Healthy adipose tissue after menopause: contribution of balanced diet and physical exercise

Published: March 14, 2025

The accumulation of adipose tissue is associated with metabolic disorders, including insulin resistance, type 2 diabetes (T2D), dyslipidemia, syndrome, and cardiovascular diseases (CVD). Menopause might predispose women to increase body weight tissue, decrease lean muscle mass. Furthermore, postmenopausal display fat mass redistribution greater in the visceral area mainly due hormonal shifts that result a higher testosterone/estradiol ratio. These effects are less favorable adipokine profile, cardiac dysfunction after menopause. Fat determined by balance between storage triacylglycerol (TAG) (lipogenesis) removal stored TAG (lipolysis) combination differentiation new adipocytes (adipogenesis). Disturbances dynamics lead an lipogenesis (hypertrophy) and/or adipogenesis (hyperplasia) accommodate excess energy intake. While large dysfunctional have secretion inflammatory adipocytokines, small healthier improvements. Different strategies can be used prevent or reduce gain mass, as well maintain healthy tissue; however, robust evidence, lifestyle interventions should pillars this process. This review provides comprehensive summary findings on role balanced diet physical exercise improving composition promoting women.

Language: Английский

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The effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 Diabetes mellitus and metabolic-associated steatotic liver disease

Internal and Emergency Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 14, 2025

Abstract Sodium-glucose co-transporter type-2 (SGLT2) inhibitors have been identified to a crucial hepatoprotective role in patients with type 2 diabetes (T2DM) and metabolic-associated steatotic liver disease (MASLD). Thus, we aimed assess the effect of SGLT2 on hepatic steatosis T2DM MASLD added standard care (SOC) treatment. Our study was single-arm clinical trial no ISRCTN85961860. Thirty were recruited from outpatient endocrinology clinic Internal Medicine Department at Kasr Al-Aini Hospital, Cairo University, Egypt. Patients received Empagliflozin 10 mg daily which SOC treatment followed up for 24 weeks. Magnetic resonance imaging proton density fat fraction (MRI-PDFF) done baseline after weeks percentage change mass. Also changes Fib-4 NAFLD fibrosis scores calculated. showed statistically significant decrease mean MRI-PDFF measurement adding empagliflozin (13.297 ± 7.15) compared (15.288 8.72), P = 0.006 overall about 13.16% steatosis. There decreases BMI, fasting blood glucose, Alanine transaminase, ( < 0.001, 0.03, 0.01) respectively. differences or scores. Adding could reduce mass significantly practice guidelines be therapeutic agent T2DM.

Language: Английский

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Surveillance for patients at risk of hepatocellular carcinoma: how to improve its cost-effectiveness and expand the role of multidisciplinary tumor board?

Hepatoma Research, Journal Year: 2025, Volume and Issue: unknown

Published: March 14, 2025

Surveillance for hepatocellular carcinoma (HCC) improves early tumor detection, increases access to curative therapies, and reduces mortality by about 40%. Early diagnosis through surveillance is essential should be extended as many at-risk patients possible maximize the benefits of multidisciplinary board evaluations. Current guidelines recommend semi-annual abdominal ultrasonography (US), with/without serum alpha-fetoprotein measurement, with cirrhosis certain subgroups individuals pre-cirrhotic chronic liver disease. However, populations eligible include subsets varying degrees HCC risk, which may change over time in some individuals. As risk level a key determinant cost-effectiveness, rigid, “one-size-fits-all” strategy appears inadequate. Moreover, non-cirrhotic - particularly those advanced fibrosis are currently excluded from but benefit stratification identify whom would cost-effective. strategies must also consider potential harms, limitations US screening test. In response, alternative approaches such biomarkers-based tests abbreviated magnetic resonance imaging under investigation. This article reviews literature advocating transition current approach programs tailored individual oncological (risk-stratified surveillance) or that main factors (sex, etiology, phenotype) influence test performance (precision surveillance). Additionally, it presents seminal proposal risk-stratified algorithm designed optimize cost-effectiveness risk-benefit balance integrating variable intervals modality selection.

Language: Английский

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Metabolic dysfunction‐associated steatotic liver disease, insulin sensitivity and continuous glucose monitoring metrics in patients with type 1 diabetes: A multi‐centre cross‐sectional study

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: March 13, 2025

Abstract Background and aim We assessed the prevalence of metabolic dysfunction‐associated steatotic liver disease (MASLD) significant fibrosis in adults with type 1 diabetes mellitus (T1DM) association MASLD insulin sensitivity continuous glucose monitoring metrics. Methods consecutively enrolled 198 T1DM undergoing vibration‐controlled transient elastography stiffness measurement (LSM) controlled attenuation parameter (CAP). All participants had a (CGM) device. Insulin was evaluated by estimated disposal rate (eGDR). defined as CAP ≥ 248 db/m presence at least one cardiometabolic risk factor. Significant LSM 7 kPa. Results Patients mean age 56 years, BMI 26.0 ± 5.9 kg/m 2 , eGDR 7.1 2.3 mg/kg/min. 73 (37%) patients (using threshold 274 dB/m), 16 (8.1%) whom fibrosis. associated significantly lower (beta coefficient = −0.367, 95% confidence interval −0.472 to −0.261; p < 0.001). This remained significant, even after adjustment for age, sex, body mass index, plasma triglycerides, duration, daily dose, time above range levels, chronic kidney disease. No observed between CGM‐derived These results were not different when we used dB/m diagnosing MASLD. Conclusion In T1DM, inversely biomarkers resistance but

Language: Английский

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Effects of Pemafibrate on Serum Carnitine and Plasma Myostatin in Patients With Metabolic Dysfunction Associated Steatotic Liver Disease

Deleted Journal, Journal Year: 2025, Volume and Issue: 8(1)

Published: Jan. 1, 2025

ABSTRACT Background Pemafibrate, a selective peroxisome proliferator‐activated receptor alpha (PPARα) modulator (SPPARMα), has positive effects on liver‐related markers (e.g., liver stiffness determined by magnetic resonance elastography and alanine aminotransferase) in the PEMA‐FL study patients with metabolic dysfunction‐associated steatotic disease (MASLD). Patients MASLD reportedly have high rate of muscle mass loss; hence, prevention treatment sarcopenia is important for MASLD. PPARα may be involved expression carnitine myostatin, which are known muscle‐related markers. We conducted post‐hoc analysis to investigate pemafibrate myostatin levels. Methods The study, double‐blind, placebo‐controlled, randomized, multicenter, Phase 2 trial, randomized 118 either Pemafibrate 0.4 mg/day or placebo (1:1) group (orally, twice daily 72 weeks). This examined percentage change total carnitine, free acylcarnitine, compared those group. correlation between changes Results Pmafibrate significantly increased serum levels from baseline at Week 48 (treatment difference 24.2%; p < 0.001, 27.3%; respectively) similar trends acylcarnitine 10.7%). reduced plasma −11.0%; 0.01) baseline. Analysis significant subgroups showed almost all subgroups. percent 12 weeks demonstrated no obvious correlations ( r = 0.337, 0.358, 0.077, respectively). Conclusions decreased MASLD, potential application development progression sarcopenia, but there results effect mass. Further research warranted determine whether these physiology can lead clinical benefits Trial Registration: ClinicalTrials.gov identifier: NCT03350165.

Language: Английский

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