Objective We aimed to investigate the patterns of fasting blood glucose(FBG)trajectories and analyze the relationship between various occupational hazard factors and FBG trajectories in male steelworkers.Methods The s...Objective We aimed to investigate the patterns of fasting blood glucose(FBG)trajectories and analyze the relationship between various occupational hazard factors and FBG trajectories in male steelworkers.Methods The study cohort included 3,728 workers who met the selection criteria for the Tanggang Occupational Cohort(TGOC)between 2017 and 2022.A group-based trajectory model was used to identify the FBG trajectories.Environmental risk scores(ERS)were constructed using regression coefficients from the occupational hazard model as weights.Univariate and multivariate logistic regression analyses were performed to explore the effects of occupational hazard factors using the ERS on FBG trajectories.Results FBG trajectories were categorized into three groups.An association was observed between high temperature,noise exposure,and FBG trajectory(P<0.05).Using the first quartile group of ERS1 as a reference,the fourth quartile group of ERS1 had an increased risk of medium and high FBG by 1.90and 2.21 times,respectively(odds ratio[OR]=1.90,95%confidence interval[CI]:1.17–3.10;OR=2.21,95%CI:1.09–4.45).Conclusion An association was observed between occupational hazards based on ERS and FBG trajectories.The risk of FBG trajectory levels increase with an increase in ERS.展开更多
The circadian clock is crucial for the progression of cardiovascular diseases.Our previous studies showed that acrolein,an environmental pollutant,exacerbated atherosclerosis by reducing CLOCK/BMAL1 levels and disrupt...The circadian clock is crucial for the progression of cardiovascular diseases.Our previous studies showed that acrolein,an environmental pollutant,exacerbated atherosclerosis by reducing CLOCK/BMAL1 levels and disrupting circadian rhythm;in contrast,intermittent fasting(IF),a dietary regimen,ameliorated acrolein-induced atherosclerosis.In the current study,mice were administered acrolein at a dose of 3 mg/(kg·day)via drinking water and subjected to IF for 18 h(from 0:00 to 18:00).We observed that IF reduced the formation of aortic lesions accelerated by acrolein in Apo E-/-mice.Upon exposure to acrolein,the expression of Rel A,Il1b,and Tnf increased in the liver and heart tissues,but these changes were reversed by IF treatment.Notably,IF treatment upregulated the expression of adenosine monophosphate(AMP)-activated protein kinase catalytic subunit alpha-1(AMPKα1),p-AMPKα1,and sirtuin 1(SIRT1),while inhibiting acrolein-induced mitogen-activated protein kinase(MAPK)activation.Additionally,the expression of circadian genes Clock/Bmal1 was suppressed and disrupted by acrolein,whereas IF restored their expression.Moreover,consistent with the in vivo findings,shortterm starvation in vitro,as a fasting cell model,alleviated the dysregulation of CLOCK/BMAL1 and upregulated SIRT1 expression by modulating the AMPK and reactive oxygen species(ROS)-MAPK pathways activated by acrolein.In summary,we demonstrated that IF suppressed the ROS-MAPK pathway but activated the AMPK pathway to enhance the expression of circadian clock genes,thereby ameliorating acrolein-induced atherogenesis,which may shed light on strategies for preventing cardiovascular diseases.展开更多
Food is a critical environmental factor that influences animal survival,especially for small passerines due to their high mass-specific metabolic rates.Basal metabolic rate(BMR)reflects the energy expended by endother...Food is a critical environmental factor that influences animal survival,especially for small passerines due to their high mass-specific metabolic rates.Basal metabolic rate(BMR)reflects the energy expended by endothermic animals for basic physiological processes and constitutes a major part of their daily energy budget.Some birds have been shown to employ compensatory mechanisms during food shortages,temporarily reducing these selfmaintenance expenditures without using hypothermia.However,the mechanisms of BMR adjustment remain unexplored.In the present study,we assessed the phenotypic variation in basal thermogenesis of Eurasian Tree Sparrows(Passer montanus)by comparing a control group to groups fasted for 6,12,18,and 24 h.We focused on the correlation between a reduction in energy metabolism and the alterations of cellular metabolic activities,mitochondrial substrate supply,and changes in serum thyroid hormones during fasting.Our data indicated that fasting groups had significantly lower body mass,BMR,body temperature,and body fat content.Furthermore,fasting groups had significantly lower glycogen levels,mitochondrial state 4 respiration and cytochrome c oxidase(CCO)activity in the liver,and CCO activity in pectoral muscle.The levels of avian uncoupling protein(avUCP)m RNA were significantly reduced,while the levels of myostatin protein in pectoral muscle were significantly increased in the fasting groups.Furthermore,the groups subjected to fasting exhibited significantly lower levels of serum glucose,triglyceride,thyroxine(T_(4)),and triiodothyronine(T_(3)).Positive correlations were observed between the following pairs of variables:log BMR and log body mass,log body mass and log body fat,log BMR and log state 4 respiration in the liver,log BMR and log CCO activity in the liver and muscle,log BMR and log av-UCP m RNA expression,whereas a negative correlation was observed between log BMR and log myostatin level.In addition,a positive correlation was also detected between log T_(3) and each of the following:log BMR,state 4 respiration,and log CCO activity in the liver.Our results suggested that decreased metabolic thermogenesis via down-regulation in cellular aerobic capacity of organs and serum thyroid hormones may be an important survival strategy for fasting Tree Sparrows to reduce energy expenditure.展开更多
Type 2 diabetes mellitus(T2DM)is increasing among adolescents,but paediatric risk predictors are relatively underdeveloped.This study aimed to establish the associations of visceral adiposity index(VAI)and cardiorespi...Type 2 diabetes mellitus(T2DM)is increasing among adolescents,but paediatric risk predictors are relatively underdeveloped.This study aimed to establish the associations of visceral adiposity index(VAI)and cardiorespiratory fitness(CRF)with fasting plasma glucose in 418 Nigerian adolescents aged 11 years to 19 years.Using a cross-sectional design,participants were stratified by VAI and CRF tertiles to examine variations in impaired fasting glucose(IFG)risk.The findings of this study revealed significant gender differences:In the case of boys,high VAI and low CRF is associated with IFG,while no association was present in girls.CRF,measured by the 20-meter shuttle run,was a stronger predictor of IFG than VAI,suggesting that physical fitness is a protective factor against glucose dysreg-ulation.These findings point to VAI and CRF as useful,non-invasive predictors of risk for T2DM in youth,supporting school-based fitness programs that promote CRF and attenuate visceral adiposity,particularly in males.Future work must validate these predictors across various ethnic populations and identify other risk factors that can augment plans for early interventions aimed at the prevention of adolescent T2DM.展开更多
BACKGROUND Intermittent fasting(IF),particularly time-restricted feeding(TRF),is increasingly popular has gained popularity for weight loss,yet management,but its effects impact on gut health remain unclear.Remains in...BACKGROUND Intermittent fasting(IF),particularly time-restricted feeding(TRF),is increasingly popular has gained popularity for weight loss,yet management,but its effects impact on gut health remain unclear.Remains inadequately understood.This study explores how investigated the effects of TRF effects on intestinal health and explored the underlying mechanisms.AIM To assess the effects of IF on intestinal health,elucidate the mechanisms involved.METHODS Mice were divided into two groups:Normal control(NC)and IF.The IF group underwent TRF,while the NC group had unrestricted access to food.Body weight,fecal characteristics,and intestinal morphology were analyzed.Colon tissue,serum,and fecal samples were collected for histological analysis,enzymelinked immunosorbent assay,flow cytometry,16S rRNA sequencing,and metabolomic profiling.RESULTS IF significantly affected body weight and intestinal morphology,compromised the intestinal barrier,increased pro-inflammatory cytokines,and heightened gut immune activation(P<0.05).It also disrupted the gut microbiota,promoting proinflammatory bacteria,reducing anti-inflammatory metabolites,and elevating pro-inflammatory metabolites(P<0.05).Indoleacrylic acid(IAA)supplementation notably alleviated intestinal inflammation and reversed immune dysfunction induced by IF(P<0.05).CONCLUSION Prolonged IF exacerbates intestinal inflammation by impairing gut barrier integrity and disrupting microbial homeostasis.However,IAA supplementation effectively mitigates fasting-induced intestinal inflammation and immune imbalance,suggesting its potential as a therapeutic agent.展开更多
BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effec...BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effectiveness of GLP-1RAs in these situations.AIM To evaluate the safety and efficacy of GLP-1RA in patients with T2DM fasting during Ramadan.METHODS Electronic databases were systematically searched for relevant studies that featured GLP-1RA in the intervention arm and other glucose-lowering medications in the control arm.The primary outcome was adverse events(AEs)during Ramadan for both groups;other outcomes included changes in glycemic and anthropometric measures during the peri-Ramadan period.RESULTS Four studies[three randomized-controlled trials with low risk of bias(RoB)and one prospective observational study with serious RoB]involving 754 subjects were analyzed.GLP-1RA group achieved greater glycated hemoglobin reduction than the non-GLP-1RA group[mean difference(MD):-0.31%,95%CI:-0.61 to-0.01,P=0.04,I2=77%]with a lower risk of documented symptomatic hypoglycemia(risk ratio=0.38,95%CI:0.16 to 0.88,P=0.02).Any AEs,serious AEs,or AEs that led to treatment discontinuation were comparable between the two groups.The GLP-1RA group experienced greater weight loss compared to the non-GLP-1RA group(MD:-2.0 kg,95%CI:-3.37 to-0.63,P=0.004,I2=95%).There were comparable changes in blood pressure and lipid profile between the two groups.GLP-1RA users experienced higher risks of gastrointestinal AEs,nausea,and vomiting;however,the risks of heartburn,abdominal pain,and diarrhea were similar in both groups.CONCLUSION Limited evidence suggests that GLP-1RAs are safe for T2DM management during Ramadan,offering modest benefits in blood sugar control and weight loss.Large multicenter trials are needed to confirm their safety and efficacy in at-risk populations,improving clinical practice decision-making.展开更多
Objective To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study.Methods This prospective,community-based cohort stu...Objective To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study.Methods This prospective,community-based cohort study included 12,054 patients with diabetes.From 2006 to 2012,38,272 fasting blood glucose(FBG)measurements were obtained from these participants.FBG trajectory patterns were generated using latent mixture modelling.Cox proportional hazards models were applied to assess the subsequent risk of cerebral infarction associated with different FBG trajectory patterns.Results At baseline,the mean age of the participants was 55.2 years.Four distinct FBG trajectories were identified based on FBG concentrations and their changes over the 6-year follow-up period.After a median follow-up of 6.9 years,786 cerebral infarction events were recorded.Different trajectory patterns were associated with significantly varied outcome risks(Log-Rank P<0.001).Compared with the low-stability group,Hazard Ratio(HR)adjusted for potential confounders were 1.37 for the moderate-increasing group,1.23 for the elevated-decreasing group,and 2.08 for the elevated-stable group.Conclusion Sustained high FBG levels were found to play a critical role in the development of ischemic stroke among patients with diabetes.Controlling FBG levels may reduce the risk of cerebral infarction.展开更多
A recent article highlighted the hepatic benefits of intermittent fasting,particularly during Ramadan.However,the rising use of glucagon-like peptide-1(GLP-1)/glucose-dependent insulinotropic polypeptide(GIP)receptor ...A recent article highlighted the hepatic benefits of intermittent fasting,particularly during Ramadan.However,the rising use of glucagon-like peptide-1(GLP-1)/glucose-dependent insulinotropic polypeptide(GIP)receptor agonists(RAs)is altering public behavior,leading to decreased interest in diet and exercise.With a focus on hepatic health,we analyzed global search trends using Google Trends™data from January 1,2022 to December 31,2024,focusing on the keywords"fasting","intermittent fasting","diet","nutrition","liver",Semaglutide("Ozempic"™,the most widely known GLP-1 RA)and Tirzepatide("Mounjaro"™,a newer dual GLP-1 and GIP RA).Search interest for"intermittent fasting"and"diet"showed a significant decline over time(Spearman's rho:-0.582 and-0.605,respectively,both P<0.001),while interest in"fasting"and"nutrition"remained stable.Search interest for Semaglutide,Tirzepatide,"fasting and liver","diet and liver"and Semaglutide and"liver"increased(Spearman's rho:+0.914,+0.936,+0.369,+0.297 and+0.808,respectively,all P<0.001).These findings suggest a trend of shifting away from traditional dieting toward broader health concerns,likely influenced by the increasing use of GLP-1/GIP RAs.展开更多
Objective To observe the effect of electroacupuncture at ear and body acupoints for the instant fasting blood glucose of model machins with type 2 diabetes mellitus（T2DM）.Methods For 10 machins with type2 diabetes,t...Objective To observe the effect of electroacupuncture at ear and body acupoints for the instant fasting blood glucose of model machins with type 2 diabetes mellitus（T2DM）.Methods For 10 machins with type2 diabetes,the electroacupuncture was applied at ＂Zusanli＂（足三里 ST 36）,＂Sanyinjiao＂（三阴交 SP 6） and three ＂Jiangtangdian＂（降糖点） in the ear continuously for 5 days,with the frequency of 2/15 Hz（The 2 Hz and the 15 Hz were transferred every second） and current of2 mA.The treatment was given once every day for 30 min.The fasting blood glucose was measured before acupuncture,after acupuncture for15 min and 30 min in the 5 days.Results On the first day,after 30-minute acupuncture the fasting blood glucose was reduced obviously compared with that before treatment（P〈0.01）.On the third and the fifth days,after acupuncture for 15 min and 30 min the fasting blood glucose was apparently lower than that before acupuncture（all P〈0.05）.On the fourth day,after acupuncture for 30 min the fasting blood glucose was decreased markedly than that before acupuncture（P〈0.05）.After 30-minute acupuncture on the fifth day,the fasting blood glucose was lower obviously than that before treatment on the first day（P〈0.05）.Conclusion ①The electroacupuncture at ear and body acupoints can reduce the instant fasting blood glucose of T2 DM machins apparently.② There is time effect on instant fasting blood glucose of T2 DM machins treated by electroacupuncture.The efficacy of 30-minute stimulation is superior to that of 15-minute acupuncture.After acupuncture continuously for 4 days,the effect is better than that with acupuncture for3 days successively.展开更多
Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The dur...Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The duration of fasting differs from one regimen to another.Ramadan fasting(RF)is a religious fasting for Muslims,it lasts for only one month every one lunar year.In this model of fasting,observers abstain from food and water for a period that extends from dawn to sunset.The period of daily fasting is variable(12-18 hours)as Ramadan rotates in all seasons of the year.Consequently,longer duration of daily fasting is observed during the summer.In fact,RF is a peculiar type of IF.It is a dry IF as no water is allowed during the fasting hours,also there are no calorie restrictions during feeding hours,and the mealtime is exclusively nighttime.These three variables of the RF model are believed to have a variable impact on different liver diseases.RF was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improve-ments in anthropometric measures,metabolic profile,and liver biochemistry regardless of the calorie restriction among lean and obese patients.The situation is rather different for patients with liver cirrhosis.RF was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of cirrhosis.Cirrhotic patients developed new ascites,ascites were increased,had higher serum bilirubin levels after Ramadan,and frequently developed hepatic encephalopathy and acute upper gastrointestinal bleeding.These complications were higher among patients with Child class B and C cirrhosis,and some fatalities occurred due to fasting.Liver transplant recipients as a special group of patients,are vulnerable to dehydration,fluctuation in blood immunosuppressive levels,likelihood of deterioration and hence observing RF without special precautions could represent a real danger for them.Patients with Gilbert syndrome can safely observe RF despite the minor elevations in serum bilirubin reported during the early days of fasting.展开更多
Cancer is one of the most common causes of morbidity and mortality worldwide.The high demand for specific nutrients and the sensitivity to nutritional deficiencies are newly recognized features of cancer cells.Dietary...Cancer is one of the most common causes of morbidity and mortality worldwide.The high demand for specific nutrients and the sensitivity to nutritional deficiencies are newly recognized features of cancer cells.Dietary interventions can suppress tumor demand for particular nutrients and alter certain nutrients to target a tumor's metabolic vulnerability.Cyclic fasting or fasting-mimicking diets(FMDs)are popular approaches that can reduce nutrient intake over a specific period.Accumulating evidence suggests that FMDs attenuate tumor growth by altering the energy metabolism of cancer cells.Furthermore,FMDs potentiate the sensitivity of tumors to conventional cancer treatments and limit adverse events.Recent findings also highlight the potential value of FMDs in boosting antitumor immune surveillance.However,clinical trials regarding the impact of FMDs on cancer patients remain limited and controversial.Here,we provide the latest information on the effects of FMDs on cancer progression and treatment,focusing on future clinical applications.展开更多
Requesting patients to come with long fasting state (12 - 14 hours) for lipid profile measurements are a major inconvenience. However, most blood tests, even glycemic management, can be done in a non-fasting state, fo...Requesting patients to come with long fasting state (12 - 14 hours) for lipid profile measurements are a major inconvenience. However, most blood tests, even glycemic management, can be done in a non-fasting state, for example by requesting an HbA1C. It is understandable that when we order lipid profile test, laboratories are very rigid on fasting (12 - 14 h) or refuse to do the test if fasting is not enough. To answer these delusions, we conducted a cross-sectional study among the health care workers at Teaching Hospital Batticaloa, SriLanka, after an overnight fast (12 - 14 hours) blood taken for lipid profile. Following weeks, we collected blood from the same healthcare workers, after breakfast (2 - 4 hours after meal). In this study, measurements of fasting lipid profile, including high-density lipoproteins (HDL), low-density lipoproteins (LDL), total cholesterol (TC), triglyceride (TG) and non-HDL significantly (p < 0.05) differ from non-fasting lipid profile measurement. The mean difference in lipid profile in fasting versus non-fasting among healthcare workers was 34.13 mg/dl for TG, -5.65 mg/dl for total TC, -1.94 mg/dl for HDL-cholesterol, 3.71 mg/dl for non-HDL and 12.3 mg/dl for LDL-cholesterol. This momentous change of different meanings does not play any significant role in cardiovascular risk assessment. However, a patient with a family history of the premature atherosclerotic cardiovascular disease (ASCVD), or familial hyperlipidemia, screening and follow-up should preferably be performed with fasting.展开更多
Objective: Fasting for lipid profiles is a deeply-rooted tradition that is being revisited. In patients with diabetes, such fasting poses a risk of hypoglycemia, as observed in recent studies and case reports. This ia...Objective: Fasting for lipid profiles is a deeply-rooted tradition that is being revisited. In patients with diabetes, such fasting poses a risk of hypoglycemia, as observed in recent studies and case reports. This iatrogenic, overlooked, form of hypoglycemia has been referred to as Fasting-Evoked En-route Hypoglycemia in Diabetes (FEEHD). The objective of the study is to determine the prevalence of FEEHD in clinical practice. Methods: A two-page survey was administered to adults with diabetes on anti-diabetic medication(s). Patients were asked if they recalled having experienced hypoglycemia while fasting for laboratory tests (FEEHD) during the preceding 12 months. Results: Of 168 patients enrolled, 166 completed the survey, with a mean age of 55.3 (SD: 15.4) years. Seventy-nine (47.6%) were females. Of these 166 patients, 119 (71 %) had type 2 diabetes. Forty-five patients (27.1%) reported having experienced one or more FEEHD events. Notably, only 31.1% of the patients who experienced a FEEHD event informed their provider of the event, and only 40% of FEEHD events reportedly resulted in any subsequent provider-made medication change(s) to prevent future events. Conclusions: This is the first study of FEEHD prevalence in clinical practice, the results of which serve to increase awareness amongst clinicians about the occurrence of FEEHD. We believe that FEEHD appears to be overlooked by clinicians. The prevalence of FEEHD in clinical practice is strikingly high (27.1%). More concerning is the significant underreporting of FEEHD events by patients to their clinicians (31%). We hope this study will trigger further investigation to confirm these preliminary findings and modify practice guidelines.展开更多
Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic r...Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.展开更多
Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-cond...Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman.展开更多
OBJECTIVE:To assess the therapeutic effect of weekend fasting and administration of a modified Lingguizhugan decoction on metabolic syndrome(MetS).METHODS:Twenty-one patients with MetS were recruited from the First Af...OBJECTIVE:To assess the therapeutic effect of weekend fasting and administration of a modified Lingguizhugan decoction on metabolic syndrome(MetS).METHODS:Twenty-one patients with MetS were recruited from the First Affiliated Hospital of Sun Yat-Sen University.Fasting plasma glucose(FPG),30-min and 2-h post-prandial blood glucose(PG),fasting serum insulin(FINS),blood pressure(BP),body mass index(BMI),waist circumference(WC),homeostasis model assessment for insulin resistance index(HOMA-IR),and levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were tested.Patients were allowed to drink only water and a Chinese herbal decoction during weekends.All samples were tested again after 12 weeks of treatment.RESULTS:FPG,30-min PG,2-h PG,FINS,LDL-C,systolic BP,diastolic BP,BMI,WC,and HOMA-IR de-creased significantly(P<0.05)compared with before treatment.Levels of TG,TC,and HDL-C did not change significantly.CONCLUSION:Weekend fasting improved glucose metabolism,lowered BP,reduced LDL-C levels,BMI,and WC.These data suggest that weekend fasting may be an effective therapy for MetS by protection against coronary atherosclerosis.展开更多
AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2...AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m<sup>2</sup>]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ<sup>2</sup> likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.展开更多
OBJECTIVE:To explore the effect of Linguizhugan decoction on hyperlipidemia rats with caloric restriction.METHODS:The hyperlipidemia model of rat was induced by high fat diet for 8 weeks.After the model was establishe...OBJECTIVE:To explore the effect of Linguizhugan decoction on hyperlipidemia rats with caloric restriction.METHODS:The hyperlipidemia model of rat was induced by high fat diet for 8 weeks.After the model was established,26 rats were randomly divided into 4 groups:the control group(n=6),the model group(n=6),the intermittent fasting(IF) group(n= 8),and the IF and herbal medicine(IFH) group(n= 6).IF group was applied intermittent fasting every other day.The IFH group was given Linguizhugan decoction every day and intermittent fasting every other day.Blood samples were taken at the end of 16 weeks,and serum ghrelin and lipid was tested.RESULTS:Serum ghrelin in the IF group significantly increased(P<0.01).Serum ghrelin in IFH group was lower than the IF group(P<0.05),but higher than the model group(P<0.01).CONCLUSION:Linguizhugan decoction may play a part in regulation of energy and appetite in hyperlipidemia rats with IF.展开更多
Intermittent fasting(IF)is becoming a prevailing topic worldwide,as it can cause changes in the body’s energy metabolism processes,improve health,and affect the progression of many diseases,particularly in the circum...Intermittent fasting(IF)is becoming a prevailing topic worldwide,as it can cause changes in the body’s energy metabolism processes,improve health,and affect the progression of many diseases,particularly in the circumstance of oncology.Recent research has shown that IF can alter the energy metabolism of tumor cells,thereby inhibiting tumor growth and improving antitumor immune responses.Furthermore,IF can increase cancer sensitivity to chemotherapy and radiotherapy and reduce the side effects of these traditional anticancer treatments.IF is therefore emerging as a promising approach to clinical cancer treatment.However,the balance between long-term benefits of IF compared with the harm from insufficient caloric intake is not well understood.In this article,we review the role of IF in tumorigenesis and tumor therapy,and discuss some scientific problems that remain to be clarified,which might provide some assistance in the application of IF in clinical tumor therapy.展开更多
Changes in distribution density,morphology and secretory content of endocrine cells in the gastro-entero-pancreatic system of black-spotted frogs Rana nigromaculata before and after fasting were investigated using imm...Changes in distribution density,morphology and secretory content of endocrine cells in the gastro-entero-pancreatic system of black-spotted frogs Rana nigromaculata before and after fasting were investigated using immunohistochemistry and antisera to six gut hormones.Six types of endocrine cells were detected in the digestive tract of Rana nigromaculata,including 5-hydroxytryptamine(5-HT),gastrin(GAS),somatostatin(SOM),glucagon(GLU),pancreatic polypeptide(PP)and vasoactive intestinal polypeptide(VIP)cells.After fasting,the density of 5-HT cells in the esophagus,cardia and fundus,GAS cells in the fundus and pylorus,PP cells in the fundus decreased significantly(P<0.01),while SOM cells in the cardia,GLU cells in the rectum increased significantly(P<0.01).The cytoplasmic processes of 5-HT cells became shorter or not detectable.The secretory content of GAS cells reduced in the cardia.The positive immunostaining reaction in the perinuclear region of SOM cells in the cardia,fundus and pylorus became weaker,while the staining intensity in the periphery of these cells became stronger.VIP cells were not detectable in the whole digestive tract after fasting.Five types of endocrine cells were found in the pancreas of Rana nigromaculata,including 5-HT,GAS,SOM,GLU and PP cells.After fasting,the density of 5-HT cells decreased slightly(P>0.05),while SOM,GAS,GLU and PP cells increased significantly(P<0.01).Furthermore,the secretory content of GLU cells increased significantly.Considering their functionalities,our results indicate that the changes of GEP endocrine cells in Rana nigromaculata responded adaptively to starvation-induced stress.展开更多
基金supported by the Key Research and Development Program of the Ministry of Science and Technology of China(grant number:2016YF0900605)the Key Research and Development Program of Hebei Province(grant number:192777129D)+1 种基金the Joint Fund for Iron and Steel of the Natural Science Foundation of Hebei Province(grant number:H2016209058)the National Natural Science Foundation for Regional Joint Fund of China(grant number:U22A20364)。
文摘Objective We aimed to investigate the patterns of fasting blood glucose(FBG)trajectories and analyze the relationship between various occupational hazard factors and FBG trajectories in male steelworkers.Methods The study cohort included 3,728 workers who met the selection criteria for the Tanggang Occupational Cohort(TGOC)between 2017 and 2022.A group-based trajectory model was used to identify the FBG trajectories.Environmental risk scores(ERS)were constructed using regression coefficients from the occupational hazard model as weights.Univariate and multivariate logistic regression analyses were performed to explore the effects of occupational hazard factors using the ERS on FBG trajectories.Results FBG trajectories were categorized into three groups.An association was observed between high temperature,noise exposure,and FBG trajectory(P<0.05).Using the first quartile group of ERS1 as a reference,the fourth quartile group of ERS1 had an increased risk of medium and high FBG by 1.90and 2.21 times,respectively(odds ratio[OR]=1.90,95%confidence interval[CI]:1.17–3.10;OR=2.21,95%CI:1.09–4.45).Conclusion An association was observed between occupational hazards based on ERS and FBG trajectories.The risk of FBG trajectory levels increase with an increase in ERS.
基金supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions and the Key Project of Jiangsu Commission of Health(Grant No.ZD2022012)。
文摘The circadian clock is crucial for the progression of cardiovascular diseases.Our previous studies showed that acrolein,an environmental pollutant,exacerbated atherosclerosis by reducing CLOCK/BMAL1 levels and disrupting circadian rhythm;in contrast,intermittent fasting(IF),a dietary regimen,ameliorated acrolein-induced atherosclerosis.In the current study,mice were administered acrolein at a dose of 3 mg/(kg·day)via drinking water and subjected to IF for 18 h(from 0:00 to 18:00).We observed that IF reduced the formation of aortic lesions accelerated by acrolein in Apo E-/-mice.Upon exposure to acrolein,the expression of Rel A,Il1b,and Tnf increased in the liver and heart tissues,but these changes were reversed by IF treatment.Notably,IF treatment upregulated the expression of adenosine monophosphate(AMP)-activated protein kinase catalytic subunit alpha-1(AMPKα1),p-AMPKα1,and sirtuin 1(SIRT1),while inhibiting acrolein-induced mitogen-activated protein kinase(MAPK)activation.Additionally,the expression of circadian genes Clock/Bmal1 was suppressed and disrupted by acrolein,whereas IF restored their expression.Moreover,consistent with the in vivo findings,shortterm starvation in vitro,as a fasting cell model,alleviated the dysregulation of CLOCK/BMAL1 and upregulated SIRT1 expression by modulating the AMPK and reactive oxygen species(ROS)-MAPK pathways activated by acrolein.In summary,we demonstrated that IF suppressed the ROS-MAPK pathway but activated the AMPK pathway to enhance the expression of circadian clock genes,thereby ameliorating acrolein-induced atherogenesis,which may shed light on strategies for preventing cardiovascular diseases.
基金financially supported by grants from the National Natural Science Foundation of China (Nos.32371573,32171497,and 31971420)。
文摘Food is a critical environmental factor that influences animal survival,especially for small passerines due to their high mass-specific metabolic rates.Basal metabolic rate(BMR)reflects the energy expended by endothermic animals for basic physiological processes and constitutes a major part of their daily energy budget.Some birds have been shown to employ compensatory mechanisms during food shortages,temporarily reducing these selfmaintenance expenditures without using hypothermia.However,the mechanisms of BMR adjustment remain unexplored.In the present study,we assessed the phenotypic variation in basal thermogenesis of Eurasian Tree Sparrows(Passer montanus)by comparing a control group to groups fasted for 6,12,18,and 24 h.We focused on the correlation between a reduction in energy metabolism and the alterations of cellular metabolic activities,mitochondrial substrate supply,and changes in serum thyroid hormones during fasting.Our data indicated that fasting groups had significantly lower body mass,BMR,body temperature,and body fat content.Furthermore,fasting groups had significantly lower glycogen levels,mitochondrial state 4 respiration and cytochrome c oxidase(CCO)activity in the liver,and CCO activity in pectoral muscle.The levels of avian uncoupling protein(avUCP)m RNA were significantly reduced,while the levels of myostatin protein in pectoral muscle were significantly increased in the fasting groups.Furthermore,the groups subjected to fasting exhibited significantly lower levels of serum glucose,triglyceride,thyroxine(T_(4)),and triiodothyronine(T_(3)).Positive correlations were observed between the following pairs of variables:log BMR and log body mass,log body mass and log body fat,log BMR and log state 4 respiration in the liver,log BMR and log CCO activity in the liver and muscle,log BMR and log av-UCP m RNA expression,whereas a negative correlation was observed between log BMR and log myostatin level.In addition,a positive correlation was also detected between log T_(3) and each of the following:log BMR,state 4 respiration,and log CCO activity in the liver.Our results suggested that decreased metabolic thermogenesis via down-regulation in cellular aerobic capacity of organs and serum thyroid hormones may be an important survival strategy for fasting Tree Sparrows to reduce energy expenditure.
文摘Type 2 diabetes mellitus(T2DM)is increasing among adolescents,but paediatric risk predictors are relatively underdeveloped.This study aimed to establish the associations of visceral adiposity index(VAI)and cardiorespiratory fitness(CRF)with fasting plasma glucose in 418 Nigerian adolescents aged 11 years to 19 years.Using a cross-sectional design,participants were stratified by VAI and CRF tertiles to examine variations in impaired fasting glucose(IFG)risk.The findings of this study revealed significant gender differences:In the case of boys,high VAI and low CRF is associated with IFG,while no association was present in girls.CRF,measured by the 20-meter shuttle run,was a stronger predictor of IFG than VAI,suggesting that physical fitness is a protective factor against glucose dysreg-ulation.These findings point to VAI and CRF as useful,non-invasive predictors of risk for T2DM in youth,supporting school-based fitness programs that promote CRF and attenuate visceral adiposity,particularly in males.Future work must validate these predictors across various ethnic populations and identify other risk factors that can augment plans for early interventions aimed at the prevention of adolescent T2DM.
基金Supported by the Anhui University Research Project,No.2022AH051171Natural Science Foundation Project of Anhui Province,No.2408085QH271+6 种基金Anhui Medical University Scientific Research Level Improvement Plan,No.2022xkjT028Health Research Project of Anhui Province,No.AHWJ2023A30047the Anhui Provincial Natural Science Foundation,No.2208085MH240the Scientific Research Project of Anhui Provincial Department of Education,No.2022AH051167the Anhui Quality Engineering Project,No.2023sx200,No.2023jyjxggyjY087 and No.2023zyxwjxalk046the Anhui Provincial Postgraduate Education Quality Project,No.2024cxcysj062and Anhui Medical University Graduate Research and Practice Innovation Project,No.YJS20240095.
文摘BACKGROUND Intermittent fasting(IF),particularly time-restricted feeding(TRF),is increasingly popular has gained popularity for weight loss,yet management,but its effects impact on gut health remain unclear.Remains inadequately understood.This study explores how investigated the effects of TRF effects on intestinal health and explored the underlying mechanisms.AIM To assess the effects of IF on intestinal health,elucidate the mechanisms involved.METHODS Mice were divided into two groups:Normal control(NC)and IF.The IF group underwent TRF,while the NC group had unrestricted access to food.Body weight,fecal characteristics,and intestinal morphology were analyzed.Colon tissue,serum,and fecal samples were collected for histological analysis,enzymelinked immunosorbent assay,flow cytometry,16S rRNA sequencing,and metabolomic profiling.RESULTS IF significantly affected body weight and intestinal morphology,compromised the intestinal barrier,increased pro-inflammatory cytokines,and heightened gut immune activation(P<0.05).It also disrupted the gut microbiota,promoting proinflammatory bacteria,reducing anti-inflammatory metabolites,and elevating pro-inflammatory metabolites(P<0.05).Indoleacrylic acid(IAA)supplementation notably alleviated intestinal inflammation and reversed immune dysfunction induced by IF(P<0.05).CONCLUSION Prolonged IF exacerbates intestinal inflammation by impairing gut barrier integrity and disrupting microbial homeostasis.However,IAA supplementation effectively mitigates fasting-induced intestinal inflammation and immune imbalance,suggesting its potential as a therapeutic agent.
基金thankful to Dr.Marina George Kudiyirickal MSc,MJDF-RCS,PhD for providing us the audio core tip of this article.
文摘BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effectiveness of GLP-1RAs in these situations.AIM To evaluate the safety and efficacy of GLP-1RA in patients with T2DM fasting during Ramadan.METHODS Electronic databases were systematically searched for relevant studies that featured GLP-1RA in the intervention arm and other glucose-lowering medications in the control arm.The primary outcome was adverse events(AEs)during Ramadan for both groups;other outcomes included changes in glycemic and anthropometric measures during the peri-Ramadan period.RESULTS Four studies[three randomized-controlled trials with low risk of bias(RoB)and one prospective observational study with serious RoB]involving 754 subjects were analyzed.GLP-1RA group achieved greater glycated hemoglobin reduction than the non-GLP-1RA group[mean difference(MD):-0.31%,95%CI:-0.61 to-0.01,P=0.04,I2=77%]with a lower risk of documented symptomatic hypoglycemia(risk ratio=0.38,95%CI:0.16 to 0.88,P=0.02).Any AEs,serious AEs,or AEs that led to treatment discontinuation were comparable between the two groups.The GLP-1RA group experienced greater weight loss compared to the non-GLP-1RA group(MD:-2.0 kg,95%CI:-3.37 to-0.63,P=0.004,I2=95%).There were comparable changes in blood pressure and lipid profile between the two groups.GLP-1RA users experienced higher risks of gastrointestinal AEs,nausea,and vomiting;however,the risks of heartburn,abdominal pain,and diarrhea were similar in both groups.CONCLUSION Limited evidence suggests that GLP-1RAs are safe for T2DM management during Ramadan,offering modest benefits in blood sugar control and weight loss.Large multicenter trials are needed to confirm their safety and efficacy in at-risk populations,improving clinical practice decision-making.
基金supported by the National Key R&D Program of China(2021YFC2500500)National Natural Science Foundation of China(Grant Nos.81973112,92049302,and U22A20364).
文摘Objective To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study.Methods This prospective,community-based cohort study included 12,054 patients with diabetes.From 2006 to 2012,38,272 fasting blood glucose(FBG)measurements were obtained from these participants.FBG trajectory patterns were generated using latent mixture modelling.Cox proportional hazards models were applied to assess the subsequent risk of cerebral infarction associated with different FBG trajectory patterns.Results At baseline,the mean age of the participants was 55.2 years.Four distinct FBG trajectories were identified based on FBG concentrations and their changes over the 6-year follow-up period.After a median follow-up of 6.9 years,786 cerebral infarction events were recorded.Different trajectory patterns were associated with significantly varied outcome risks(Log-Rank P<0.001).Compared with the low-stability group,Hazard Ratio(HR)adjusted for potential confounders were 1.37 for the moderate-increasing group,1.23 for the elevated-decreasing group,and 2.08 for the elevated-stable group.Conclusion Sustained high FBG levels were found to play a critical role in the development of ischemic stroke among patients with diabetes.Controlling FBG levels may reduce the risk of cerebral infarction.
文摘A recent article highlighted the hepatic benefits of intermittent fasting,particularly during Ramadan.However,the rising use of glucagon-like peptide-1(GLP-1)/glucose-dependent insulinotropic polypeptide(GIP)receptor agonists(RAs)is altering public behavior,leading to decreased interest in diet and exercise.With a focus on hepatic health,we analyzed global search trends using Google Trends™data from January 1,2022 to December 31,2024,focusing on the keywords"fasting","intermittent fasting","diet","nutrition","liver",Semaglutide("Ozempic"™,the most widely known GLP-1 RA)and Tirzepatide("Mounjaro"™,a newer dual GLP-1 and GIP RA).Search interest for"intermittent fasting"and"diet"showed a significant decline over time(Spearman's rho:-0.582 and-0.605,respectively,both P<0.001),while interest in"fasting"and"nutrition"remained stable.Search interest for Semaglutide,Tirzepatide,"fasting and liver","diet and liver"and Semaglutide and"liver"increased(Spearman's rho:+0.914,+0.936,+0.369,+0.297 and+0.808,respectively,all P<0.001).These findings suggest a trend of shifting away from traditional dieting toward broader health concerns,likely influenced by the increasing use of GLP-1/GIP RAs.
基金National Basic Research Program of China:2012CB518503National twelfth five-year science and technology support program:2012BAF14B10Special fund of technology research and development for institute by Ministry of science and Technology of China:2011EG152313
文摘Objective To observe the effect of electroacupuncture at ear and body acupoints for the instant fasting blood glucose of model machins with type 2 diabetes mellitus（T2DM）.Methods For 10 machins with type2 diabetes,the electroacupuncture was applied at ＂Zusanli＂（足三里 ST 36）,＂Sanyinjiao＂（三阴交 SP 6） and three ＂Jiangtangdian＂（降糖点） in the ear continuously for 5 days,with the frequency of 2/15 Hz（The 2 Hz and the 15 Hz were transferred every second） and current of2 mA.The treatment was given once every day for 30 min.The fasting blood glucose was measured before acupuncture,after acupuncture for15 min and 30 min in the 5 days.Results On the first day,after 30-minute acupuncture the fasting blood glucose was reduced obviously compared with that before treatment（P〈0.01）.On the third and the fifth days,after acupuncture for 15 min and 30 min the fasting blood glucose was apparently lower than that before acupuncture（all P〈0.05）.On the fourth day,after acupuncture for 30 min the fasting blood glucose was decreased markedly than that before acupuncture（P〈0.05）.After 30-minute acupuncture on the fifth day,the fasting blood glucose was lower obviously than that before treatment on the first day（P〈0.05）.Conclusion ①The electroacupuncture at ear and body acupoints can reduce the instant fasting blood glucose of T2 DM machins apparently.② There is time effect on instant fasting blood glucose of T2 DM machins treated by electroacupuncture.The efficacy of 30-minute stimulation is superior to that of 15-minute acupuncture.After acupuncture continuously for 4 days,the effect is better than that with acupuncture for3 days successively.
文摘Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The duration of fasting differs from one regimen to another.Ramadan fasting(RF)is a religious fasting for Muslims,it lasts for only one month every one lunar year.In this model of fasting,observers abstain from food and water for a period that extends from dawn to sunset.The period of daily fasting is variable(12-18 hours)as Ramadan rotates in all seasons of the year.Consequently,longer duration of daily fasting is observed during the summer.In fact,RF is a peculiar type of IF.It is a dry IF as no water is allowed during the fasting hours,also there are no calorie restrictions during feeding hours,and the mealtime is exclusively nighttime.These three variables of the RF model are believed to have a variable impact on different liver diseases.RF was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improve-ments in anthropometric measures,metabolic profile,and liver biochemistry regardless of the calorie restriction among lean and obese patients.The situation is rather different for patients with liver cirrhosis.RF was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of cirrhosis.Cirrhotic patients developed new ascites,ascites were increased,had higher serum bilirubin levels after Ramadan,and frequently developed hepatic encephalopathy and acute upper gastrointestinal bleeding.These complications were higher among patients with Child class B and C cirrhosis,and some fatalities occurred due to fasting.Liver transplant recipients as a special group of patients,are vulnerable to dehydration,fluctuation in blood immunosuppressive levels,likelihood of deterioration and hence observing RF without special precautions could represent a real danger for them.Patients with Gilbert syndrome can safely observe RF despite the minor elevations in serum bilirubin reported during the early days of fasting.
基金supported by the National Natural Science Foundation of China(No.82172704).
文摘Cancer is one of the most common causes of morbidity and mortality worldwide.The high demand for specific nutrients and the sensitivity to nutritional deficiencies are newly recognized features of cancer cells.Dietary interventions can suppress tumor demand for particular nutrients and alter certain nutrients to target a tumor's metabolic vulnerability.Cyclic fasting or fasting-mimicking diets(FMDs)are popular approaches that can reduce nutrient intake over a specific period.Accumulating evidence suggests that FMDs attenuate tumor growth by altering the energy metabolism of cancer cells.Furthermore,FMDs potentiate the sensitivity of tumors to conventional cancer treatments and limit adverse events.Recent findings also highlight the potential value of FMDs in boosting antitumor immune surveillance.However,clinical trials regarding the impact of FMDs on cancer patients remain limited and controversial.Here,we provide the latest information on the effects of FMDs on cancer progression and treatment,focusing on future clinical applications.
文摘Requesting patients to come with long fasting state (12 - 14 hours) for lipid profile measurements are a major inconvenience. However, most blood tests, even glycemic management, can be done in a non-fasting state, for example by requesting an HbA1C. It is understandable that when we order lipid profile test, laboratories are very rigid on fasting (12 - 14 h) or refuse to do the test if fasting is not enough. To answer these delusions, we conducted a cross-sectional study among the health care workers at Teaching Hospital Batticaloa, SriLanka, after an overnight fast (12 - 14 hours) blood taken for lipid profile. Following weeks, we collected blood from the same healthcare workers, after breakfast (2 - 4 hours after meal). In this study, measurements of fasting lipid profile, including high-density lipoproteins (HDL), low-density lipoproteins (LDL), total cholesterol (TC), triglyceride (TG) and non-HDL significantly (p < 0.05) differ from non-fasting lipid profile measurement. The mean difference in lipid profile in fasting versus non-fasting among healthcare workers was 34.13 mg/dl for TG, -5.65 mg/dl for total TC, -1.94 mg/dl for HDL-cholesterol, 3.71 mg/dl for non-HDL and 12.3 mg/dl for LDL-cholesterol. This momentous change of different meanings does not play any significant role in cardiovascular risk assessment. However, a patient with a family history of the premature atherosclerotic cardiovascular disease (ASCVD), or familial hyperlipidemia, screening and follow-up should preferably be performed with fasting.
文摘Objective: Fasting for lipid profiles is a deeply-rooted tradition that is being revisited. In patients with diabetes, such fasting poses a risk of hypoglycemia, as observed in recent studies and case reports. This iatrogenic, overlooked, form of hypoglycemia has been referred to as Fasting-Evoked En-route Hypoglycemia in Diabetes (FEEHD). The objective of the study is to determine the prevalence of FEEHD in clinical practice. Methods: A two-page survey was administered to adults with diabetes on anti-diabetic medication(s). Patients were asked if they recalled having experienced hypoglycemia while fasting for laboratory tests (FEEHD) during the preceding 12 months. Results: Of 168 patients enrolled, 166 completed the survey, with a mean age of 55.3 (SD: 15.4) years. Seventy-nine (47.6%) were females. Of these 166 patients, 119 (71 %) had type 2 diabetes. Forty-five patients (27.1%) reported having experienced one or more FEEHD events. Notably, only 31.1% of the patients who experienced a FEEHD event informed their provider of the event, and only 40% of FEEHD events reportedly resulted in any subsequent provider-made medication change(s) to prevent future events. Conclusions: This is the first study of FEEHD prevalence in clinical practice, the results of which serve to increase awareness amongst clinicians about the occurrence of FEEHD. We believe that FEEHD appears to be overlooked by clinicians. The prevalence of FEEHD in clinical practice is strikingly high (27.1%). More concerning is the significant underreporting of FEEHD events by patients to their clinicians (31%). We hope this study will trigger further investigation to confirm these preliminary findings and modify practice guidelines.
文摘Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.
文摘Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman.
基金Supported by the International Science andTechnology Cooperation Program of Guangdong Province(No.2009-B050700022)
文摘OBJECTIVE:To assess the therapeutic effect of weekend fasting and administration of a modified Lingguizhugan decoction on metabolic syndrome(MetS).METHODS:Twenty-one patients with MetS were recruited from the First Affiliated Hospital of Sun Yat-Sen University.Fasting plasma glucose(FPG),30-min and 2-h post-prandial blood glucose(PG),fasting serum insulin(FINS),blood pressure(BP),body mass index(BMI),waist circumference(WC),homeostasis model assessment for insulin resistance index(HOMA-IR),and levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were tested.Patients were allowed to drink only water and a Chinese herbal decoction during weekends.All samples were tested again after 12 weeks of treatment.RESULTS:FPG,30-min PG,2-h PG,FINS,LDL-C,systolic BP,diastolic BP,BMI,WC,and HOMA-IR de-creased significantly(P<0.05)compared with before treatment.Levels of TG,TC,and HDL-C did not change significantly.CONCLUSION:Weekend fasting improved glucose metabolism,lowered BP,reduced LDL-C levels,BMI,and WC.These data suggest that weekend fasting may be an effective therapy for MetS by protection against coronary atherosclerosis.
基金Supported by Department of Medicine,University of Saskat-chewan,and the College of Pharmacy and Nutrition,University of Saskatchewan
文摘AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m<sup>2</sup>]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ<sup>2</sup> likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.
基金Supported by International Science and Technology Cooperation Program of Guangdong Province (No.2009B050700022)
文摘OBJECTIVE:To explore the effect of Linguizhugan decoction on hyperlipidemia rats with caloric restriction.METHODS:The hyperlipidemia model of rat was induced by high fat diet for 8 weeks.After the model was established,26 rats were randomly divided into 4 groups:the control group(n=6),the model group(n=6),the intermittent fasting(IF) group(n= 8),and the IF and herbal medicine(IFH) group(n= 6).IF group was applied intermittent fasting every other day.The IFH group was given Linguizhugan decoction every day and intermittent fasting every other day.Blood samples were taken at the end of 16 weeks,and serum ghrelin and lipid was tested.RESULTS:Serum ghrelin in the IF group significantly increased(P<0.01).Serum ghrelin in IFH group was lower than the IF group(P<0.05),but higher than the model group(P<0.01).CONCLUSION:Linguizhugan decoction may play a part in regulation of energy and appetite in hyperlipidemia rats with IF.
基金supported by the Program for Highlevel Innovative Talents in Guizhou Province(Grant No.QKH-RC-2016-4031)the National Natural Science Foundation of China(Grant No.31760258)+2 种基金the Program for New Century Excellent Talents in University,the Ministry of Education of China(Grant No.NCET-12-0661)the Program for Excellent Young Talents of Zunyi Medical University(Grant No.15ZY-001)the Project of the Guizhou Provincial Department of Science and Technology(Grant No.QKH-JC-2018-1428)。
文摘Intermittent fasting(IF)is becoming a prevailing topic worldwide,as it can cause changes in the body’s energy metabolism processes,improve health,and affect the progression of many diseases,particularly in the circumstance of oncology.Recent research has shown that IF can alter the energy metabolism of tumor cells,thereby inhibiting tumor growth and improving antitumor immune responses.Furthermore,IF can increase cancer sensitivity to chemotherapy and radiotherapy and reduce the side effects of these traditional anticancer treatments.IF is therefore emerging as a promising approach to clinical cancer treatment.However,the balance between long-term benefits of IF compared with the harm from insufficient caloric intake is not well understood.In this article,we review the role of IF in tumorigenesis and tumor therapy,and discuss some scientific problems that remain to be clarified,which might provide some assistance in the application of IF in clinical tumor therapy.
基金supported by Open Fund of Key Laboratory of Bio-Macromolecular Evolution(No.2006B001)Foundation for outstanding academic team of Zoological Biology in Anhui Normal UniversitySpecial Foundation for Provincial Key Laboratories of Biotic Environment and Ecological Safety and Key Laboratory for Conservation and Use of Important Biological Resources of Anhui Province
文摘Changes in distribution density,morphology and secretory content of endocrine cells in the gastro-entero-pancreatic system of black-spotted frogs Rana nigromaculata before and after fasting were investigated using immunohistochemistry and antisera to six gut hormones.Six types of endocrine cells were detected in the digestive tract of Rana nigromaculata,including 5-hydroxytryptamine(5-HT),gastrin(GAS),somatostatin(SOM),glucagon(GLU),pancreatic polypeptide(PP)and vasoactive intestinal polypeptide(VIP)cells.After fasting,the density of 5-HT cells in the esophagus,cardia and fundus,GAS cells in the fundus and pylorus,PP cells in the fundus decreased significantly(P<0.01),while SOM cells in the cardia,GLU cells in the rectum increased significantly(P<0.01).The cytoplasmic processes of 5-HT cells became shorter or not detectable.The secretory content of GAS cells reduced in the cardia.The positive immunostaining reaction in the perinuclear region of SOM cells in the cardia,fundus and pylorus became weaker,while the staining intensity in the periphery of these cells became stronger.VIP cells were not detectable in the whole digestive tract after fasting.Five types of endocrine cells were found in the pancreas of Rana nigromaculata,including 5-HT,GAS,SOM,GLU and PP cells.After fasting,the density of 5-HT cells decreased slightly(P>0.05),while SOM,GAS,GLU and PP cells increased significantly(P<0.01).Furthermore,the secretory content of GLU cells increased significantly.Considering their functionalities,our results indicate that the changes of GEP endocrine cells in Rana nigromaculata responded adaptively to starvation-induced stress.
