameters showed that restrained eaters were less insulin resistant and participants with MetS had higher emotional eating and lower restrained eating. Besides, restrained eaters had lower triglyceride, homeostasis model assessment-insulin resistance (HOMA-IR), fasting insulin, blood glucose, and higher high-density lipoprotein cholesterol (HDL-C) levels; and emotional eating was parallel with fasting insulin level and HOMA-IR. Conclusions: MetS had strong associations with eating behaviors as restrained, emotional and external. In line with the findings of the study, additionally, women were more susceptible to MetS than men were. In the regulation of restrictive, emotional and external eating behaviors, dietitians and psychology experts should be in cooperation to treat disordered eating patterns. (AU)

Introducción: el síndrome metabólico (MetS) puede tener un efecto bidireccional sobre la alimentación emocional y restrictiva. Objetivos: nuestro objetivo es encontrar interacciones entre el MetS y la alimentación emocional y la alimentación restrictiva, sumado a la depresión. Métodos: se trata de un estudio transversal. un grupo de participantes de entre 18 y 63 años, en su mayoría obesos (n = 200). Para encontrar asociaciones entre los patrones de alimentación y el síndrome metabólico se utilizaron el Test de Actitudes Alimentarias (EAT-26), el Inventario de Depresión de Beck (BDI) y el Cuestionario Holandés de Comportamiento Alimentario (DEBQ). Resultados: nuestro estudio mostró evidencias de relaciones fisiológicas entre la alimentación restrictiva y emocional con el MetS. Los parámetros bioquímicos reflejaron que aquellos que comían contenidamente eran menos resistentes a la insulina y los participantes con MetS presentaban una mayor alimentación emocional y una menor restricción alimenticia. Además, los que comían contenidamente tenían niveles más bajos de triglicéridos, HOMA-IR, insulina en ayunas y glucosa en sangre, frente a niveles más altos de HDL-C. Asimismo, la alimentación emocional reflejó una relación paralela con el nivel de insulina en ayunas y HOMA-IR. Conclusiones se evidenció una notable asociación entre el MetS y los comportamientos alimenticios restrictivos, emocionales y externos. De acuerdo con los hallazgos del estudio, además, las mujeres eran más susceptibles al MetS que los hombres. En la regulación de las conductas alimenticias restrictivas, emocionales y externas, los dietistas y los expertos en psicología deben coadyuvar para tratar patrones de desórdenes alimenticios. (AU)

Restrained, emotional eating and depression can be a risk factor for metabolic syndrome.

Introduction: Introduction: metabolic syndrome (MetS) can have a bidirectional effect on emotional and restrained eating. Objectives: our aims are to find interrelations between MetS and emotional eating, restrained eating, additionally with depression. Methods: cross-sectional study. Participants aged between 18 and 63, and mostly were obese (n = 200). Eating Attitudes Test (EAT-26), Beck Depression Inventory (BDI) and Dutch Eating Behavior Questionnaire (DEBQ) were used to find associations between eating patterns and metabolic syndrome. Results: our study ensured evidences for physiological relations between restrained and emotional eating with MetS. Biochemical parameters showed that restrained eaters were less insulin resistant and participants with MetS had higher emotional eating and lower restrained eating. Besides, restrained eaters had lower triglyceride, homeostasis model assessment-insulin resistance (HOMA-IR), fasting insulin, blood glucose, and higher high-density lipoprotein cholesterol (HDL-C) levels; and emotional eating was parallel with fasting insulin level and HOMA-IR. Conclusions: MetS had strong associations with eating behaviors as restrained, emotional and external. In line with the findings of the study, additionally, women were more susceptible to MetS than men were. In the regulation of restrictive, emotional and external eating behaviors, dietitians and psychology experts should be in cooperation to treat disordered eating patterns.

Introducción: Introducción: el síndrome metabólico (MetS) puede tener un efecto bidireccional sobre la alimentación emocional y restrictiva. Objetivos: nuestro objetivo es encontrar interacciones entre el MetS y la alimentación emocional y la alimentación restrictiva, sumado a la depresión. Métodos: se trata de un estudio transversal. Un grupo de participantes de entre 18 y 63 años, en su mayoría obesos (n = 200). Para encontrar asociaciones entre los patrones de alimentación y el síndrome metabólico se utilizaron el Test de Actitudes Alimentarias (EAT-26), el Inventario de Depresión de Beck (BDI) y el Cuestionario Holandés de Comportamiento Alimentario (DEBQ). Resultados: nuestro estudio mostró evidencias de relaciones fisiológicas entre la alimentación restrictiva y emocional con el MetS. Los parámetros bioquímicos reflejaron que aquellos que comían contenidamente eran menos resistentes a la insulina y los participantes con MetS presentaban una mayor alimentación emocional y una menor restricción alimenticia. Además, los que comían contenidamente tenían niveles más bajos de triglicéridos, HOMA-IR, insulina en ayunas y glucosa en sangre, frente a niveles más altos de HDL-C. Asimismo, la alimentación emocional reflejó una relación paralela con el nivel de insulina en ayunas y HOMA-IR. Conclusiones: se evidenció una notable asociación entre el MetS y los comportamientos alimenticios restrictivos, emocionales y externos. De acuerdo con los hallazgos del estudio, además, las mujeres eran más susceptibles al MetS que los hombres. En la regulación de las conductas alimenticias restrictivas, emocionales y externas, los dietistas y los expertos en psicología deben coadyuvar para tratar patrones de desórdenes alimenticios.

Predicting metabolic syndrome by visceral adiposity index, body roundness index, dysfunctional adiposity index, lipid accumulation product index, and body shape index in adults.

Introduction: Introduction: the increasing prevalence of metabolic syndrome draws attention to the importance of detecting metabolic syndrome with practical methods in the early period. Objectives: to compare anthropometric measurements and indexes for prediction of metabolic syndrome (MetS) in adults. Methods: the study was conducted with adults classified as MetS (n = 92) and a control group (n = 137) according to the International Diabetes Federation. Anthropometric measurements, visceral adiposity index (VAI), dysfunctional adiposity index (DAI), A body shape index (ABSI), lipid accumulation product (LAP), body roundness index (BRI), glucose, lipid biomarkers, and blood pressure (BP) levels were compared. A ROC analysis was performed. Results: MetS frequency was determined to be 40.2 % (n = 92). All biochemical parameters except high-density lipoprotein-cholesterol and BP levels, all anthropometric measurements, and all index values except ABSI of the MetS group were higher than in the control group (p < 0.001). DAI had the highest discriminatory ability for MetS (AUC = 0.921). While the discriminatory ability of LAP was slightly lower (AUC = 0.915), ABSI had the lowest ability for MetS (AUC = 0.606). Conclusion: according to the study findings, MetS was found in almost half of individuals, and the LAP index and DAI can be used as predictive tools for early detection of MetS.

Introducción: Antecedentes: la creciente prevalencia del síndrome metabólico llama la atención sobre la importancia de detectar el síndrome metabólico con métodos prácticos en el período temprano. Objetivos: comparar medidas e índices antropométricos para la predicción del síndrome metabólico (MetS) en adultos. Métodos: el estudio se realizó con un grupo de adultos clasificados como MetS (n = 92) y un grupo de control (n = 137), según la Federación Internacional de Diabetes. Se compararon las variables: medidas antropométricas, índice de adiposidad visceral (VAI), índice de adiposidad disfuncional (DAI), índice de forma corporal (ABSI), producto de acumulación lipídica (LAP), índice de redondez corporal (BRI), glucosa, biomarcadores de lípidos y niveles de presión arterial (PA). Se realizaron análisis ROC. Resultados: la frecuencia del MetS se determinó en un 40,2 % (n = 92). Todos los parámetros bioquímicos, excepto el colesterol unido a lipoproteínas de alta densidad y los niveles de PA, todas las mediciones antropométricas y todos los valores de los indices, excepto el ABSI del grupo MetS, fueron superiores a los del grupo de control (p < 0,001). El DAI presentó la mayor capacidad de discriminación del MetS (AUC = 0,921), mientras que la capacidad de discriminación del LAP fue ligeramente menor (AUC = 0,915) y el ABSI presentó la capacidad más baja para detectar el MetS (AUC = 0,606). Conclusiones: de acuerdo con los hallazgos del estudio, el MetS se encontró en casi la mitad de los individuos y los índices LAP y DAI se pueden utilizar como herramientas predictivas para la detección temprana del MetS.

Liposomal Inhalation after Tracheostomy-A Randomized Controlled Trial.

BACKGROUND: Tracheostomy is a common procedure in critical care. The aim of this study was to evaluate the application of a liposomal inhalation compared to standard physiologic saline (SPS) inhalation on basis of objective and subjective parameters of airway inflammation. METHODS: We evaluated in this two-armed, double-blinded and randomized control group study the effect of liposomal compared with SPS inhalation in newly tracheotomized patients. The primary endpoint was defined as trend of tracheobronchial IL-6 secretion at day 1 compared to day 10. Further objective and subjective parameter were evaluated. RESULTS: Fifty patients were randomized in each arm. Tracheal IL-6 levels decreased significantly only after liposomal inhalation. Both inhalative agents seem to have an effect on the respiratory impairment after tracheostomy. Subjective patient impairment was reduced significantly from day 1 to day 10 after tracheostomy with liposomal inhalation. CONCLUSIONS: Liposomal inhalation demonstrated an advantage over SPS inhalation in newly tracheotomized patients.

"New" inhalant plant allergens.

Specific IgE measurements obtained from patients suffering from respiratory allergy (n = 952) show that, despite similar climatic conditions, there are clear regional differences in pollen sensitization between North Rhine-Westphalia and Bavaria. The data on sensitization levels and pollen concentration was taken from the research and development project Ufoplan 3710 61 228 of the German Environment Agency for North Rhine-Westphalia and Bavaria (2011 - 2014). Most poly-sensitized patients have already shown sensitization, both in the form of cross-reactivity and species-specific sensitization, to "new" pollen allergens, such as Bermuda grass and olive tree. These plants are currently not common in Germany, but may become considerably more widespread due to the increase in average yearly temperatures caused by the global warming. The other "new" aeroallergens discussed here are plants that can be found throughout Germany, such as nettle, cypress, and pine. Their current sensitization levels are higher than 8%; however, their clinical impact appears to be underestimated. For clinical practice it is important to identify when patients' symptoms are typically severe and which regional plants might be responsible for the patients' complaints in this period of time, as this affects further diagnostic strategy. Allergens having an immune effect can then be targeted by specific immunotherapies. The information on complaints of the patients should be regularly recorded in symptom diaries. Recording this information for at least 1 year may allow to discover a correlation between specific types of pollen and allergy symptoms.

Cyclooxygenase activity in bradykinin-induced dermal extravasation. A study in mice and humans.

BACKGROUND: Non-allergic angioedema is largely driven by increased plasma levels of bradykinin and over-activation of bradykinin receptor type II (B2), but the specific downstream signalling pathways remain unclear. The aim of this study was to identify signal transduction events involved in bradykinin-induced dermal extravasation. METHODS: Quantification of dermal extravasation was accomplished following intradermal (i.d.) injection of bradykinin or the B2 agonist labradimil in mice with endothelial NO-synthase (eNOS) deficiency and in C57BL/6J mice pre-treated with vehicle, NO-synthase or cyclooxygenase (COX) inhibitors. In the multicentre clinical study ABRASE, 38 healthy volunteers received i.d. bradykinin injections into the ventral forearm before and after oral treatment with the COX inhibitor ibuprofen (600 mg). The primary endpoint of ABRASE was the mean time to complete resolution of wheals (TTCR) and the secondary endpoint was the change of maximal wheal size. RESULTS: Neither NOS inhibitors nor eNOS deficiency altered bradykinin-induced extravasation. In striking contrast, the COX inhibitors ibuprofen, diclofenac, SC560 and celecoxib significantly diminished this extravasation when given before injection. As for diclofenac, a similar but significantly lower effect was observed when given after i.d. injection of bradykinin. Similar results were obtained when bradykinin was replaced by labradimil. In volunteers, ibuprofen significantly reduced TTCR (P < 0.001) and maximal wheal size (P = 0.0044). CONCLUSION: These data suggest that COX activity contributes to bradykinin-induced dermal extravasation in mice and humans. In addition, our findings may open new treatment options and point to a potential activity of drugs interfering with the release of the COX substrate arachidonic acid, e.g. glucocorticoids.

A 2-Year Follow-up Study of an Absorbable Implant to Treat Nasal Valve Collapse.

The safety and effectiveness of an absorbable implant for lateral cartilage support have been recently demonstrated in subjects with nasal valve collapse (NVC) at 12 months postprocedure. This follow-up study aimed to assess whether the safety and effectiveness of the implant persist in these patients for 24 months after the procedure. Thirty subjects with Nasal Obstruction Symptom Evaluation (NOSE) score ≥ 55 and isolated NVC were treated; 14 cases were performed in an operating suite under general anesthesia and 16 cases were performed in a clinic-based setting under local anesthesia. The implant, a polylactic acid copolymer, was placed with a delivery tool within the nasal wall to provide lateral cartilage support. Subjects were followed up through 24 months postprocedure. Fifty-six implants were placed in 30 subjects. The mean preoperative NOSE score was 76.7 ± 14.8, with a range of 55 to 100. At 24 months, the mean score was 32.0 ± 29.3, reflecting an average within-patient reduction of -44.0 ± 31.1 points. There were no device-related adverse events in the 12 to 24 months period. There were five subjects who exited the study prior to the 24-month follow-up. Four of the five subjects who exited were elected for further intervention and one subject was lost to follow-up. This study demonstrates safety of an absorbable implant for lateral nasal wall support and symptom improvement in some subjects with NVC at 24 months postprocedure.

Activin-A Is a Pro-Inflammatory Regulator in Type-2-Driven Upper Airway Disease.

BACKGROUND: Allergic upper airway disease involves pro-inflammatory type-2 cytokines such as IL-5 and regulatory tissue repair mediators, in particular transforming growth factor (TGF)-ß1. The TGF-ß-superfamily member activin-A displays multiple biological functions and shares certain signalling pathways with TGF-ß1. We aimed to examine the coregulation of mucosal activin-A and TGF-ß1 in acute allergic and chronic Th2-driven upper airway disease. METHODS: We investigated mucosal cytokine expression profiles and kinetics using RT-PCR after nasal allergen challenges in patients with seasonal allergic rhinitis. Furthermore, we analysed mucosal specimens from patients with chronic upper airway disease with nasal polyps using ELISPOTs and confocal microscopy. In addition, we stimulated nasal mucosa ex vivo from patients with nasal polyps as well as primary nasal cell cultures from healthy donors. RESULTS: Mucosal activin-A expression revealed increasing correlation with IL-5 and TGF-ß1 at 0.25, 6, and 24 h, respectively, and was significantly upregulated at 6 h after allergen challenge. The correlated expression was found to be more pronounced in chronic disease with nasal polyps, showing substantially (48-fold) increased activin-A-producing cells in nasal polyps by ELISPOT, while submucosal downstream signalling as determined by confocal microscopy was decreased. Ex vivo stimulations of nasal tissue suggested that activin-A and TGF-ß1 mutually regulate each other's expression at the mRNA level and, when combined, enhance IL-5 expression. CONCLUSION: Activin-A in allergic upper airway disease acts as a pro-inflammatory mediator and TGF-ß1 modifier. Our data in the upper airways oppose the view of potentially anti-inflammatory properties in contrast to lymphatic compartments.

The role of bradykinin receptor type 2 in spontaneous extravasation in mice skin: implications for non-allergic angio-oedema.

BACKGROUND AND PURPOSE: Non-allergic angio-oedema is a life-threatening disease mediated by activation of bradykinin type 2 receptors (B2 receptors). The aim of this study was to investigate whether activation of B2 receptors by endogenous bradykinin contributes to physiological extravasation. This may shed new light on the assumption that treatment with an angiotensin converting enzyme inhibitor (ACEi) results in an alteration in the vascular barrier function predisposing to non-allergic angio-oedema. EXPERIMENTAL APPROACH: We generated a new transgenic mouse model characterized by endothelium-specific overexpression of the B2 receptor (B2tg ) and established a non-invasive two-photon laser microscopy approach to measure the kinetics of spontaneous extravasation in vivo. The B2tg mice showed normal morphology and litter size as compared with their transgene-negative littermates (B2n ). KEY RESULTS: Overexpression of B2 receptors was functional in conductance vessels and resistance vessels as evidenced by B2 receptor-mediated aortic dilation to bradykinin in presence of non-specific COX inhibitor diclofenac and by significant hypotension in B2tg respectively. Measurement of dermal extravasation by Miles assay showed that bradykinin induced extravasation was significantly increased in B2tg as compared with B2n . However, neither endothelial overexpression of B2 receptors nor treatment with the ACEi moexipril or B2 antagonist icatibant had any effect on spontaneous extravasation measured by two-photon laser microscopy. CONCLUSIONS AND IMPLICATIONS: Activation of B2 receptors does not appear to be involved in spontaneous extravasation. Therefore, the assumption that treatment with an ACEi results in an alteration in the physiological vascular barrier function predisposing to non-allergic angio-oedema is not supported by our findings.