The single point insulin sensitivity estimator (SPISE) is associated with bone health in Arab adults.

BACKGROUND: The Single Point Insulin Sensitivity Estimator (SPISE) index is a surrogate marker for insulin sensitivity. Given the emerging role of bone as an active endocrine organ, its associations with non-invasive measures of extra-skeletal functions such as insulin sensitivity warrant investigation. AIMS: This study aimed to explore the relationship between the SPISE index and Bone Mineral Density (BMD) in an adult population. METHODS: Data from a total of 1270 Arab adults (84% females, mean age 56.7 ± 8.1 years) from the Osteoporosis Registry Database of the Chair for Biomarkers of Chronic Diseases in King Saud University, Riyadh, Saudi Arabia was used in this study. T-scores and SPISE were calculated. Regression models were used to determine associations between SPISE and bone health indices. RESULTS: The low BMD group (N = 853; T-score <-1.0) had significantly higher SPISE values than those with normal BMD (N = 417; T-score - 1.0 and above) (4.6 ± 1.3 vs. 4.3 ± 1.2, p < 0.001). Multivariate linear regression, adjusted for covariates, confirmed a significant inverse association between SPISE and BMD for all participants (ß=-0.22, p < 0.001), as well as both groups [normal BMD (ß = -0.10, p = 0.02) and low BMD groups (ß = -0.15, p < 0.001)]. SPISE, family history of T2DM, and history of fractures collectively account for 17% of the variances perceived in T-score for all participants (p < 0.001). CONCLUSIONS: A significant inverse association between the SPISE index and BMD was observed in adults, suggesting a link between BMD and extra-skeletal health. Underlying mechanisms need to be investigated prospectively using BMD as secondary outcomes in lifestyle modification programs.

Dose Intervals and Time since Final Dose on Changes in Metabolic Indices after COVID-19 Vaccination.

The rapid development and implementation of COVID-19 vaccines merit understanding its effects on metabolic indices. This retrospective longitudinal study investigated the influence of first-to-second-dose intervals and time since the final dose on the metabolic indices of individuals receiving COVID-19 vaccinations. A total of 318 Saudi subjects (59.7% females) aged 12-60 years received COVID-19 vaccines via the national vaccination program. We collected the anthropometric data and fasting blood samples at specific time points before vaccination and after the final vaccination dose, and biochemical metabolic indices, including glucose and lipid profile, were measured. We also collected the dates of vaccination and COVID-19 history during the study period. The participants were stratified into groups based on first-to-second-dose intervals and time since the final dose to compare pre-and post-vaccination changes in metabolic indices between the groups. Logistic regression analysis revealed no differences in pre- to post-vaccination metabolic status between groups based on first-to-second-dose intervals in either adolescents or adults. However, shorter intervals (≤6 months) between the final dose and follow-up were associated with a decrease in total cardiometabolic components, especially triglyceride levels (OR = 0.39, 95% CI: (0.22-0.68), p < 0.001) than longer intervals (>6 months) in adults. In conclusion, time duration since final dose was associated with pre- to post-vaccination changes in metabolic indices, especially triglyceride levels, indicating that post-vaccination improvements wane over time. Further research is needed to validate the observed relationship, as it may contribute to optimizing vaccine effectiveness and safety in the future.

Acute Glycemic Control in Prediabetes Individuals Favorably Alters Serum NLRP3 Inflammasome and Related Interleukins.

Hyperglycemia associated with prediabetes (PD) alters NLRP3 inflammasome activity and related interleukins, yet no study has evaluated the expression of the NLRP3 inflammasome complex and related interleukins in individuals with a PD condition that did or did not develop type 2 diabetes mellitus (T2DM). This study investigated the effect of 6 months of lifestyle modification on the expression of the NLRP3 inflammasome and related interleukins (1α, 1ß, 18, 33 and 37) in the sera of individuals with a PD condition that did or did not develop T2DM. This interventional study included 67 Saudi adults (mean age = 41.9 ± 8.0 years, mean BMI = 33.2 ± 5.5 kg/m2). Overnight-fasting serum samples were collected at baseline and at the 6-month follow-up. Serum levels of NLRP3, capsase-1 and related ILs were analyzed at both visits using commercially available immunoassay kits. Results showed that IL-1α increased in the PD group that developed T2DM (p = 0.046), IL-33 decreased in the PD group that reverted to normal (p < 0.001) and NLRP3 decreased in the PD group that remained PD (p = 0.01). Results also showed a positive over-time correlation between NLRP3 and both IL-1α and IL-33 (p < 0.001 and p = 0.028, respectively). In conclusion, glycemic control favorably altered NLRP3 inflammasome complex activity, and lifestyle modification in PD individuals is crucial in reversing harmful metabolic and inflammatory phenotypes.

Association of bone mineralization markers with dietary nutrient intake in adolescents with and without biochemical osteomalacia.

Background: Dietary intake is widely known to play a crucial role in achieving peak bone mass among children and adolescents. Unfortunately, this information is lacking among Arab adolescents, an understudied demographic that has recently been observed to have a high prevalence of abnormal mineralization markers [low serum 25(OH)D, high serum alkaline phosphatase (ALP), low calcium (Ca) and/or inorganic phosphate (Pi)] suggestive of biochemical osteomalacia (OM, defined as any 2 of the 4 parameters). In order to fill this gap, we aimed to evaluate the associations of serum markers of biochemical OM with dietary intake of macronutrients, vitamins and trace minerals. Methods: Saudi adolescents (N = 2,938, 57.8% girls), aged 12-17 years from 60 different schools in Riyadh, Saudi Arabia were included. Dietary intake of nutrients was calculated following a semi-quantitative 24 h dietary recall over 3 weekdays and 1 weekend-day using a validated food frequency questionnaire. Compliance to reference daily intake (RDI) of macronutrients, vitamins and trace minerals were calculated. Fasting blood samples were collected and circulating levels of 25(OH)D, ALP, Ca, and Pi were analyzed. Results: A total of 1819 (1,083 girls and 736 boys) adolescents provided the dietary recall data. Biochemical OM was identified in 175 (9.6%) participants (13.5% in girls, 3.9% in boys, p < 0.01) while the rest served as controls (N = 1,644). All participants had serum 25(OH)D levels <50 nmoL/L. Most participants had very low dietary intakes of Ca (median ~ 290 mg) and vitamin D (median ~ 4 µg) which are far below the RDI of 1,300 mg/day and 20 µg/day, respectively. In contrast, excess dietary intakes of Pi, Na, K, and Fe were observed in all participants. In the biochemical OM group, thiamine and protein intake were significant predictors of serum 25(OH)D, explaining 4.3% of the variance perceived (r = 0.23, adjusted r2 = 4.3%, p = 0.01). Among controls, dietary vitamin C and vitamin D explained 0.6% of the total variation in serum 25(OH)D (r = 0.09, adjusted r2 = 0.6%, p = 0.004). Conclusion: Arab adolescents do not meet the RDI for dietary Ca and vitamin D, and none have sufficient vitamin D status (25(OH)D levels >50 nmol/L) but they exceed the RDI for dietary Pi. Interpreting these data in the light of the increased prevalence of rickets in Arab countries, food fortification to optimise vitamin D and Ca intake in Saudi adolescents should be considered.

Nitric oxide induces antioxidant machinery, PSII functioning and artemisinin biosynthesis in Artemisia annua under cadmium stress.

Soil contamination by heavy metals poses a significant environmental challenge, as the practical implementation of existing remediation technologies in the field has encountered numerous obstacles. This has necessitated the requirement of finding alternate solutions to reduce the harm caused to plants. In this study, nitric oxide (NO) was investigated for its potential to reduce cadmium (Cd) toxicity in A. annua plants. Although NO plays a vital role in the growth and development of plants, information on its role in reducing abiotic stress in plants is limited. A. annua plants were exposed to 20 and 40 mg/kg Cd regardless of the addition of exogenous sodium nitroprusside (SNP), a NO donor, at 200 µM concentration. Results showed that SNP treatment improved plant growth, photosynthesis, chlorophyll fluorescence, pigment content, and artemisinin production while reducing Cd accumulation and improving membrane stability in A. annua during Cd stress. The results demonstrated that NO can effectively reverse Cd-induced damage in A. annua by modulating the antioxidant system, maintaining redox homeostasis, and improving photosynthetic performance and different fluorescence parameters such as Fv/Fm, ФPSII, and ETR. The supplementation of SNP caused a substantial improvement in chloroplast ultrastructure, stomatal behavior, and different attributes relate to glandular secretory trichomes, which in turn increased artemisinin production; 14.11 % in plants exposed to Cd stress of 20 mg/kg. Our findings highlight that NO could be useful in mediating the repair of Cd-induced damage to A. annua, and suggest that it may play a critical role in plant signaling networks, improving plant adaptability to Cd stress. The results have important implications for developing new strategies to mitigate the negative impacts of environmental contaminants on plant health, and ultimately, the ecosystem.

Differences and Associations of NLRP3 Inflammasome Levels with Interleukins 1α, 1ß, 33 and 37 in Adults with Prediabetes and Type 2 Diabetes Mellitus.

Inflammasome activation of the nucleotide-binding domain, leucine-rich-containing family, and pyrin domain-containing-3 (NLRP3) has been observed to be involved in the pathogenesis of numerous inflammatory diseases, including prediabetes (PD) and type 2 diabetes mellitus (T2DM). Varying levels of glycemia can trigger inflammasome activation; yet, limited studies have reported the associations between NLRP3 levels or other circulating interleukins (ILs) and glycemic status. This study investigated the differences and associations between serum levels of NLRP3 and IL-1α, IL-1ß, IL-33 and IL-37 in Arab adults with PD and T2DM. A total of 407 Saudi adults (151 males and 256 females) (mean age = 41.4 ± 9.1 years and mean BMI = 30.7 ± 6.4 kg/m2) were included. Overnight-fasting serum samples were collected. The participants were stratified according to T2DM status. Serum levels of NLRP3 and ILs of interest were assessed using commercially available assays. In all participants, age- and BMI-adjusted circulating levels of IL-37 were significantly higher in the T2DM group (p = 0.02) than in healthy controls (HC) and the PD group. A general linear model analysis revealed that NLRP3 levels were significantly influenced by T2DM status; age; and ILs 18, 1α and 33 (p-values 0.03, 0.04, 0.005, 0.004 and 0.007, respectively). IL-1α and triglycerides significantly predicted NLRP3 levels by as much as 46% of the variance perceived (p < 0.01). In conclusion, T2DM status significantly influenced NLRP3 expression and other IL levels in varying degrees. Whether these altered levels of inflammasome markers can be favorably reversed through lifestyle interventions needs to be investigated prospectively in the same population.

Insights into strigolactone (GR24) mediated regulation of cadmium-induced changes and ROS metabolism in Artemisia annua.

Agricultural soil contamination and subsequently crops still require alternative solutions to reduce associated environmental risks. The effects of strigolactones (SLs) in alleviating cadmium (Cd) phytotoxicity in Artemisia annua plants were investigated during this study. Strigolactones play a vital role during plant growth and development due to their complex interplay during a plethora of biochemical processes. However, information on the potential of SLs to elicit abiotic stress signaling and trigger physiological modifications in plants is limited. In order to decipher the same, A. annua plants were exposed to different concentrations of Cd (20 and 40 mg kg-1), with or without the supplementation of exogenous SL (GR24, a SL analogue) at 4 µM concentration. Under Cd stress, excess Cd accumulation resulted in reduced growth, physio-biochemical traits, and artemisinin content. However, the follow-up treatment of GR24 maintained a steady state equilibrium between reactive oxygen species and antioxidant enzymes, improved chlorophyll fluorescence parameters such as Fv/Fm, ФPSII, and ETR for improved photosynthesis, enhanced chlorophyll content, maintained chloroplast ultrastructure, improved the glandular trichome (GT) attributes and artemisinin production in A. annua. Moreover, it also resulted in improved membrane stability, reduced Cd accumulation, and regulated the behaviour of stomatal apertures for better stomatal conductance under Cd stress. The results of our study suggest that GR24 could be highly effective in alleviating Cd-induced damages in A. annua. It acts via the modulation of the antioxidant enzyme system for redox homeostasis, protection of the chloroplasts and pigments for improved photosynthetic performance, and improved GT attributes for enhanced artemisinin production in A. annua.

Improved HDL Cholesterol through Vitamin D Status Correction Substantially Lowers 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Vitamin D-Deficient Arab Adults.

This interventional study aimed to determine whether correcting vitamin D status in deficient Arab adults [25(OH)D <50 nmol/L] improves their 10-year risk of Atherosclerotic Cardiovascular Disease (ASCVD) risk scores. Saudi adults (58 males 62 females) with baseline vitamin D deficiency (<50 nmol/L) were given 50,000 IU cholecalciferol weekly for 2 months, then twice a month, followed by daily 1000 IU until month 6. Fasting blood samples were collected pre- and post-intervention and assessed for glucose, lipids, and 25(OH)D levels. The predicted 10-year ASCVD risk scores were calculated at baseline and after intervention. At baseline, significantly higher 10-year ASCDV risk scores were observed in males than females (9% vs. 3%, p < 0.001). After 6 months, only 21% (25 out of 120) achieved 25(OH)D levels above optimal level (≥75 nmol/L). While modest improvements were seen in glucose and lipid profiles, only HDL cholesterol showed favorable significant changes in all participants, which translated to significantly improved 10-year ASCVD risk scores independent of whether they achieved optimum vitamin D status. Still, those who achieved optimal vitamin D levels had a modestly larger decrease in ASCVD risk scores than those with less optimal 25(OH)D levels (-23% versus -18%) and this improvement was slightly more pronounced in males (-26% versus -10%, or 16% improvement) than females (-47% versus -32%, or 15% improvement). In conclusion, vitamin D status correction significantly enhances HDL cholesterol which prospectively reduces 10-year ASCVD risk as vitamin D levels approach optimum status among adult Arabs with baseline vitamin D deficiency. This improvement appears to be slightly more apparent in males than females.

Involvement of abscisic acid in silicon-mediated enhancement of copper stress tolerance in Artemisia annua.

Heavy metal (HM) toxicity is a well-known hazard which causes deleterious impact on the growth and development of plants. The impact of abscisic acid (ABA) in presence of silicon (Si) on plant development and quality traits has largely gone unexplored. The effects of ABA and Si on the growth, yield, and quality characteristics of Artemisia annua L. plants growing under copper (Cu) stress (20 and 40 mg kg-1) were investigated in a pot experiment. During this investigation, Cu stress caused severe damage to the plants but exogenous administration of Si and ABA ameliorated the harmful effects of Cu toxicity, and the plants displayed higher biomass and improved physio-biochemical attributes. Copper accumulated in the roots and shoots and its toxicity caused oxidative stress as demonstrated by the increased 2-thiobarbituric acid reactive substance (TBARS) content. It also resulted in the increased activity of antioxidant enzymes, however, the exogenous Si and ABA supplementation decreased the buildup of reactive oxygen species (ROS) and lipid peroxidation, alleviating the oxidative damage produced by HM stress. Copper toxicity had a considerable negative impact on glandular trichome density, ultrastructure as well as artemisinin production. However, combined Si and ABA enhanced the size and density of glandular trichomes, resulting in higher artemisinin production. Taken together, our results demonstrated that exogenous ABA and Si supplementation protect A. annua plants against Cu toxicity by improving photosynthetic characteristics, enhancing antioxidant enzyme activity, protecting leaf structure and integrity, avoiding excess Cu deposition in shoot and root tissues, and helping in enhanced artemisinin biosynthesis. Our results indicate that the combined application of Si and ABA improved the overall growth of plants and may thus be used as an effective approach for the improvement of growth and yield of A. annua in Cu-contaminated soils.

Sex-Specific Cut-Offs of Single Point Insulin Sensitivity Estimator (SPISE) in Predicting Metabolic Syndrome in the Arab Adolescents.

The Single Point Insulin Sensitivity Estimator (SPISE) is a novel surrogate marker for insulin sensitivity and was found comparable to the gold standard clamp test as well as for predicting the Metabolic Syndrome (MetS) in several populations. The present study aimed to assess for the first time, the validity of SPISE in predicting MetS among Arab adolescents. In this cross-sectional study, 951 Saudi adolescents aged 10−17 years were randomly recruited from different schools across Riyadh, Saudi Arabia. Anthropometrics were measured and fasting blood samples were collected for the assessment of glucose, lipid profile, adipokines, C-reactive protein and 25 hydroxyvitamin (OH) D. MetS was defined using the National Cholesterol Education Program's (NCEP) criteria with age-specific thresholds for adolescents. The SPISE as well as insulin resistance (HOMA-IR) indices were calculated. The over-all prevalence of MetS was 8.6% (82 out of 951). SPISE index was significantly lower in MetS than non-MetS participants in both sexes (5.5 ± 2.5 vs. 9.4 ± 3.2, p < 0.001 in boys and 4.4 ± 1.4 vs. 8.6 ± 3.2, p < 0.001 in girls). The SPISE index showed a significant inverse correlation with resistin, leptin, and C-reactive protein, and a significant positive correlation with adiponectin and 25(OH) D. Areas under the curve (AUC) revealed fair and good accuracy for predicting MetS 84.1% and 90.3% in boys and girls, respectively. The sex-specific cut-off proposed was SPISE index ≤6.1 (sensitivity 72.2% and specificity 83.9%) for boys and ≤6.46 (sensitivity 96.3% and specificity 73.4%), for girls. This study suggests that the SPISE index is a simple and promising diagnostic marker of insulin sensitivity and MetS in Arab adolescents.

Systems biology of chromium-plant interaction: insights from omics approaches.

Plants are frequently subjected to heavy metal (HM) stress that impedes their growth and productivity. One of the most common harmful trace metals and HM discovered is chromium (Cr). Its contamination continues to increase in the environment due to industrial or anthropogenic activities. Chromium is severely toxic to plant growth and development and acts as a human carcinogen that enters the body by inhaling or taking Cr-contaminated food items. Plants uptake Cr via various transporters, such as sulfate and phosphate transporters. In nature, Cr is found in various valence states, commonly Cr (III) and Cr (VI). Cr (VI) is soil's most hazardous and pervasive form. Cr elevates reactive oxygen species (ROS) activity, impeding various physiological and metabolic pathways. Plants have evolved various complex defense mechanisms to prevent or tolerate the toxic effects of Cr. These defense mechanisms include absorbing and accumulating Cr in cell organelles such as vacuoles, immobilizing them by forming complexes with organic chelates, and extracting them by using a variety of transporters and ion channels regulated by various signaling cascades and transcription factors. Several defense-related proteins including, metallothioneins, phytochelatins, and glutathione-S-transferases aid in the sequestration of Cr. Moreover, several genes and transcriptional factors, such as WRKY and AP2/ERF TF genes, play a crucial role in defense against Cr stress. To counter HM-mediated stress stimuli, OMICS approaches, including genomics, proteomics, transcriptomics, and metallomics, have facilitated our understanding to improve Cr stress tolerance in plants. This review discusses the Cr uptake, translocation, and accumulation in plants. Furthermore, it provides a model to unravel the complexities of the Cr-plant interaction utilizing system biology and integrated OMICS approach.

Establishing the Prevalence of Osteomalacia in Arab Adolescents Using Biochemical Markers of Bone Health.

Nutrition-acquired osteomalacia is a bone mineralization disorder associated with dietary calcium and/or solar vitamin D deficiency, risk factors considered common in the Middle Eastern region. Establishing less invasive, cheap, and widely available diagnostic markers for this underdiagnosed entity is essential, in particular for screening in high-risk groups. This study assessed the prevalence of biochemical osteomalacia in Arab adolescents. In this cross-sectional study performed between September 2019 and March 2021, adolescents aged 12−17 years from 60 different secondary and preparatory year schools in Riyadh, Saudi Arabia were included. Anthropometrics and fasting blood samples were collected. Biochemical osteomalacia was defined as any two of the following four serum markers of hypomineralization, namely low 25 hydroxyvitamin D (25OHD < 30 nmol/L), high alkaline phosphatase (ALP), low calcium (Ca), and/or inorganic phosphorous (Pi). A total of 2938 Arab adolescents [1697 girls; mean age (years) 14.8 ± 1.8; 1241 boys; mean age 15.1 ± 1.6] were recruited. Vitamin D deficiency was noted in 56.2% (n = 953) of girls and 27.1% (n = 336) of boys (p < 0.001). The overall prevalence of biochemical osteomalacia was 10.0% (n = 295/2938) and was higher in girls than boys (14.7% vs. 3.6%, p < 0.001). The prevalence of low serum Ca and/or Pi was also higher in girls than in boys (24.2% vs. 12.5%, respectively, p < 0.001), as well as elevated ALP (5.1% vs. 1.5%, p < 0.001). Overall, girls were 4.6 times (95% CI 3.3−6.4) more likely to have biochemical osteomalacia than boys. Screening of apparently healthy Arab adolescents revealed a high prevalence of deranged mineralization markers suggestive of biochemical osteomalacia, which was significantly more common in girls than boys and was likely associated with Arab traditional clothing and diet. The proposed combination of typically altered mineralization markers for the diagnosis of osteomalacia is, at best, suggestive until further comparisons with established diagnostic tools (histological analysis of bone biopsies) are conducted.

Chromium in plant-soil nexus: Speciation, uptake, transport and sustainable remediation techniques.

Heavy metal (HM) pollution has become a serious global problem due to the non-biodegradable nature of the HMs and their persistence in the environment. Agricultural soil is a non-renewable resource that requires careful management so that it can fulfill the increasing demand for agricultural food production. However, different anthropogenic activities have resulted in a large-scale accumulation of HMs in soil which is detrimental to soil and plant health. Due to their ubiquity, increased bioavailability, toxicity, and non-biodegradable nature, HM contamination has formed a roadblock in the way of achieving food security, safety, and sustainability in the future. Chromium (Cr), specifically Cr(VI) is a highly bioavailable HM with no proven role in the physiology of plants. Chromium has been found to be highly toxic to plants, with its toxicity also influenced by chemical speciation, which is in turn controlled by different factors, such as soil pH, redox potential, organic matter, and microbial population. In this review, the different factors that influence Cr speciation were analyzed and the relationship between biogeochemical transformations of Cr and its bioavailability which may be beneficial for devising different Cr remediation strategies has been discussed. Also, the uptake and transport mechanism of Cr in plants, with particular reference to sulfate and phosphate transporters has been presented. The biological solutions for the remediation of Cr contaminated sites which offer safe and viable alternatives to old-style physical and chemical remediation strategies have been discussed in detail. This review provides theoretical guidance in developing suitable approaches for the better management of these remediation strategies.

Cardiometabolic Effects of a 12-Month, COVID-19 Lockdown-Interrupted Lifestyle Education Program for Arab Adolescents.

Background: Childhood obesity and pediatric metabolic syndrome (MetS) have steadily increased during the last decade in Saudi Arabia. Intervention programs to prevent cardiometabolic disorders in Arab youth are needed. Objective: In this multi-school intervention study which was disrupted by COVID-19-imposed lockdowns (September 2019-April 2021), a 12-month lifestyle education program focused on improving the cardiometabolic status of Arab adolescents was investigated. Methods: A total of 2,677 Saudi students aged 12-18 years were recruited from 60 different secondary and preparatory year schools in Riyadh city, Saudi Arabia. The intervention was initially in-person counseling sessions and the subsequent sessions conducted virtually post-pandemic. Baseline anthropometrics and fasting blood samples for glucose, HbA1c, and lipid assessments were collected at baseline and after 12 months (704 participants). Results: Only 704 out of 2,677 (73.7% dropout) completed the intervention. At baseline, 19.6% of the participants were overweight and 18.1% were obese. A modest but significant decrease in the prevalence of central obesity [11.2 vs. 6.7% (-4.5% change, p = 0.002)], hypertension [22.3 vs. 11.4% (-10.9% change, p < 0.001)], and low-HDL cholesterol [61.6 vs. 23.3% (-38.3% change, p < 0.001)] was noted. Consequently, the prevalence of hypertriglyceridemia increased from 22.7 to 56.3% (+ 33.6%, p < 0.001) overtime. Also, the proportion of subjects who were able to change their status from MetS to non-MetS was significantly more in overweight/obese at baseline than normal weight (16.9 vs. 3.6%, adjusted OR = 3.42, p < 0.001). Conclusion: Interrupted lifestyle education programs secondary to COVID-19-imposed lockdowns still provided modest effects in improving cardiometabolic indices of Arab adolescents. Given the high digital literacy of Arab youth, improving the delivery of virtual lifestyle education programs may prove beneficial.

COVID-19 Lockdown and Lifestyle Changes in Saudi Adults With Types 1 and 2 Diabetes.

Objective: We aimed to evaluate and compare the impact of COVID-19 lockdown on lifestyle changes and other common related effects of the lockdown in Saudi adults with diabetes mellitus (DM), both type 1 (T1D) and type 2 diabetes (T2D). Methods: 265 T1D and 285 T2D individuals were included in this cross-sectional survey during lockdown using an online questionnaire and compared with 297 participants without DM. Variables included demographics, treatment changes, use of supplements, change in sleeping habits and physical activity, dietary changes, social and mental health, and education and awareness during COVID-19 lockdown. Results: The COVID-19 lockdown was associated with more treatment doses in people with T1D but not in those with T2D (p = 0.003). More participants with T1D and T2D than the control group reported that they felt symptoms of depression during lockdown (ORs of 1.83, p = 0.008 and 2.2, p = 0.001, respectively) and that lockdown affected them psychologically (ORs of 1.64, p = 0.019 and 1.85, p = 0.005, respectively). More participants with T1D than controls reported that their physical activity decreased during lockdown (OR of 2.70, p = 0.024). Furthermore, significantly lesser participants in both DM groups than controls agreed that the health education regarding COVID-19 covered everything (ORs of 0.41, p < 0.001 and 0.56, p < 0.001, respectively for T1D and T2D groups). Regarding dietary habits, the DM groups reported more changes in either the number of daily meals, meal content, or mealtimes than the control group. Conclusions: COVID-19 lockdown-associated lifestyle changes were more prevalent in individuals with T1D and T2D compared to control. Findings may assist public health authorities in outlining their responses in pandemics and promote healthy lifestyle adaptations in this high-risk cohort to limit adverse effects in future lockdowns.

Associations of Bone Mineral Density with RANKL and Osteoprotegerin in Arab Postmenopausal Women: A Cross-Sectional Study.

Background and objective: There is limited information as to the association of several key bone markers with bone mineral density (BMD) in understudied ethnic groups. This study investigated the relationship between circulating levels of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-Β ligand (RANKL) with BMD in Arab postmenopausal women. Materials and methods: In this cross-sectional study, a total of 617 Saudi postmenopausal women from the Osteoporosis Registry of the Chair for Biomarkers of Chronic Diseases were included. Anthropometric data, BMD, and biochemical data were retrieved from the registry. Participants were stratified into three groups based on T-score; n = 169 with osteoporosis, n = 282 with osteopenia, and n = 166 normal. Analysis of bone markers including RANKL, OPG, osteocalcin, and N-terminal telopeptide (NTx) was completed using commercially available bioassays. Results: The results suggested that OPG was significantly and positively correlated with age in the osteoporosis group (r = 0.29, p < 0.05), while it was inversely correlated with BMD femoral neck left (r = −0.56, p < 0.001) and BMD femoral neck right (r = −0.37, p < 0.05) in the same group. Moreover, RANKL showed a significant inverse correlation with NTx in the osteopenia group (r = −0.37, p < 0.05). Furthermore, the RANKL/OPG ratio had a positive and significant correlation with BMI (r = 0.34, p < 0.05), BMD femoral neck left (r = 0.36, p < 0.05) and BMD femoral neck right (r = 0.35, p < 0.05) in the osteopenia group. By contrast, it showed a significant inverse correlation with waist to hip ratio in the osteoporosis group (r = −0.38, p < 0.05). Multiple regression analysis showed that OPG contributes to BMD variations in the osteopenia group (p = 0.03). Conclusions: In conclusion, changes in circulating levels of RANKL and OPG might be a protective mechanism contrary to the increased bone loss in postmenopausal women.

Effects of a 12-Month Hybrid (In-Person + Virtual) Education Program in the Glycemic Status of Arab Youth.

This 12-month school-based intervention study investigated the effects of hybrid educational lifestyle modifications on glycemic control among Saudi youth with different glycemic statuses. A total of 2600 Arab adolescents aged 12−18 years were recruited from 60 randomly selected schools. Anthropometrics, blood glucose, and HbA1c were measured pre- and post-intervention. Participants were grouped according to baseline HbA1c into normal, prediabetes, and diabetes groups. All participants received lifestyle education at base line and at every 3-month interval to improve diet and exercise behavior. Diabetic and prediabetic participants received a tailored lifestyle intervention. Post-intervention, 643 participants were analyzed as follows: 20 participants from the diabetes group, 39 from prediabetes, and 584 from the normal group. A modest but significant improvement in the glycemic status of diabetic and prediabetic participants was observed, but not in the normal group. In the diabetes group, 11 (55%) participants achieved normal HbA1c levels, 5 had prediabetes levels, and only 4 remained within diabetes HbA1c levels. In the prediabetes group, 34 (87.2%) participants achieved normal HbA1c levels, while 2 (5.1%) participants remained prediabetic and 3 (7.7%) had diabetes HbA1c levels (p < 0.001). This hybrid lifestyle intervention program modestly reduces the risk of T2DM among youth with elevated HbA1c levels. The challenge of sustaining interest in adopting lifestyle changes for a longer duration should be addressed in further studies in this population.

Exogenous Strigolactone (GR24) Positively Regulates Growth, Photosynthesis, and Improves Glandular Trichome Attributes for Enhanced Artemisinin Production in Artemisia annua.

Artemisia annua is a medicinal plant particularly known for the production of a sesquiterpene lactone artemisinin; a specialty metabolite known for its efficacy in the treatment of malaria by killing different strains of Plasmodium falciparum due to radicals released upon the cleavage of its endoperoxide motif. Considering these facts and the immense medicinal value of artemisinin, the enhancement of in planta production of artemisinin is highly desirable. As strigolactones are known to regulate various aspects of plant growth and development, the effects of foliar spray of different concentrations of synthetic strigolactone analog GR24 (0, 0.5, 1, 2, 4, and 8 µM) on A. annua were studied. As compared to the control group, the foliar application of GR24 had a positive impact on general growth, photosynthesis, and other physiological indices with 4 µM GR24 showing the best results. The results indicate that GR24 application increased the plant biomass and various attributes related to photosynthesis, like total chlorophyll content, chlorophyll fluorescence, stomatal conductance, internal CO2, and net photosynthetic rate. Moreover, the activity of various enzymes related to photosynthesis like carbonic anhydrase, nitrate reductase, and RuBisCO was escalated. The GR24 also improved certain attributes related to glandular trichomes, with a significant enhancement in content and yield of artemisinin as compared to untreated plants.

Associations of zinc-α-2-glycoprotein with metabolic syndrome and its components among adult Arabs.

Epidemiological studies suggest that the Zinc-α-2-glycoprotein (ZAG) plays significant physiological roles. In this study we investigate whether ZAG could be considered as a clinical biomarker in the diagnosis and prognosis of metabolic syndrome (MetS) in Saudi population. As such insights urgently required for management of MetS. Thus, we have determined serum levels of ZAG in patients with MetS and normal individuals. We have also assessed the correlation between ZAG and different components of MetS. In this case-control study, clinical information of 200 Saudi male and female subjects (age range 30-65) with MetS (n = 100) and healthy controls (n = 100) were extracted from the database of the Chair of Biomarkers of Chronic Disease (CBCD) in King Saud University (KSU), Riyadh, Saudi Arabia. MetS was screened according to NCEP ATP III criteria (National Cholesterol Education Program Adult Treatment Panel III). Fasting glucose and lipid profile levels were measured using Konelab. Serum TNF-α, IL- 6, CRP and ZAG levels were measured using commercially available assays. There was an age-dependent significant increase in ZAG level among MetS subjects than controls (43.8 ± 19.5 vs 48.1 ± 14.8; P = 0.04). A significant inverse correlation between ZAG and serum HDL-cholesterol (r = - 0.20, P < 0.05) was observed. Whereas, triglycerides (r = 0.25, P < 0.01), waist circumference (WHR) (r = 0.17, P < 0.05) and CRP (r = 0.24, P < 0.01) were all significantly and positively associated with ZAG. Circulating ZAG is associated with MetS in an age-dependent manner. Serum ZAG is a potential biomarker for MetS.