Therapeutic Effect of Fucoidan on Metabolic Diseases: Experimental Data and Clinical Evidence.

The rising prevalence of metabolic diseases represents a major challenge to public health worldwide. Therefore, there is a strong need to conduct research on the effectiveness of complementary and alternative therapies for metabolic disorders. Fucoidan is a fucose-enriched and sulfated polysaccharide extracted from ubiquitous brown seaweed. The antihypertensive, antidiabetic, antiobesity, and hypolipidemic effects of fucoidan have been reported in preclinical research and clinical trials. This study aims to review the mechanisms of action and the experimental and clinical use of different types of fucoidan for the treatment of metabolic diseases.

Use of mNUTRIC-Score for Nutrition Risk Assessment and Prognosis Prediction in Critically Ill Patients with COVID-19: A Retrospective Observational Study.

INTRODUCTION: Nutritional risk is highly prevalent in patients with COVID-19. Relevant data on nutritional assessment in the critically ill population are scarce. This study was conducted to evaluate the modified Nutrition Risk in the Critically Ill (mNUTRIC)-Score as a mortality risk factor in mechanically ventilated patients with COVID-19. METHODS: We conducted this retrospective observational study in critically ill patients with COVID-19. Patients' characteristics and clinical information were obtained from electronic medical records. The nutritional risk for each patient was assessed at the time of mechanical ventilation using the mNUTRIC-Score. The major outcome was 28-day mortality. RESULTS: Ninety-eight patients were analyzed (mean age, 57.22 ± 13.66 years, 68.4% male); 46.9% of critically ill COVID-19 patients were categorized as being at high nutrition risk (mNUTRIC-Score of ≥5). A multivariate logistic regression model indicated that high nutritional risk has higher 28-day hospital mortality (OR = 4.206, 95% CI: 1.147-15.425, p=0.030). A multivariate Cox regression analysis showed that high-risk mNUTRIC-Score had a significantly increased full-length mortality risk during hospitalization (OR = 1.991, 95% CI: 1.219-3.252, p=0.006). CONCLUSION: The mNUTRIC-Score is an independent mortality risk factor during hospitalization in critically ill COVID-19 patients.

Loss of muscle strength in patients under hemodialysis evaluated by dynamometry in the Mexican population / Pérdida de fuerza muscular en pacientes en hemodiálisis evaluados mediante dinamometría en la población mexicana

INTRODUCTION: chronic kidney disease contributes to decreased muscle strength and physical function through a decrease in muscle mass. Current evidence suggests that hemodialysis can accentuate this complication, as well as lead to deterioration of the patient's overall health. The aim of this study is to compare muscle strength in a group of Mexican patients undergoing hemodialysis, evaluated by dynamometry, with available reference values. MATERIALS AND METHODS: a cross-sectional study was conducted in male and female patients between 20 and 81 years of age, with stage-5 chronic kidney disease, from the outpatient Hospital General Regional No 46 of the Mexican Social Security Institute. Muscle strength was assessed by means of a mechanical dynamometer. The average value classified by age and gender was compared with the 50th percentile of a reference study. Inter-group differences were calculated with the nonparametric Mann-Whitney U-test, and correlation using Pearson's test, logistic regression, and chi-squared test. All patients signed an informed consent form. RESULTS: a total of 150 patients, 97 (64.7 %) men and 53 (35.3 %) women, were included in the study. The mean dynamometric value for muscle strength was 21.5 ± 10.1 kg, and a significant correlation was found with age, weight, and hemoglobin concentration. CONCLUSION: patients undergoing hemodialysis treatment for chronic kidney disease were found to be at the 10th percentile for muscle strength, as measured by dynamometry, thus demonstrating a marked decrease in muscle strength. This result could, however, also have been affected by different variables such as patient age, height, weight, glomerular filtration rate (GFR), hemoglobin concentration, serum creatinine, serum glucose, and the subjective global assessment, given that a significant association was also found between these and muscle strength

INTRODUCCIÓN: la enfermedad renal crónica contribuye a disminuir la fuerza muscular y la función física a través de una disminución de la masa muscular. De acuerdo con la evidencia, la hemodiálisis puede acentuar esta complicación, así como llevar al paciente a un deterioro del estado general de salud. El objetivo de la investigación fue comparar la fuerza muscular de pacientes con hemodiálisis, evaluada mediante dinamometría en una población mexicana, con los valores de referencia. MATERIAL Y MÉTODOS: se realizó un estudio transversal en pacientes masculinos y femeninos de 20 a 81 años, con enfermedad renal crónica en estadio 5, del área de consulta externa del Hospital General Regional No 46 del Instituto Mexicano del Seguro Social. La fuerza muscular se evaluó por medio de un dinamómetro mecánico. El valor promedio clasificado por rango de edad y género se comparó con el percentil 50 de un estudio de referencia. Las diferencias intergrupales se calcularon con la prueba no paramétrica de la U de Mann-Whitney y la correlación mediante la prueba de Pearson. Todos los pacientes firmaron la carta de consentimiento informado. RESULTADOS: la muestra del estudio fue de 150 pacientes, 97 (64,7 %) hombres y 53 (35,3 %) mujeres. De acuerdo con la dinamometría, la media fue de 21,5 ± 10,1 kg; se demostró una correlación significativa entre la edad, el peso y la hemoglobina. CONCLUSIÓN: se encontró que los pacientes con enfermedad renal crónica sometidos a hemodiálisis se encontraban en el percentil 10 de fuerza muscular, medido por dinamometría, lo que demuestra una disminución marcada de dicha fuerza muscular. Sin embargo, este resultado también podría verse afectado por diferentes variables, como la edad del paciente, la altura, el peso, la tasa de filtración glomerular (TFG), la concentración de hemoglobina, la creatinina sérica, la glucosa sérica y la evaluación global subjetiva, dado que se encontró una asociación significativa entre estos factores y la fuerza muscular

Effect of Linagliptin Versus Metformin on Glycemic Variability in Patients with Impaired Glucose Tolerance.

BACKGROUND: Impaired glucose tolerance (IGT) and glycemic variability may be associated with increased risk of micro- and macrovascular complications. The aim of this study was to assess the effect of linagliptin versus metformin on glycemic variability in patients with IGT. MATERIAL AND METHODS: A randomized, double-blind clinical trial with parallel groups was carried out in 16 adult patients with IGT, overweight or obesity. All patients signed an informed consent. The therapies were randomly assigned: (a) metformin 500 mg bid (n = 8) or (b) linagliptin 5 mg a.m. and placebo p.m. (n = 8), both for 90 days. At the beginning of the trial and 3 months later, fasting glucose, glycated hemoglobin A1c, oral glucose tolerance test (OGTT), and glycemic variability [area under the curve (AUC) of glucose, mean amplitude of glycemic excursion (MAGE), standard deviation (SD) of glucose, coefficient of variation (CV) of glucose, and mean blood glucose (MBG)] were measured. Mann-Whitney U, Wilcoxon, and Fisher exact tests were used for statistical analyses. RESULTS: Both groups were similar in basal characteristics. After linagliptin administration, a significant decrease in glucose levels at 120 min of OGTT (9.0 ± 0.9 vs. 6.9 ± 2.2 mmol/L, P = 0.012) was observed. Glycemic variability showed a similar behavior and there were no significant differences in the AUC, MAGE, SD of glucose, CV of glucose, and MBG between groups. CONCLUSION: Linagliptin administration resulted in better glycemic control according to the decrease of glucose levels by the OGTT at 120 min in patients with IGT. Meanwhile, glycemic variability was not modified in any of the study groups.

Effect of tadalafil administration on insulin secretion and insulin sensitivity in obese men.

AIM: To evaluate the effect of tadalafil administration on insulin secretion and insulin sensitivity in obese men without diabetes. METHODS: A randomized, double-blind, placebo-controlled clinical trial was carried out in obese male patients between 30 and 50 years of age. Eighteen subjects were randomly assigned to two groups of nine patients each. During a 28-day period, subjects received 5 mg orally of tadalafil or placebo each night. Patients were evaluated before and after the intervention. Total insulin secretion and first phase of insulin secretion were calculated by insulinogenic index and Stumvoll index, respectively, and insulin sensitivity was calculated using the Matsuda index. Tolerability and compliance were evaluated permanently throughout the study. RESULTS: There were no significant differences after administration of tadalafil in total insulin secretion (0.82 ± 0.45 vs. 0.61 ± 0.27, p = 0.594), first phase of insulin secretion (1332 ± 487 vs. 1602 ± 800, p = 0.779) and insulin sensitivity (4.6 ± 1.2 vs. 4.9 ± 2.5, p = 0.779). No significant differences were shown in other measurements. CONCLUSION: Tadalafil administration for 28 days did not modify insulin secretion or insulin sensitivity in obese men.

Effect of fucoidan administration on insulin secretion and insulin resistance in overweight or obese adults.

The aim of this article is to evaluate the effect of fucoidan administration on insulin secretion and insulin sensitivity in overweight or obese adults. A randomized, double-blind, placebo-controlled clinical trial was carried out in 25 obese or overweight volunteers. Thirteen patients received an oral dose of 500 mg of fucoidan once daily before breakfast and 12 patients received placebo for 3 months. Before and after the intervention, fasting glucose and 2-h postload, total cholesterol, high-density lipoprotein cholesterol, triglycerides, and insulin levels were measured. Low-density lipoprotein cholesterol (LDL-C) and homeostasis model analysis formulas (HOMA) for ß-cell function and insulin resistance were calculated. The results showed a significant decrease in diastolic blood pressure (71.7 ± 12.2 vs. 67.8 ± 13.8 mmHg; P<.05) and LDL-C (3.1 ± 0.5 vs. 2.7 ± 0.6 mmol/l; P<.01) with increase in insulin levels (60.6 ± 24.0 vs. 78.6 ± 32.4 pmol/l; P<.05), HOMA ß-cell (35.0 ± 20.8 vs. 50.6 ± 18.7; P<.05) and HOMA IR (1.9 ± 1.2 vs. 2.6 ± 1.8; P<.05) were observed after fucoidan administration. We conclude that fucoidan administration during a 3-month period in overweight or obese adults decreased diastolic blood pressure and LDL-C concentrations, increasing insulin secretion and insulin resistance.