Updates of precision medicine in type 2 diabetes

Diabetes mellitus is prevalent worldwide and affects 1 in 10 adults. Despite the successful development of glucose-lowering drugs, such as glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 inhibitors recently, the proportion of patients achieving satisfactory glucose control has not risen as expected. The heterogeneity of diabetes determines that a one-size-fits-all strategy is not suitable for people with diabetes. Diabetes is undoubtedly more heterogeneous than the conventional subclassification, such as type 1, type 2, monogenic and gestational diabetes. The recent progress in genetics and epigenetics of diabetes has gradually unveiled the mechanisms underlying the heterogeneity of diabetes, and cluster analysis has shown promising results in the substratification of type 2 diabetes, which accounts for 95% of diabetic patients. More recently, the rapid development of sophisticated glucose monitoring and artificial intelligence technologies further enabled comprehensive consideration of the complex individual genetic and clinical information and might ultimately realize a precision diagnosis and treatment in diabetics.

Ferritin - novel uses of a well-known marker in paediatrics

Serum ferritin is one of the most widely used laboratory tests and is associated with both iron deficiency and iron overload. Currently, more and more attention is paid to the involvement of ferritin in processes other than iron metabolism. Low serum ferritin is unanimously associated with iron deficiency, while elevated serum ferritin may be a consequence of various medical conditions such as iron overload, an inflammatory process, SARS-CoV-2, organ failure, cancer, and endocrine disorders, including metabolic syndrome. We present a review of the literature on the role of ferritin in a variety of less obvious disease states in children.Copyright © 2023 Termedia Publishing House Ltd.. All rights reserved.

Bioactive compounds of cinnamon and their effect on decreasing metabolic syndrome: systematic review / Compuestos bioactivos de canela y su efecto en la disminución del síndrome metabólico: revisión sistemática

Introducción. El síndrome metabólico (SM) aumenta el ingreso hospitalario y el riesgo de desarrollar COVID-19, los fármacos utilizados para su tratamiento ocasionan efectos secundarios por lo que se ha optado por la búsqueda de alternativas terapéuticas a base de compuestos bioactivos contenidos en plantas medicinales. La canela se utiliza como agente terapéutico debido a sus propiedades comprobadas con diversos mecanismos de acción reportados en el tratamiento de varias patologías. Objetivo. Documentar los estudios in vitro, in vivo, estudios clínicos y los mecanismos de acción reportados del efecto de la administración de extractos y polvo de canela en las comorbilidades relacionadas con el SM. Materiales y métodos. Revisión sistemàtica de artículos en bases de datos electrónicas, incluyendo estudios de canela en polvo, extractos acuosos, de acetato de etilo y metanol de la corteza de canela, período de 5 años, excluyendo todo artículo relacionado a su efecto antimicrobiano, antifúngico y aceite de canela. Resultados. Las evidencias de los principales compuestos bioactivos contenidos en la canela validan su potencial en el tratamiento de enfermedades relacionadas al SM, con limitados estudios que indagan en los mecanismos de acción correspondientes a sus actividades biológicas. Conclusiones. Las evidencias de las investigaciones validan su potencial en el tratamiento de estas patologías, debido a sus principales compuestos bioactivos: cinamaldehído, transcinamaldehído, ácido cinámico, eugenol y, antioxidantes del tipo proantocianidinas A y flavonoides, los cuales participan en diversos mecanismos de acción que activan e inhiben enzimas, con efecto hipoglucemiante (quinasa y fosfatasa), antiobesogénico (UPC1), antiinflamatorio (NOS y COX), hipolipemiante (HMG-CoA) y antihipertensivo (ECA)(AU)

Introduction. Metabolic syndrome (MS) increases hospital admission and the risk of developing COVID-19. Due to the side effects caused by the drugs used for its treatment, the search for therapeutic alternatives based on bioactive compounds contained in medicinal plants has been chosen. Cinnamon is used as a therapeutic agent due to its proven properties with various mechanisms of action reported in the treatment of various pathologies. Objective. To document the in vitro and in vivo studies, clinical studies and the mechanisms of action reported on the effect of the administration of cinnamon extracts and powder on comorbidities related to MS. Materials and methods. Systematic review of articles in electronic databases, including studies of cinnamon powder, aqueous extracts, ethyl acetate and methanol from cinnamon bark, over a period of 5 years, excluding all those articles related to its antimicrobial, antifungal and antimicrobial effect. cinnamon oil. Results. The evidence of the main bioactive compounds contained in cinnamon validates its potential in the treatment of diseases related to MS, with limited studies that investigate the mechanisms of action corresponding to its biological activities. Conclusions. Research evidence validates its potential in the treatment of these pathologies, due to its main bioactive compounds: cinnamaldehyde, transcinnamaldehyde, cinnamic acid, eugenol, and antioxidants of the proanthocyanidin A type and flavonoids, which participate in various mechanisms of action that activate and they inhibit enzymes, with hypoglycemic (kinase and phosphatase), antiobesogenic (UPC1), anti-inflammatory (NOS and COX), lipid-lowering (HMG-CoA) and antihypertensive (ACE) effects(AU)

Effect of the Combination of Hibiscus sabdariffa in Combination with Other Plant Extracts in the Prevention of Metabolic Syndrome: A Systematic Review and Meta-Analysis.

Metabolic syndrome is a complex and multifactorial disorder associated with increased risk of cardiovascular disease and type 2 diabetes, exacerbated by a sedentary lifestyle and situations such as the COVID-19 pandemic. Recent studies have shown that consumption of fruits and vegetables high in polyphenols has a protective effect, reducing cardiovascular risk. Hibiscus sabdariffa (HS) in combination with other plant extracts has recently attracted scientists' attention due to its potential use in the treatment of metabolic syndrome. This systematic review and meta-analysis examines the effects of HS in combination with other plant extracts on the prevention of metabolic syndrome, exploring their synergistic effects and potential as therapeutic agents. For this purpose, a systematic search of randomized clinical trials (RCTs) was conducted in four different databases and the data obtained were then used for a meta-analysis. Initially, the titles and abstracts of 1368 studies were read. From these, 16 studies were examined closely for their eligibility, and finally, seven RCTs with 332 participants were included in both the meta-analysis and the qualitative analysis. Our results show that HS in combination with other plant extracts improved anthropometric parameters, blood pressure, and lipid profile (low density lipoprotein cholesterol and total cholesterol) compared to a placebo control group. It is important to note that although this meta-analysis suggests that HS in combination with other plant extracts may have a beneficial effect on cardiovascular parameters, further research is needed to determine the optimal dose and intake duration.

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression.

Globally, the coexistence of metabolic syndrome (MetS) and HIV has become an important public health problem, putting coronavirus disease 19 (COVID-19) hospitalized patients at risk for severe manifestations and higher mortality. A retrospective cross-sectional analysis was conducted to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients using secondary data from the Department of Health in Limpopo Province, South Africa. The study included 15,151 patient clinical records of laboratory-confirmed COVID-19 cases. Data on MetS was extracted in the form of a cluster of metabolic factors. These included abdominal obesity, high blood pressure, and impaired fasting glucose captured on an information sheet. Spatial distribution of mortality among patients was observed; overall (21-33%), hypertension (32-43%), diabetes (34-47%), and HIV (31-45%). A multinomial logistic regression model was applied to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients. Mortality among COVID-19 patients was associated with being older (≥50+ years), male, and HIV positive. Having hypertension and diabetes reduced the duration from admission to death. Being transferred from a primary health facility (PHC) to a referral hospital among COVID-19 patients was associated with ventilation and less chance of being transferred to another health facility when having HIV plus MetS. Patients with MetS had a higher mortality rate within seven days of hospitalization, followed by those with obesity as an individual component. MetS and its components such as hypertension, diabetes, and obesity should be considered a composite predictor of COVID-19 fatal outcomes, mostly, increased risk of mortality. The study increases our understanding of the common contributing variables to severe manifestations and a greater mortality risk among COVID-19 hospitalized patients by investigating the influence of MetS, its components, and HIV coexistence. Prevention remains the mainstay for both communicable and non-communicable diseases. The findings underscore the need for improvement of critical care resources across South Africa.

PANLAR 2023 Abstracts

The proceedings contain 238 papers. The topics discussed include: treatment with tofacitinib attenuates muscle loss through Myogenin activation in collagen-induced arthritis;plasma cytokine levels in a group of Colombian patients with moderate systemic lupus erythematosus and rheumatoid arthritis;prevalence of neoplastic disease in patients with systemic sclerosis in a south American cohort;characterization of rheumatic manifestations in patients with HIV infection from a south American hospital;anthropometric measures of central adiposity in the evaluation of metabolic syndrome in patients with idiopathic inflammatory myopathies;anti RO 52/60 antibodies and their clinical serological correlation. single center descriptive study;safety and immunogenicity of CoronaVac and CHADOX1 vaccines against SARS-COV-2 in patients with rheumatoid arthritis: Brazilian multicentric study;and effect of ABO and RH blood type on SARS-COV-2 infection severity in patients with rheumatic diseases: data from the national SAR-COVID registry.

Effects of sumac supplementation on metabolic markers in adults with metabolic syndrome: a triple-blinded randomized placebo-controlled cross-over clinical trial.

BACKGROUND: Despite the prior evidence of the impacts of sumac on glycemic indices, lipid profile and visceral fat, there is a lack of evidence regarding the efficacy of sumac in cases with metabolic syndrome (MetS). Therefore, we aimed to assess the effect of sumac supplementation on MetS markers among adults with this syndrome. METHODS: In this triple-blinded randomized placebo-controlled cross-over clinical trial 47 adults with MetS were randomly assigned to receive 500 mg sumac or placebo (lactose) capsule, twice a day. Each phase took 6 weeks and there was a 2-week washout between phases. All clinical evaluations and laboratory tests were conducted before and after each phase. RESULTS: At the baseline of the study, mean (± SD) age, weight, and waist circumference of participants were respectively 58.7 (± 5.8) yr, 79.9 (± 14.3) kg, and 107.6 (± 10.8) cm. Intention to treat analysis (ITT) analyses revealed that sumac supplementation decreased systolic blood pressure by 5 mmHg (128.8 ± 21.4 at the baseline vs. 123.2 ± 17.6 after 6 weeks intervention, P = 0.001). The comparison of changes in two trial arms showed that sumac supplementation significantly reduced systolic blood pressure (sumac group -5.59 ± 10.6 vs. control group 0.76 ± 10.5, P = 0.004), but did not change anthropometric indices or diastolic blood pressure. Similar results were also found in the per-protocol analyses. CONCLUSIONS: This cross-over trial revealed that sumac supplementation could reduce systolic blood pressure in men and women with MetS. Daily intake of 1000 mg sumac, as an adjuvant therapy, may be beneficial in management of MetS in adults.

Adipose tissue, systematic inflammation, and neurodegenerative diseases

Obesity is associated with several diseases, including mental health. Adipose tissue is distributed around the internal organs, acting in the regulation of metabolism by storing and releasing fatty acids and adipokine in the tissues. Excessive nutritional intake results in hypertrophy and proliferation of adipocytes, leading to local hypoxia in adipose tissue and changes in these adipokine releases. This leads to the recruitment of immune cells to adipose tissue and the release of pro-inflammatory cytokines. The presence of high levels of free fatty acids and inflammatory molecules interfere with intracellular insulin signaling, which can generate a neuroinflammatory process. In this review, we provide an up-to-date discussion of how excessive obesity can lead to possible cognitive dysfunction. We also address the idea that obesity-associated systemic inflammation leads to neuroinflammation in the brain, particularly the hypothalamus and hippocampus, and that this is partially responsible for these negative cognitive outcomes. In addition, we discuss some clinical models and animal studies for obesity and clarify the mechanism of action of anti-obesity drugs in the central nervous system.Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.

The prevalence and contributing risk factors of coronavirus disease 2019 infection in patients with metabolic syndrome.

BACKGROUND: Components of metabolic syndrome (MetS) was reported to contribute to severe and worse outcomes of coronavirus disease 2019 (COVID-19). Hereby, we evaluated the association of MetS and its components with susceptibility to COVID-19. METHODS: Here, 1000 subjects with MetS were recruited that were diagnosed via the International Diabetes Federation (IDF) criterion. Real-time PCR was exerted to detect SARS-CoV-2 in the nasopharyngeal swabs. RESULTS: Among the MetS patients, 206 (20.6%) cases were detected to have COVID-19. Smoking (OR = 5.04, 95%CI = 3.53-7.21, P < 0.0001) and CVD (OR = 1.62, 95%CI = 1.09-2.40, P = 0.015) were associated with increased chance of COVID-19 infection in the MetS patients. BMI was significantly higher (P = 0.0001) in MetS cases with COVID-19 than those without COVID-19. Obesity was associated with increased susceptibility to COVID-19 in MetS patients (OR = 2.00, 95%CI = 1.47-2.74, P < 0.0001). Total cholesterol, TG, LDL were significantly higher in the MetS cases with COVID-19 than those without COVID-19. Dyslipidemia was associated with increased chance of COVID-19 (OR = 1.50, 95%CI = 1.10-2.05, P = 0.0104). FBS level was significantly higher in the MetS cases with COVID-19. T2DM was associated with increased risk of COVID-19 in MetS patients (OR = 1.43, 95%CI = 1.01-2.00, P = 0.0384). Hypertension was associated with increased chance of COVID-19 in the MetS patients (OR = 1.44, 95%CI = 1.05-1.98, P = 0.0234). CONCLUSIONS: MetS and its components, like obesity, diabetes, dyslipidemia, cardiovascular complications were associated with increased chance of COVID-19 infection development and probably with aggravated symptoms in such patients.

The Effect of a Moderately Restricted Carbohydrate Diet on Cardiometabolic Risk Factors in Overweight and Obese Women With Metabolic Syndrome: A Randomized Controlled Trial.

PURPOSE: Metabolic syndrome (MetS) is a major public health concern that increases the risk of cardiovascular disease and mortality. In previous studies of MetS management, low-carbohydrate diets have been strongly emphasized, despite the fact that many apparently healthy individuals have difficulties adhering to these diets on a long-term basis. The purpose of the present study was to elucidate the effects of a moderately restricted carbohydrate diet (MRCD) on cardiometabolic risk factors in women with MetS. METHODS: This parallel 3-month, single-blind randomized controlled trial was conducted in Tehran, Iran, among 70 women with overweight or obesity aged 20 to 50 years with MetS. Patients were randomly allocated to receive either MRCD (42%-45% carbohydrates and 35%-40% fats) (n = 35) or a normal weight loss diet (NWLD) (52%-55% carbohydrates and 25%-30% fats) (n = 35). Both diets contained the same quantity of protein, which accounted for 15% to 17% of total energy. Anthropometric measurements, blood pressure, lipid profile, and glycemic indices were all assessed before and after the intervention. FINDINGS: Compared with the NWLD group, following an MRCD significantly decreased weight (-4.82 vs -2.40 kg; P = 0.01), body mass index (-1.88 vs -0.94 kg/m2; P = 0.01), waist circumference (-5.34 vs -2.75 cm; P = 0.01), hip circumference (-2.58 vs -1.11 cm; P = 0.01), serum triglyceride (-26.8 vs -7.19 mg/dL; P = 0.01), and increased serum HDL-C levels (1.89 vs. 0.24 mg/dL; P = 0.01). There was no significant difference between the 2 diets in waist-to-hip ratio, serum total cholesterol, serum LDL-C, systolic and diastolic blood pressure, fasting blood glucose, insulin levels, or the homeostasis model assessment for insulin resistance. IMPLICATIONS: Moderate carbohydrate replacement with dietary fats significantly improved weight, body mass index, waist circumference, hip circumference, serum triglyceride, and HDL-C levels among women with MetS. Iranian Registry of Clinical Trials identifier: IRCT20210307050621N1.

Coronavirus Disease 2019, Diabetes, and Inflammation: A Systemic Review.

People with cardiometabolic diseases [namely type 2 diabetes (T2D), obesity, or metabolic syndrome] are more susceptible to coronavirus disease 2019 (COVID-19) infection and endure more severe illness and poorer outcomes. Hyperinflammation has been suggested as a common pathway for both diseases. To examine the role of inflammatory biomarkers shared between COVID-19 and cardiometabolic diseases, we reviewed and evaluated published data using PubMed, SCOPUS, and World Health Organization COVID-19 databases for English articles from December 2019 to February 2022. Of 248 identified articles, 50 were selected and included. We found that people with diabetes or obesity have (i) increased risk of COVID-19 infection; (ii) increased risk of hospitalization (those with diabetes have a higher risk of intensive care unit admissions) and death; and (iii) heightened inflammatory and stress responses (hyperinflammation) to COVID-19, which worsen their prognosis. In addition, COVID-19-infected patients have a higher risk of developing T2D, especially if they have other comorbidities. Treatments controlling blood glucose levels and or ameliorating the inflammatory response may be valuable for improving clinical outcomes in these patient populations. In conclusion, it is critical for health care providers to clinically evaluate hyperinflammatory states to drive clinical decisions for COVID-19 patients.

COVID-19 and asthma in paediatric age: Does the metabolic syndrome matters?

Background: Among the paediatric population there was no increase in asthma related morbidity with COVID-19. This study aimed to evaluate the pattern of the lung function tests after SARS CoV-2 infection. Method(s): Retrospective characterization of 79 paediatric patients with lung function tests performed after 6-8 weeks of SARS-CoV- 2 infection, between March 2020 and December 2021. Some endpoints were analysed like asthma as a comorbidity, lung function measurements, body mass index (BMI) and hospitalizations. Result(s): The mean age of this sample was 12.2 +/- 2.1 years old [4;17], 59% were male and 53% had asthma. The non asthmatic children were younger (10.1 +/- 1.8 years old). Body mass index (BMI) was calculated for all patients at the time of lung function test, 56% had a normal weight (n = 40), 37.9% were overweight (n = 30), and 11.3% (n = 9) were obese. More than a half of the non asthmatic group had a normal weight (58%, n = 24), 33% were overweight (n = 10) and 33% were obese (n = 3). In the asthma group, 40% (n = 16) had a normal weight, 67% were overweight or were obese (n = 20 and 6, respectively). None of the involved children had restrictive pattern post COVID-19, nor an obstruction, and as for diffusion tests, all the results were in between the limits of normality. Only one non asthmatic patient was hospitalised. Three asmathic patients reported post COVID-19 symptoms, like tiredness, hyposmia, and chest pain for a period of 6 month at least, as well four non asthmatic patients, with similar symptoms. Conclusion(s): Taking into account lung function tests performed after COVID-19 infection, there was no negative impact in asmathic/non asthmatic children outcomes. However there is a higher proportion of asmathic overweighted/obese children with COVID-19 infection, which reinforce that metabolic syndrome seems to play an important role on this disease.

The effect of COVID-19 on vascular elasticity and liver function in overweight patients.

Objective. To study the changes in the vascular wall, vascular age and metabolic parameters in polymorbid COVID-19 conva-lescents. Material and methods. The study included 62 patients with hypertension who reached the target blood pressure (BP) with dual an-tihypertensive therapy after severe and extremely severe COVID-19. The following examinations were performed: laboratory tests of metabolic parameters, assessment of changes in the vessel elasticity indices (pulse-wave velocity (PWV), augmentation index (AI), central systolic BP (cSBP), 24-hour BP monitoring, and non-invasive markers of liver fibrosis. Results. According to office BP measurements, after the coronavirus infection, an increase in systolic BP (SBP) by 29.6% and di-astolic BP (DBP) by 23.6%, as well as heart rate (HR) by 11.8% (p<0.05) was reported during regular antihypertensive therapy. In addition, 24-hour BP monitoring data indicated an increase in the average daily SBP, DBP, and heart rate. After the coronavirus infection, an increase in PWV by 35.4% (p<0.05), AI by 24.4% (p<0.05), cSBP by 22.1% were reported. Carbohydrate and lipid metabolism parameters deteriorated. A pronounced adverse effect of coronavirus infection on liver function was observed. The vascular age (according to the modified SCORE scale) increased by 6 years (p<0.05). Conclusion. Our study showed that patients after severe and extremely severe COVID-19 have a high risk of liver fibrosis, hypertension and lipid metabolism control worsening and accelerating vascular aging.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Prevalence of metabolic syndrome criteria among adults post COVID pandemic situation and steps towards prevention

Metabolic Syndrome (MetS) is one among the Non-Communicable Diseases (NCDs) which might occur due to genetic, environmental, physiological and behavioural factors. MetS is increasing alarmingly in the population. Addressing the modifiable factors to reduce the risk is of prime importance. The current study is intended to observe the prevalence of Metabolic Syndrome criteria with respect to its relation to lifestyle factors among subjects post pandemic situation and the MetS incidence to understand how the disease can be prevented and the means to improve the public health. Random sampling method was used to enrol 20-50 year old (male and female) urban adults of Bengaluru into the study. Type-I-diabetics, lactating and pregnant women, post-cardiac surgery/ pre-post-transplant/ covid-19 recovered patients were excluded. Height, weight, Waist-Circumference (WC) and hip-circumference were measured. BMI and Waist-Hip Ratio (WHR) were calculated. Fasting Blood Glucose (FBS), Triglycerides (TG), HDL, Blood Pressure (BP) values were analysed and recorded. Diet recall was captured and calories consumed per day was estimated. The habits of exercise routine, smoking, tobacco chewing and alcohol were observed. IDF (International Diabetes Federation, 2006) criteria was used to categorise MetS. The data was analysed using relevant statistical tools. A total of 1211 adults (females 486 and males 725) were assessed. High WC indicating central obesity was observed in 55%. High FBS was observed in 29%. Hyper-triglyceridemia was more in males (36%) than females (19%). Low HDL was observed in 65% females against 43% males. High BP was observed among 10% in males and 8% in females. Lack of exercise was observed among 81% of the adults. Due to pandemic situation 10.7% stopped doing exercise. Moderate activity in 5.6% and vigorous activity in 2.8% was recorded;68% of the subjects were consuming >2000 calories/day on an average;18.6% were alcoholic. MetS was observed in 10.6% and MetS-2 criteria in 33.4% and MetS-1criteria in 24.5% before pandemic situation and post pandemic there was an increase. MetS was observed in 12.2% and MetS-2criteria in 49.7% and MetS-1criteria in 27.9% post pandemic. The lack of exercise and high-calorie consumption had a significant correlation with altered lipid values and central obesity. High WC had significant relation to High BMI. WHR had very significant correlation with high FBS and TG. Women had significantly high WC compared to men. The alcohol habit had a significant correlation with hypertriglyceridemia in males. Increased calorie consumption had a moderate correlation with raised FBS and WHR. MetS was significantly observed in those who had lack of exercise, high calorie consumption and alcohol habit. Findings suggest that MetS is in rise in 31-50 year age group. Central obesity, dyslipidemia and high FBS were predominant in 31-40 year group. High BP was observed in 45-50 years age group. Identifying and educating the young adults to correct their life style is the need of the hour to reduce increase of MetS in community.

Outcome of Patients with Common Endocrine Diseases Who Had COVID-19 in two Centers in Lagos, Nigeria: A Cross-Sectional Study.

BACKGROUND: Endocrine diseases are ubiquitous. In our environment, diabetes mellitus (DM), obesity and thyroid disorders represent the most common examples. Diabetes mellitus is a global health problem with a myriad of complications. We sought to evaluate outcome in terms of fatality in those with common endocrine diseases who were infected with COVID-19. AIMS AND OBJECTIVES: To determine outcome in terms of mortality in patients with common endocrine diseases who contracted COVID-19. MATERIALS AND METHODS: We conducted an observational, descriptive, cross-sectional study with 120 participants drawn from the endocrinology/DM clinic at the Lagos University Teaching Hospital and Serenity Hospital, Surulere (a private medical clinic). Data collected included age, gender, type of endocrine disease, comorbid diseases, and COVID-19 status. Through charts from the medical records department, outcome of participants in terms of mortality was determined. RESULTS: Data of 120 subjects were analyzed. There were 61males and 59 females, yielding a male:female ratio of 1:1. Mean age was 58 years and the mode was 46 years. Over half (88) of the patients had diabetes mellitus, 22 had obesity, and 17 had thyroid disorders. The case fatality rate of patients with endocrine diseases who had COVID-19 was 11%, with about 85% of these deaths occurring in the elderly (those aged above 60 years). Ninety-two percent of the patients who died had type 2 DM. Approximately 80% of patients who were infected with COVID-19 had at least one co-morbid disease. CONCLUSION: Older age, type 2 diabetes mellitus, and the presence of at least one comorbidity were associated with increased mortality in patients with endocrine diseases who were infected with COVID-19 in our study.

CONTEXTE: Les maladies endocriniennes sont omniprésentes. Dans notre environnement, le diabète sucré, l'obésité et les troubles thyroïdiens en sont les exemples les plus courants. Le diabète est un problème de santé mondial qui s'accompagne d'une myriade de complications. Nous avons cherché à évaluer l'issue en termes de mortalité chez les personnes atteintes de maladies endocriniennes courantes qui ont été infectées par COVID-19. BUTS ET OBJECTIFS: Déterminer l'issue en termes de mortalité chez les patients atteints de maladies endocriniennes courantes qui ont contracté COVID 19. MATÉRIEL ET MÉTHODOLOGIES: Nous avons mené une étude observationnelle, descriptive et transversale auprès de 120 participants provenant de la clinique d'endocrinologie/DM de l'hôpital universitaire de Lagos et de l'hôpital Serenity, Surulere (clinique médicale privée). Les données recueillies comprenaient l'âge, le sexe, le type de maladie endocrinienne, les maladies concomitantes et le statut COVID-19. Les résultats des participants en termes de mortalité ont été déterminés à partir des dossiers médicaux. RÉSULTATS: Les données de 120 sujets ont été analysées. Il y avait 61 hommes et 59 femmes, avec un ratio homme/femme de 1:1. L'âge moyen était de 58 ans, le mode de 46 ans. Plus de la moitié [88] des patients souffraient de diabète sucré. 22 patients souffraient d'obésité et 17 de troubles thyroïdiens. Le taux de létalité des patients souffrant de maladiesendocriniennes et atteints de COVID-19 était de 11 %, 85 % de ces décès survenant chez des personnes âgées, c'est-à-dire de plus de 60 ans. 92 % des patients décédés souffraient de diabète de type 2. Environ 80 % des patients infectés par COVID-19 présentaient au moins une maladie concomitante. CONCLUSION: L'âge avancé, le diabète de type 2, la présence d'au moins une comorbidité sont associés à une mortalité accrue chez les patients atteints de maladies endocriniennes et infectés par COVID-19 dans notre étude. Mots-clés: Maladies endocriniennes, COVID-19, comorbidités, syndrome métabolique.

Hospitalization Burden of Patients with Kidney Stones and Metabolic Comorbidities in Spain during the Period 2017-2020.

Nephrolithiasis has become an increasing worldwide problem during the last decades. Metabolic syndrome, its components, and related dietary factors have been pointed out as responsible for the increasing incidence. The objective of this study was to evaluate the trends in the hospitalization rates of patients with nephrolithiasis, hospitalization features, costs, and how metabolic syndrome traits influence both the prevalence and complications of lithiasic patients. An observational retrospective study was conducted by analyzing hospitalization records from the minimum basic data set, including all patient hospitalizations in Spain in which nephrolithiasis has been coded as a main diagnosis or as a comorbidity during the period 2017-2020. A total of 106,407 patients were hospitalized and coded for kidney or ureteral lithiasis in this period. The mean age of the patients was 58.28 years (CI95%: 58.18-58.38); 56.8% were male, and the median length of stay was 5.23 days (CI95%: 5.06-5.39). In 56,884 (53.5%) patients, kidney or ureteral lithiasis were coded as the main diagnosis; the rest of the patients were coded mostly as direct complications of kidney or ureteral stones, such as "non-pecified renal colic", "acute pyelonephritis", or "tract urinary infection". The hospitalization rate was 56.7 (CI95%: 56.3-57.01) patients per 100,000 inhabitants, showing neither a significant increasing nor decreasing trend, although it was influenced by the COVID-19 pandemic. The mortality rate was 1.6% (CI95%: 1.5-1.7), which was higher, if lithiasis was coded as a comorbidity (3.4% CI95%: 3.2-3.6). Metabolic syndrome diagnosis component codes increased the association with kidney lithiasis when age was higher, reaching the highest in the eighth decade of life. Age, diabetes, and hypertension or lithiasis coded as a comorbidity were the most common causes associated with the mortality of lithiasic patients. In Spain, the hospitalization rate of kidney lithiasis has remained stable during the period of study. The mortality rate in lithiasic patients is higher in elderly patients, being associated with urinary tract infections. Comorbidity conditions such as diabetes mellitus and hypertension are mortality predictors.

Diabetogenic viruses: linking viruses to diabetes mellitus.

Diabetes Mellitus (DM) is a group of chronic metabolic diseases distinguished by elevated glycemia due to the alterations in insulin metabolism. DM is one of the most relevant diseases of the modern world, with high incidence and prevalence worldwide, associated with severe systemic complications and increased morbidity and mortality rates. Although genetic factors and lifestyle habits are two of the main factors involved in DM onset, viral infections, such as enteroviruses, cytomegalovirus, hepatitis C virus, human immunodeficiency virus, severe acute respiratory syndrome coronavirus 2, among others, have been linked as triggers of type 1 (T1DM) and type 2 (T2DM) diabetes. Over the years, various groups identified different mechanisms as to how viruses can promote these metabolic syndromes. However, this field is still poorly explored and needs further research, as millions of people live with these pathologies. Thus, this review aims to ex-plore the different processes of how viruses can induce DM and their contribution to the prevalence and incidence of DM worldwide.

Evidence That Increasing Serum 25(OH)D Concentrations to 30 ng/mL in the Kingdom of Saudi Arabia and the United Arab Emirates Could Greatly Improve Health Outcomes.

Accumulating evidence supports the potential protective effects of vitamin D against chronic diseases such as Alzheimer's disease, autoimmune diseases, cancers, cardiovascular disease (ischaemic heart disease and stroke), type 2 diabetes, hypertension, chronic kidney disease, stroke, and infectious diseases such as acute respiratory tract diseases, COVID-19, influenza, and pneumonia, as well as adverse pregnancy outcomes. The respective evidence is based on ecological and observational studies, randomized controlled trials, mechanistic studies, and Mendelian randomization studies. However, randomized controlled trials on vitamin D supplementation have largely failed to show benefits, probably due to poor design and analysis. In this work, we aim to use the best available evidence on the potential beneficial effects of vitamin D to estimate the expected reduction in incidence and mortality rates of vitamin D-related diseases in the Kingdom of Saudi Arabia and the United Arab Emirates if minimum serum 25(OH)D concentrations were to be raised to 30 ng/mL. Estimated reductions by 25% for myocardial infarction incidence, 35% for stroke incidence, 20 to 35% for cardiovascular disease mortality, and 35% for cancer mortality rates depicted a promising potential for raising serum 25(OH)D. Methods to increase serum 25(OH)D concentrations at the population level could include food fortification with vitamin D3, vitamin D supplementation, improved dietary vitamin D intake, and sensible sun exposure.

The effect of COVID-19 on vascular elasticity and liver function in overweight patients.

Objective. To study the changes in the vascular wall, vascular age and metabolic parameters in polymorbid COVID-19 conva-lescents. Material and methods. The study included 62 patients with hypertension who reached the target blood pressure (BP) with dual an-tihypertensive therapy after severe and extremely severe COVID-19. The following examinations were performed: laboratory tests of metabolic parameters, assessment of changes in the vessel elasticity indices (pulse-wave velocity (PWV), augmentation index (AI), central systolic BP (cSBP), 24-hour BP monitoring, and non-invasive markers of liver fibrosis. Results. According to office BP measurements, after the coronavirus infection, an increase in systolic BP (SBP) by 29.6% and di-astolic BP (DBP) by 23.6%, as well as heart rate (HR) by 11.8% (p<0.05) was reported during regular antihypertensive therapy. In addition, 24-hour BP monitoring data indicated an increase in the average daily SBP, DBP, and heart rate. After the coronavirus infection, an increase in PWV by 35.4% (p<0.05), AI by 24.4% (p<0.05), cSBP by 22.1% were reported. Carbohydrate and lipid metabolism parameters deteriorated. A pronounced adverse effect of coronavirus infection on liver function was observed. The vascular age (according to the modified SCORE scale) increased by 6 years (p<0.05). Conclusion. Our study showed that patients after severe and extremely severe COVID-19 have a high risk of liver fibrosis, hypertension and lipid metabolism control worsening and accelerating vascular aging.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

The effect of COVID-19 on vascular elasticity and liver function in overweight patients.

Objective. To study the changes in the vascular wall, vascular age and metabolic parameters in polymorbid COVID-19 conva-lescents. Material and methods. The study included 62 patients with hypertension who reached the target blood pressure (BP) with dual an-tihypertensive therapy after severe and extremely severe COVID-19. The following examinations were performed: laboratory tests of metabolic parameters, assessment of changes in the vessel elasticity indices (pulse-wave velocity (PWV), augmentation index (AI), central systolic BP (cSBP), 24-hour BP monitoring, and non-invasive markers of liver fibrosis. Results. According to office BP measurements, after the coronavirus infection, an increase in systolic BP (SBP) by 29.6% and di-astolic BP (DBP) by 23.6%, as well as heart rate (HR) by 11.8% (p<0.05) was reported during regular antihypertensive therapy. In addition, 24-hour BP monitoring data indicated an increase in the average daily SBP, DBP, and heart rate. After the coronavirus infection, an increase in PWV by 35.4% (p<0.05), AI by 24.4% (p<0.05), cSBP by 22.1% were reported. Carbohydrate and lipid metabolism parameters deteriorated. A pronounced adverse effect of coronavirus infection on liver function was observed. The vascular age (according to the modified SCORE scale) increased by 6 years (p<0.05). Conclusion. Our study showed that patients after severe and extremely severe COVID-19 have a high risk of liver fibrosis, hypertension and lipid metabolism control worsening and accelerating vascular aging.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.