Objective To investigate activation of brown adipose tissue （BAT） stimulated by medium-chain triglyceride （MCT）. Methods 30 Male C57BL/6J obese mice induced by fed high fat diet （HFD） were divided into 2 groups,...Objective To investigate activation of brown adipose tissue （BAT） stimulated by medium-chain triglyceride （MCT）. Methods 30 Male C57BL/6J obese mice induced by fed high fat diet （HFD） were divided into 2 groups, and fed another HFD with 2% MCT or long-chain triglyceride （LCT） respectively for 12 weeks. Body weight, blood biochemical variables, interscapular brown fat tissue （IBAT） mass, expressions of mRNA and protein of beta 3-adrenergic receptors （β3-AR）, uncoupling protein-1 （UCP1）, hormone sensitive lipase （HSL）, protein kinase A （PKA）, and adipose triglyceride lipase （ATGL） in IBAT were measured. Results Significant decrease in body weight and body fat mass was observed in MCT group as compared with LCT group （P〈O.05） after 12 weeks. Greater increases in IBAT mass was observed in MCT group than in LCT group （P〈O.05）. Blood TG, TC, LDL-C in MCT group were decreased significantly, meanwhile blood HDL-C, ratio of HDL-C/LDL-C and norepinephrine were increased markedly. Expressions of mRNA and protein of β3-AR, UCP1, PKA, HSL, ATGL in BAT were greater in MCT group than in LCT group （P〈O.05）. Conclusion Our results suggest that MCT stimulated the activation of BAT, possible via norepinephrine pathway, which might partially contribute to reduction of the body fat mass in obese mice fed high fat diet.展开更多
d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycer...d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycerol. MCTs have been extensively investigated for their ability to reduce body fat accumulation. We previously investigated the anti-obesity effects of a combination of dietary d-allulose and MCT (5% - 13%) in rats;however, we could not confirm the anti-obesity effects of MCT or observed synergetic effects between d-allulose and MCT on body fat loss. We speculated that our previous studies were influenced by the excessive amount of MCT in the diets. Therefore, in this study, we aimed to investigate the anti-obesity effects of the simultaneous intake of d-allulose and MCT in rats fed an obesity-inducing high-fat diet with a low amount of MCTs (2%). Thirty-two male Wistar rats (3-week-old) were randomly divided into four groups: control, d-allulose, MCT, and d-allulose + MCT groups. Rats in each group were fed ad libitum on a control (no d-Allulose or MCT), 5% d-allulose, 2% MCT, or 5% d-allulose + 2% MCT diets for 16 weeks. Abdominal adipose tissue weights were significantly lower in the d-allulose diet group than in the control group, whereas no differences were observed between results of the MCT-supplemented groups. The total body fat mass was significantly lower in the d-allulose and MCT diet groups than in the control group, but no differences were observed between the MCT-supplemented groups. These results suggested that anti-obesity effects of dietary d-allulose were observed, and the effects of dietary MCTs were weaker than those of d-allulose. Moreover, we confirmed the interaction between dietary d-allulose and MCT on indicators of obesity. Interestingly, their effects were not synergistic, as MCT supplementation offset the anti-obesity effects of dietary d-allulose. However, the specific mechanisms underlying those effects remain unknown, warranting further investigation.展开更多
Background Medium-chain triglyceride ketogenic diet(MCTKD)is previously less commonly used in China.This study was aimed to assess the efficacy and safety of the modified MCTKD in the treatment of drug-resistant epile...Background Medium-chain triglyceride ketogenic diet(MCTKD)is previously less commonly used in China.This study was aimed to assess the efficacy and safety of the modified MCTKD in the treatment of drug-resistant epilepsy in Chinese patients.Methods Patients with drug-resistant epilepsy were enrolled to receive treatment with modified MCTKD in Guangdong Sanjiu Brain Hospital during December 2020 and September 2022.The modified MCTKD contained fat that provided 50–70%of the total energy,as well as proteins and carbohydrates that provided 20–30%and 20%of energy,respectively.The fat component was composed of 20–30%medium-chain triglycerides(MCTs)and 30–40%long-chain triglycerides.The efficacy and safety of the diet were assessed at 1,3 and 6 months.Results A total of 123 patients aged 2.5 to 65 years,were included in this study.The response rates at 1,3 and 6 months were 49.6%,43.1%,and 30.9%,respectively.The seizure freedom rates at 1,3 and 6 months were 12.2%,10.6%,and 6.5%,respectively.The retention rates at 1,3 and 6 months were 98.4%,65.0%and 33.3%respectively.Side effects occurred in 21.14%of patients,which were predominantly gastrointestinal symptoms such as abdominal pain,diarrhea,vomiting,and constipation,and most of them resolved after dietary adjustments.A total of 82 patients(66.7%)discontinued the treatment with the reason of refusing to eat(8.1%),poor efficacy(35.0%),poor compliance(4.9%),and inability to follow-up(9.8%).Only 4 patients(3.3%)withdrew the diet due to side effects.Conclusions The modified MCTKD with MCTs providing 20–30%of energy has a good safety in patients with drug-resistant epilepsy,but its effectiveness needs to be enhanced.Further modifications of MCTKD with an optimal energy ratio are required to achieve a better efficacy and safety.展开更多
The aim of this study was to investigate the effect of medium-chain triglycerides(MCTs) on growth performance, nutrient digestibility, plasma metabolites and antioxidant capacity in weanling pigs. A total of 160 weanl...The aim of this study was to investigate the effect of medium-chain triglycerides(MCTs) on growth performance, nutrient digestibility, plasma metabolites and antioxidant capacity in weanling pigs. A total of 160 weanling(Duroc × Landrace x Yorkshire) pigs(age: 21 ± 1 d; body weight: 7.50 ± 0.28 kg) were randomly allotted to 4 treatments, receiving the following diets for 28 d: control diet [containing 3.5%soybean oil(SO)], MCT1 diet(containing 0.7% MCTs and 2.8% SO), MCT2 diet(containing 1.4% MCTs and2.1% SO) and MCT3 diet(containing 2.1% MCTs and 1.4% SO). Dietary inclusion of MCTs improved the average daily gain and feed efficiency(FE) of pigs compared with the control during the first 2 weeks post-weaning(P < 0.05). A similar positive effect was also observed for the overall FE in MCT2 group(P < 0.05). Compared with the control, apparent total tract digestibility(ATTD) of ether extract was improved by MCT2 and MCT3 treatment from day 12-14 post-weaning(P < 0.05). In addition, MCT2 treatment also exerted a beneficial effect on the ATTD of dry matter(P < 0.05). The increased total protein concentration and decreased urea nitrogen and malondialdehyde levels of plasma were observed in both MCT2 and MCT3 groups on day 14 post-weaning(P < 0.05). In conclusion, MCTs could improve growth performance, nutrients utilization, and antioxidant ability of weanling piglets.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification o...BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification of key prognostic factors to optimize the treatment approaches.Insulin resistance,as indicated by the triglyceride glucose(TyG)index,is increasingly recognized for its impact on cancer progression and immune modulation,and its potential role in GC prognosis is of particular interest.AIM To investigate whether the TyG index,a surrogate marker of insulin resistance,can predict the prognosis of patients with advanced GC receiving immunotherapy combined with chemotherapy.METHODS This retrospective study included 300 patients with advanced GC who received sintilimab combined with chemotherapy.The patients were categorized into two groups according to high or low TyG index,and independent prognostic factors for overall survival(OS)were determined using Cox proportional hazards regression analysis,which led to the development of a nomogram model.RESULTS Of the included patients,136 had a high TyG index and 164 had a low TyG index.The median progression-free survival of the high TyG index group was significantly longer than that of the low TyG index group.Similarly,the median OS of the high TyG index group was significantly longer than that of the low TyG index group.The ob-jective response and disease control rates in the two groups were 18.38%vs 9.15%and 58.82%vs 46.95%,res-pectively.No significant difference was noted in the incidence of adverse reactions at any level between the two groups(P>0.05).In multivariate analysis,the Eastern Cooperative Oncology Group score,programmed cell death ligand 1 expression,and TyG index acted as independent prognostic factors for OS.Of these factors,the hazard ratio of the TyG index was 0.36(95%confidence interval:0.36-0.55,P<0.001),and the nomogram model re-emphasized its importance as the main predictor of patient prognosis,followed by programmed cell death ligand 1 expression and the Eastern Cooperative Oncology Group score.CONCLUSION The TyG index is a long-term predictor of the efficacy of immunotherapy combined with chemotherapy,and patients with a high index have a better prognosis.展开更多
BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)...BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus(T2DM)population remains scarce.AIM To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.METHODS Data were drawn from the ACCORD trial and its subsequent follow-up(ACCORDION),which together included 10190 participants.To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients,Cox’s proportional-hazards model was employed.Non-linear associations and thresholds were investigated by performing restricted cubic spline regression,fitting smooth curves,and conducting piecewise regression.Additionally,we examined whether the above findings were robust through interaction and subgroup analyses.The robustness of results was further verified by a series of sensitivity assessments.Through the area under the receiver operating characteristic curve estimation,the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.RESULTS Applying multivariable Cox regression analysis,we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality.Specifically,after adjusting for multiple confounders,the cardiovascular mortality,congestive heart failure(CHF)and overall mortality risks in the highest TyG-BMI quartile were 1.74,2.65 and 1.42 times greater,respectively,when compared to the lowest quartile.The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality,while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality.TyG-BMI was found to correlate positively with future CHF.Additionally,introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.CONCLUSION Among T2DM individuals,a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality,highlighting its utility as a predictive marker for these risks.展开更多
BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of...BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.展开更多
BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complica...BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complications frequently arise,negatively impacting short-term recovery and significantly reducing patients’quality of life.In this context,accurately predicting the risk of postoperative recurrence and metastasis,coupled with targeted interventions,could substantially improve patient outcomes.The C-reactive protein-triglyceride-glucose index(CTI),a composite biomarker that integrates metabolic disturbances and systemic inflammation,has garnered increasing attention in oncology.The prognostic nutritional index(PNI),a composite measure based on serum albumin and peripheral blood lymphocyte count,is used to evaluate both the nutritional status and systemic immune function of patients.In recent years,both the CTI and PNI have demonstrated significant prognostic value in predicting tumor outcomes,assessing treatment responses,and formulating personalized treatment strategies.AIM To investigate whether the combined inflammation and insulin resistance marker,the CTI,can serve as a prognostic indicator for patients undergoing radical gastrectomy for gastric cancer.Additionally,it seeks to develop a predictive model by incorporating the PNI alongside CTI.METHODS This retrospective study included a total of 300 patients who underwent radical gastrectomy.The patients were classified into high and low CTI groups based on their CTI index.Cox proportional hazards regression analysis was performed to identify independent prognostic factors influencing overall survival(OS)and disease-free survival(DFS),and two nomogram models were developed.RESULTS Of the included patients,131 had a high CTI and 169 had a low CTI.The DFS period of the low CTI group was significantly longer than that of the high CTI group.The number of postoperative adjuvant treatments,T stage,N stage,CTI,and PNI were identified as independent prognostic factors for DFS.The hazard ratio for CTI was 2.07(95%confidence interval:1.36-3.17,P<0.001).In terms of OS,the OS period of the low CTI group was significantly longer than that of the high CTI group.Whether adjuvant treatment was administered,T stage,CTI,and PNI were independent prognostic factors for OS.The hazard ratio for CTI was 2.47(95%confidence interval:1.44-4.23,P=0.001).The nomogram models for OS and DFS further emphasized the importance of CTI as a key predictor of patient prognosis.CONCLUSION CTI is a long-term prognostic indicator for the outcome of radical gastrectomy for gastric cancer.Patients with lower CTI values have a better prognosis.The prediction models constructed by combining CTI with PNI has good predictive ability for DFS and OS after radical gastrectomy.展开更多
Background Cardiovascular disease(CVD)remains a major health challenge globally,particularly in aging populations.Using data from the China Health and Retirement Longitudinal Study(CHARLS),this study examines the Trig...Background Cardiovascular disease(CVD)remains a major health challenge globally,particularly in aging populations.Using data from the China Health and Retirement Longitudinal Study(CHARLS),this study examines the Triglyceride-glucose(TyG)index dynamics,a marker for insulin resistance,and its relationship with CVD in Chinese adults aged 45 and older.Methods This reanalysis utilized five waves of CHARLS data with multistage sampling.From 17,705 participants,5,625 with TyG index and subsequent CVD data were included,excluding those lacking 2011 and 2015 TyG data.TyG derived from glucose and triglyceride levels,CVD outcomes via self-reports and records.Participants divided into four groups based on TyG changes(2011–2015):low-low,low-high,high-low,high-high TyG groups.Results Adjusting for covariates,stable high group showed a significantly higher risk of incident CVD compared to stable low group,with an HR of 1.18(95%CI:1.03–1.36).Similarly,for stroke risk,stable high group had a HR of 1.45(95%CI:1.11–1.89).Survival curves indicated that individuals with stable high TyG levels had a significantly increased CVD risk compared to controls.The dynamic TyG change showed a greater risk for CVD than abnormal glucose metabolism,notably for stroke.However,there was no statistical difference in single incidence risk of heart disease between stable low and stable high group.Subgroup analyses underscored demographic disparities,with stable high group consistently showing elevated risks,particularly among<65 years individuals,females,and those with higher education,lower BMI,or higher depression scores.Machine learning models,including random forest,XGBoost,CoxBoost,Deepsurv and GBM,underscored the predictive superiority of dynamic TyG over abnormal glucose metabolism for CVD.Conclusions Dynamic TyG change correlate with CVD risks.Monitoring these changes could predict and manage cardiovascular health in middle-aged and older adults.Targeted interventions based on TyG index trends are crucial for reducing CVD risks in this population.展开更多
Metabolic dysfunction-associated steatotic liver disease,characterized by pathological intracellular triglyceride(TG)accumulation,is mechanistically associated with the disrupted spatiotemporal regulation of hepatocyt...Metabolic dysfunction-associated steatotic liver disease,characterized by pathological intracellular triglyceride(TG)accumulation,is mechanistically associated with the disrupted spatiotemporal regulation of hepatocyte nuclear factor(HNF)-dependent transcriptional programs.HNFs,including key members such as HNF-1α,HNF-4α,and HNF-6,constitute a liver-enriched family of transcription factors that govern hepatic lipid metabolism through hierarchical transcriptional regulatory networks.These networks critically regulate the dynamic equilibrium of TG metabolism,encompassing TG synthesis,storage,lipolysis,and lipoprotein-mediated export.This review comprehensively deciphers the molecular cascades through which HNF dysfunction exacerbates TG metabolic disorder in metabolic dysfunction-associated steatotic liver disease.Additionally,we evaluate emerging translational strategies targeting key HNF regulatory nodes and discuss current clinical challenges as well as potential solutions.展开更多
Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol ...Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol intake are the most frequent causes of hepatic steatosis. However, steatosis also often occurs with chronic hepatitis C virus(HCV) infection and is also found in rare but potentially life-threatening liver diseases of pregnancy. Clinical significance and outcome of hepatic triglyceride accumulation are highly dependent on etiology and histological pattern of steatosis. This review summarizes current concepts of pathophysiology of common causes of hepatic steatosis, including non-alcoholic fatty liver disease(NAFLD), alcoholic fatty liver disease, chronic HCV infections, drug-induced forms of hepatic steatosis, and acute fatty liver of pregnancy. Regarding the pathophysiology of NAFLD, this work focuses on the close correlation between insulin resistance and hepatic triglyceride accumulation, highlighting the potential harmful effects of systemic insulin resistance on hepatic metabolism of fatty acids on the one side and the role of lipid intermediates on insulin signalling on the other side. Current studies on lipid droplet morphogenesis have identified novel candidate proteins and enzymes in NAFLD.展开更多
Bile acids(BAs) are essential for the absorption of lipids. BA synthesis is inhibited through intestinal farnesoid X receptor(FXR) activity. BA sequestration is known to influence BA metabolism and control serum lipid...Bile acids(BAs) are essential for the absorption of lipids. BA synthesis is inhibited through intestinal farnesoid X receptor(FXR) activity. BA sequestration is known to influence BA metabolism and control serum lipid concentrations. Animal data has demonstrated a regulatory role for the FXR in triglyceride metabolism. FXR inhibits hepatic lipogenesis by inhibiting the expression of sterol regulatory element binding protein 1c via small heterodimer primer activity. Conversely, FXR promotes free fatty acids oxidation by inducing the expression of peroxisome proliferator-activated receptor α. FXR can reduce the expression of microsomal triglyceride transfer protein, which regulates the assembly of very low-density lipoproteins(VLDL). FXR activation in turn promotes the clearance of circulating triglycerides by inducing apolipoprotein C-Ⅱ, very low-density lipoproteins receptor(VLDL-R) and the expression of Syndecan-1 together with the repression of apolipoprotein C-Ⅲ, which increases lipoprotein lipase activity. There is currently minimal clinical data on triglyceride metabolism in patients with bile acid diarrhoea(BAD). Emerging data suggests that a third of patients with BAD have hypertriglyceridemia. Further research is required to establish the risk of hypertriglyceridaemia in patients with BAD and elicit the mechanisms behind this, allowing for targeted treatment.展开更多
Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aime...Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aimed to evaluate the ability of TG and TC to predict T2DM incidence.Methods Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012–2015.TG,TC,and T2DM status were measured.Cox proportional hazards models were used to estimate the association between TG,TC,and T2DM incidence.The receiver operating characteristic(ROC)curve was used to evaluate the ability of TG and TC to identify T2DM participants.Results The incidence of T2DM significantly increased with TG in women and TC in both men and women(Ptrend<0.05).Univariate Cox regression indicated that higher TG{borderline high TG[hazards ratio(HR):2.05;95%confidence interval(CI):1.40,3.00]and hypertriglyceridemia[HR:2.64;95%CI:1.68,4.15]}and TC[hypercholesterolemia(HR:2.05;95%CI:1.43,2.95)]were significantly associated with increased risk of T2DM incidence in women but not in men.Multivariate Cox regression showed that hypertriglyceridemia in women(HR:1.78,95%CI:1.07,2.97),borderline high TC in men(HR:1.61,95%CI:1.04,2.48),and hypercholesterolemia in women(HR:1.68,95%CI:1.81,2.61)had a higher significant risk of T2DM incidence.The optimal cutoff values of TG were>1.15 and>1.23 mmol/L in men and women,respectively.For TC,they were>5.17 and>5.77 mmol/L in men and women,respectively.The area under the ROCs of TG and TC were 0.54(0.51–0.57)and 0.55(0.52–0.58),respectively,in men,and 0.60(0.58–0.62)and 0.59(0.56–0.61),respectively,in women.Conclusion Elevated TG and TC were risk factors for T2DM incidence.However,no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women.Hence,TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.展开更多
Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.Howeve...Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.However the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.展开更多
AIM： To determine the real association between serum lipid levels and colonic polyp formation. METHODS： We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal a...AIM： To determine the real association between serum lipid levels and colonic polyp formation. METHODS： We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol （TC） and triglycerides （TG） in patients who underwent total colonoscopy for screening for colon cancer. RESULTS： Both levels were significantly elevated in patients with adenomas as compared with patients without any neoplastic lesion （TC 207.6 ± 29.5 vs 199.5 ±34.3, n= 4883, p〈 0.001; TG 135.0 ± 82.2 vs 108.7± 71.5, n= 4874, p〈 0.001）. The difference was significant in patients with tubular adenoma but not in those with villous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was an independent correlation factor in male （p〈0.01）, but not in female patients. The level of TG in patients with invasive carcinoma did not show a significant elevation from that in patients with adenoma. These findings suggest that hypertriglyceridemia is an independent risk factor for colonic adenoma in men. CONCLUSION： Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy may have benefit in men with hypertriglyceridemia.展开更多
The bioavailability of docosahexaenoic acid(DHA) and eicosapentaenoic acid(EPA) depends on their chemical forms. This study investigated the long-term effects of DHA-bound triglyceride(TG-DHA), DHA-bound phospholipid(...The bioavailability of docosahexaenoic acid(DHA) and eicosapentaenoic acid(EPA) depends on their chemical forms. This study investigated the long-term effects of DHA-bound triglyceride(TG-DHA), DHA-bound phospholipid(PL-DHA), and the combination of TG-DHA and egg yolk phospholipid(Egg-PL) on lipid metabolism in mice fed with a high-fat diet(fat levels of 22.5%). Male C57BL/6J mice were fed with different formulations containing 0.5% DHA, including TG-DHA, PL-DHA, and the combination of TG-DHA and Egg-PL, for 6 weeks. Serum, hepatic, and cerebral lipid concentrations and the fatty acid compositions of the liver and brain were determined. The concentrations of serum total triglyceride(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-c), and hepatic TG in the PL-DHA group and the combination group were significantly lower than those in the high-fat(HF) group(P < 0.05). Atherogenic index(AI) of the PL-DHA group was significantly lower than that of the combination group(P < 0.05). Hepatic TC level in the combination group was significantly lower than that in the HF group(P < 0.05), but no significant difference was observed between the combination group and the PL-DHA group. Both the PL-DHA and the combination groups showed significantly increased DHA levels in the liver compared with the HF group(P < 0.05). However, there were no obvious increases in the cerebral DHA levels in all DHA diet groups. These results suggest that PL-DHA was superior to the combination of TG-DHA and Egg-PL in decreasing the AI. Long-term dietary supplementation with low amount of DHA(0.5%) may improve hepatic DHA levels, although cerebral DHA levels may not be enhanced.展开更多
After exposure to mixed environments with multiple hosts, the frequency of flight take-offs for Plutella xylostella(L.) is known to increase with a concomitant decrease in female fecundity. The objective of the presen...After exposure to mixed environments with multiple hosts, the frequency of flight take-offs for Plutella xylostella(L.) is known to increase with a concomitant decrease in female fecundity. The objective of the present study was to elucidate the physiological mechanism underlying the increased flight activity and decreased fecundity of P. xylostella in mixed-host environments. We measured ovariole length, and triglyceride and vitellogenin(Vg) content in P. xylostella females after they were released into different host environments consisting of either a single host(Brassica campestris, Brassica oleracea or Brassica juncea) or a mixture of all three hosts. Our results indicated that ovariole length varied significantly between female adults from different host environments. Females from the B. campestris environment had the longest ovarioles, whereas those from the mixed environment had the shortest ones. A negative correlation was found between ovariole length and the flight take-off frequency of P. xylostella adults. Additionally, there were significant differences in the triglyceride content of P. xylostella females from different host environments. Our data revealed that more triglyceride was consumed by P. xylostella female adults from B. oleracea and the mixed environments than those from environments containing only B. campestris or B. juncea. In contrast, the relative Vg content in P. xylostella females from the mixed environment was lower than that in females from the B. campestris-, B. juncea-or B. oleracea-only environments. In conclusion, the mixed environment caused increased consumption of available energy resources(triglyceride) at the cost of retarding ovarian development and decreasing the amount of Vg produced.展开更多
BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are lacking.Reducing serum triglyceride(TG)levels quick...BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are lacking.Reducing serum triglyceride(TG)levels quickly is crucial in the early treatment of HTG-AP.Decreased serum TG levels are treated by non-invasive methods,which include anti-lipidemic agents,heparin,low-molecular weight heparin,and insulin,and invasive methods,such as blood purification including hemoperfusion(HP),plasmapheresis,and continuous renal replacement therapy.However,authoritative guidelines have not been established.Early selection of appropriate treatment is important and beneficial in controlling the development of HTG-AP.AIM To evaluate the effect between patients treated with intravenous insulin(INS)and HP to guide clinical treatment.METHODS We retrospectively reviewed 371 patients with HTG-AP enrolled in the Department of Fujian Provincial Hospital form April 2012 to March 2021.The inpatient medical and radiologic records were reviewed to determine clinical features,severity,complications,mortality,recurrence rate,and treatment.Multivariate logistic regression analyses were used to analyze risk factors for severe HTG-AP.Propensity score matching was used to compare the clinical outcomes of INS and HP.RESULTS A total of 371 patients met the HTG-AP criteria.The incidence of HTG-AP was increased by approximately 2.6 times during the 10 years(8.4%in April 2012-March 2013 and 22.3%in April 2020-March 2021).The highest incidence rate of acute pancreatitis was observed for men in the age group of 30-39 years.The amylase level was elevated in 80.1%of patients but was only three times the normal value in 46.9%of patients.The frequency of severe acute pancreatitis(26.9%),organ failure(31.5%),rate of recurrence(32.9%),and mortality(3.0%)of HTG-AP was high.Improved Marshall score,modified computed tomography severity index score,baseline TG,baseline amylase,C-reactive protein(CRP),albumin,aspartate aminotransferase,low-density lipoprotein cholesterol,urea nitrogen,creatinine,calcium,hemoglobin,free triiodothyronine,admission to intensive care unit,and mortality were significantly different between patients with different grades of severity(P<0.050).Multivariate logistic regression analysis confirmed that high CRP[P=0.005,odds ratio(OR)=1.011,95%CI:1.003-1.019],low calcium(P=0.003,OR=0.016,95%CI:0.001-0.239),and low albumin(P=0.023,OR=0.821,95%CI:0.693-0.973)were risk factors of severe HTG-AP.After propensity score matching adjusted by sex,age,severity of HTG-AP,and baseline TG,the serum TG significantly decreased in patients treated with INS(P<0.000)and HP(P<0.000)within 48 h.However,the clearance rate of TG(57.24±33.70%vs 56.38±33.61%,P=0.927)and length of stay(13.04±7.92 d vs 12.35±6.40 d,P=0.730)did not differ between the two groups.CONCLUSION The incidence of HTG-AP exhibited a significant increase,remarkable severity,and recurrent trend.Patients with mild and moderately severe acute pancreatitis can be treated effectively with INS safely and effectively without HP.展开更多
We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlip...We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels.The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis.Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal symptoms.As in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.展开更多
The brown planthopper(BPH),Nilaparvata lugens,an important rice insect pest,can enhance its virulence to BPH-resistant rice within as short a span as several generations.Here,we cloned a pancreatic triglyceride lipase...The brown planthopper(BPH),Nilaparvata lugens,an important rice insect pest,can enhance its virulence to BPH-resistant rice within as short a span as several generations.Here,we cloned a pancreatic triglyceride lipase(PTL)gene(NlPTL)in N.lugens,and found that its mRNA level was higher in the high virulence population(fed on variety Rathu Heenati,P-RH)than in the low virulence population(fed on variety Taichung Native 1,P-TN1).Knocking down NlPTL caused BPH individuals to spend more time in non-penetration and the pathway phases and less time feeding on the phloem of rice plants;these changes consequently decreased food intake,lipid content,survival rate,and fecundity in the insects.These findings reveal for the first time that PTL in BPH is involved in its virulence to rice plants.展开更多
基金supported by the National Natural Science Foundation of China(No.81172667 and No.81202203)
文摘Objective To investigate activation of brown adipose tissue （BAT） stimulated by medium-chain triglyceride （MCT）. Methods 30 Male C57BL/6J obese mice induced by fed high fat diet （HFD） were divided into 2 groups, and fed another HFD with 2% MCT or long-chain triglyceride （LCT） respectively for 12 weeks. Body weight, blood biochemical variables, interscapular brown fat tissue （IBAT） mass, expressions of mRNA and protein of beta 3-adrenergic receptors （β3-AR）, uncoupling protein-1 （UCP1）, hormone sensitive lipase （HSL）, protein kinase A （PKA）, and adipose triglyceride lipase （ATGL） in IBAT were measured. Results Significant decrease in body weight and body fat mass was observed in MCT group as compared with LCT group （P〈O.05） after 12 weeks. Greater increases in IBAT mass was observed in MCT group than in LCT group （P〈O.05）. Blood TG, TC, LDL-C in MCT group were decreased significantly, meanwhile blood HDL-C, ratio of HDL-C/LDL-C and norepinephrine were increased markedly. Expressions of mRNA and protein of β3-AR, UCP1, PKA, HSL, ATGL in BAT were greater in MCT group than in LCT group （P〈O.05）. Conclusion Our results suggest that MCT stimulated the activation of BAT, possible via norepinephrine pathway, which might partially contribute to reduction of the body fat mass in obese mice fed high fat diet.
文摘d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycerol. MCTs have been extensively investigated for their ability to reduce body fat accumulation. We previously investigated the anti-obesity effects of a combination of dietary d-allulose and MCT (5% - 13%) in rats;however, we could not confirm the anti-obesity effects of MCT or observed synergetic effects between d-allulose and MCT on body fat loss. We speculated that our previous studies were influenced by the excessive amount of MCT in the diets. Therefore, in this study, we aimed to investigate the anti-obesity effects of the simultaneous intake of d-allulose and MCT in rats fed an obesity-inducing high-fat diet with a low amount of MCTs (2%). Thirty-two male Wistar rats (3-week-old) were randomly divided into four groups: control, d-allulose, MCT, and d-allulose + MCT groups. Rats in each group were fed ad libitum on a control (no d-Allulose or MCT), 5% d-allulose, 2% MCT, or 5% d-allulose + 2% MCT diets for 16 weeks. Abdominal adipose tissue weights were significantly lower in the d-allulose diet group than in the control group, whereas no differences were observed between results of the MCT-supplemented groups. The total body fat mass was significantly lower in the d-allulose and MCT diet groups than in the control group, but no differences were observed between the MCT-supplemented groups. These results suggested that anti-obesity effects of dietary d-allulose were observed, and the effects of dietary MCTs were weaker than those of d-allulose. Moreover, we confirmed the interaction between dietary d-allulose and MCT on indicators of obesity. Interestingly, their effects were not synergistic, as MCT supplementation offset the anti-obesity effects of dietary d-allulose. However, the specific mechanisms underlying those effects remain unknown, warranting further investigation.
基金supported by Guangzhou Science and Technology Planning Project(No.202102080427)China Association against Epilepsy research foundation(No.CJ-2022-018).
文摘Background Medium-chain triglyceride ketogenic diet(MCTKD)is previously less commonly used in China.This study was aimed to assess the efficacy and safety of the modified MCTKD in the treatment of drug-resistant epilepsy in Chinese patients.Methods Patients with drug-resistant epilepsy were enrolled to receive treatment with modified MCTKD in Guangdong Sanjiu Brain Hospital during December 2020 and September 2022.The modified MCTKD contained fat that provided 50–70%of the total energy,as well as proteins and carbohydrates that provided 20–30%and 20%of energy,respectively.The fat component was composed of 20–30%medium-chain triglycerides(MCTs)and 30–40%long-chain triglycerides.The efficacy and safety of the diet were assessed at 1,3 and 6 months.Results A total of 123 patients aged 2.5 to 65 years,were included in this study.The response rates at 1,3 and 6 months were 49.6%,43.1%,and 30.9%,respectively.The seizure freedom rates at 1,3 and 6 months were 12.2%,10.6%,and 6.5%,respectively.The retention rates at 1,3 and 6 months were 98.4%,65.0%and 33.3%respectively.Side effects occurred in 21.14%of patients,which were predominantly gastrointestinal symptoms such as abdominal pain,diarrhea,vomiting,and constipation,and most of them resolved after dietary adjustments.A total of 82 patients(66.7%)discontinued the treatment with the reason of refusing to eat(8.1%),poor efficacy(35.0%),poor compliance(4.9%),and inability to follow-up(9.8%).Only 4 patients(3.3%)withdrew the diet due to side effects.Conclusions The modified MCTKD with MCTs providing 20–30%of energy has a good safety in patients with drug-resistant epilepsy,but its effectiveness needs to be enhanced.Further modifications of MCTKD with an optimal energy ratio are required to achieve a better efficacy and safety.
基金supported by the National Natural Science Foundation of China(31272454)
文摘The aim of this study was to investigate the effect of medium-chain triglycerides(MCTs) on growth performance, nutrient digestibility, plasma metabolites and antioxidant capacity in weanling pigs. A total of 160 weanling(Duroc × Landrace x Yorkshire) pigs(age: 21 ± 1 d; body weight: 7.50 ± 0.28 kg) were randomly allotted to 4 treatments, receiving the following diets for 28 d: control diet [containing 3.5%soybean oil(SO)], MCT1 diet(containing 0.7% MCTs and 2.8% SO), MCT2 diet(containing 1.4% MCTs and2.1% SO) and MCT3 diet(containing 2.1% MCTs and 1.4% SO). Dietary inclusion of MCTs improved the average daily gain and feed efficiency(FE) of pigs compared with the control during the first 2 weeks post-weaning(P < 0.05). A similar positive effect was also observed for the overall FE in MCT2 group(P < 0.05). Compared with the control, apparent total tract digestibility(ATTD) of ether extract was improved by MCT2 and MCT3 treatment from day 12-14 post-weaning(P < 0.05). In addition, MCT2 treatment also exerted a beneficial effect on the ATTD of dry matter(P < 0.05). The increased total protein concentration and decreased urea nitrogen and malondialdehyde levels of plasma were observed in both MCT2 and MCT3 groups on day 14 post-weaning(P < 0.05). In conclusion, MCTs could improve growth performance, nutrients utilization, and antioxidant ability of weanling piglets.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification of key prognostic factors to optimize the treatment approaches.Insulin resistance,as indicated by the triglyceride glucose(TyG)index,is increasingly recognized for its impact on cancer progression and immune modulation,and its potential role in GC prognosis is of particular interest.AIM To investigate whether the TyG index,a surrogate marker of insulin resistance,can predict the prognosis of patients with advanced GC receiving immunotherapy combined with chemotherapy.METHODS This retrospective study included 300 patients with advanced GC who received sintilimab combined with chemotherapy.The patients were categorized into two groups according to high or low TyG index,and independent prognostic factors for overall survival(OS)were determined using Cox proportional hazards regression analysis,which led to the development of a nomogram model.RESULTS Of the included patients,136 had a high TyG index and 164 had a low TyG index.The median progression-free survival of the high TyG index group was significantly longer than that of the low TyG index group.Similarly,the median OS of the high TyG index group was significantly longer than that of the low TyG index group.The ob-jective response and disease control rates in the two groups were 18.38%vs 9.15%and 58.82%vs 46.95%,res-pectively.No significant difference was noted in the incidence of adverse reactions at any level between the two groups(P>0.05).In multivariate analysis,the Eastern Cooperative Oncology Group score,programmed cell death ligand 1 expression,and TyG index acted as independent prognostic factors for OS.Of these factors,the hazard ratio of the TyG index was 0.36(95%confidence interval:0.36-0.55,P<0.001),and the nomogram model re-emphasized its importance as the main predictor of patient prognosis,followed by programmed cell death ligand 1 expression and the Eastern Cooperative Oncology Group score.CONCLUSION The TyG index is a long-term predictor of the efficacy of immunotherapy combined with chemotherapy,and patients with a high index have a better prognosis.
文摘BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus(T2DM)population remains scarce.AIM To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.METHODS Data were drawn from the ACCORD trial and its subsequent follow-up(ACCORDION),which together included 10190 participants.To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients,Cox’s proportional-hazards model was employed.Non-linear associations and thresholds were investigated by performing restricted cubic spline regression,fitting smooth curves,and conducting piecewise regression.Additionally,we examined whether the above findings were robust through interaction and subgroup analyses.The robustness of results was further verified by a series of sensitivity assessments.Through the area under the receiver operating characteristic curve estimation,the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.RESULTS Applying multivariable Cox regression analysis,we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality.Specifically,after adjusting for multiple confounders,the cardiovascular mortality,congestive heart failure(CHF)and overall mortality risks in the highest TyG-BMI quartile were 1.74,2.65 and 1.42 times greater,respectively,when compared to the lowest quartile.The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality,while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality.TyG-BMI was found to correlate positively with future CHF.Additionally,introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.CONCLUSION Among T2DM individuals,a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality,highlighting its utility as a predictive marker for these risks.
基金Supported by Sanming Project of Medicine in Shenzhen,No.SZZYSM202202010。
文摘BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.
文摘BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complications frequently arise,negatively impacting short-term recovery and significantly reducing patients’quality of life.In this context,accurately predicting the risk of postoperative recurrence and metastasis,coupled with targeted interventions,could substantially improve patient outcomes.The C-reactive protein-triglyceride-glucose index(CTI),a composite biomarker that integrates metabolic disturbances and systemic inflammation,has garnered increasing attention in oncology.The prognostic nutritional index(PNI),a composite measure based on serum albumin and peripheral blood lymphocyte count,is used to evaluate both the nutritional status and systemic immune function of patients.In recent years,both the CTI and PNI have demonstrated significant prognostic value in predicting tumor outcomes,assessing treatment responses,and formulating personalized treatment strategies.AIM To investigate whether the combined inflammation and insulin resistance marker,the CTI,can serve as a prognostic indicator for patients undergoing radical gastrectomy for gastric cancer.Additionally,it seeks to develop a predictive model by incorporating the PNI alongside CTI.METHODS This retrospective study included a total of 300 patients who underwent radical gastrectomy.The patients were classified into high and low CTI groups based on their CTI index.Cox proportional hazards regression analysis was performed to identify independent prognostic factors influencing overall survival(OS)and disease-free survival(DFS),and two nomogram models were developed.RESULTS Of the included patients,131 had a high CTI and 169 had a low CTI.The DFS period of the low CTI group was significantly longer than that of the high CTI group.The number of postoperative adjuvant treatments,T stage,N stage,CTI,and PNI were identified as independent prognostic factors for DFS.The hazard ratio for CTI was 2.07(95%confidence interval:1.36-3.17,P<0.001).In terms of OS,the OS period of the low CTI group was significantly longer than that of the high CTI group.Whether adjuvant treatment was administered,T stage,CTI,and PNI were independent prognostic factors for OS.The hazard ratio for CTI was 2.47(95%confidence interval:1.44-4.23,P=0.001).The nomogram models for OS and DFS further emphasized the importance of CTI as a key predictor of patient prognosis.CONCLUSION CTI is a long-term prognostic indicator for the outcome of radical gastrectomy for gastric cancer.Patients with lower CTI values have a better prognosis.The prediction models constructed by combining CTI with PNI has good predictive ability for DFS and OS after radical gastrectomy.
基金the National Natural Science Foundation of China(grant numbers 82070434,LYQ)。
文摘Background Cardiovascular disease(CVD)remains a major health challenge globally,particularly in aging populations.Using data from the China Health and Retirement Longitudinal Study(CHARLS),this study examines the Triglyceride-glucose(TyG)index dynamics,a marker for insulin resistance,and its relationship with CVD in Chinese adults aged 45 and older.Methods This reanalysis utilized five waves of CHARLS data with multistage sampling.From 17,705 participants,5,625 with TyG index and subsequent CVD data were included,excluding those lacking 2011 and 2015 TyG data.TyG derived from glucose and triglyceride levels,CVD outcomes via self-reports and records.Participants divided into four groups based on TyG changes(2011–2015):low-low,low-high,high-low,high-high TyG groups.Results Adjusting for covariates,stable high group showed a significantly higher risk of incident CVD compared to stable low group,with an HR of 1.18(95%CI:1.03–1.36).Similarly,for stroke risk,stable high group had a HR of 1.45(95%CI:1.11–1.89).Survival curves indicated that individuals with stable high TyG levels had a significantly increased CVD risk compared to controls.The dynamic TyG change showed a greater risk for CVD than abnormal glucose metabolism,notably for stroke.However,there was no statistical difference in single incidence risk of heart disease between stable low and stable high group.Subgroup analyses underscored demographic disparities,with stable high group consistently showing elevated risks,particularly among<65 years individuals,females,and those with higher education,lower BMI,or higher depression scores.Machine learning models,including random forest,XGBoost,CoxBoost,Deepsurv and GBM,underscored the predictive superiority of dynamic TyG over abnormal glucose metabolism for CVD.Conclusions Dynamic TyG change correlate with CVD risks.Monitoring these changes could predict and manage cardiovascular health in middle-aged and older adults.Targeted interventions based on TyG index trends are crucial for reducing CVD risks in this population.
基金Supported by the Science and Technology Planning Projects of Guizhou Province,No.QKHJC-MS[2025]384the Science and Technology Planning Projects of Zunyi City,No.ZSKHHZ(2023)470+3 种基金the WBE Liver Fibrosis Foundation,No.CFHPC2025028Chinese Foundation for Hepatitis Prevention and Control Muxin Research Fund of Chronic Hepatitis B,No.MX202404Beijing Liver and Gallbladder Mutual Aid Public Welfare Foundation Artificial Liver Special Fund,No.iGandanF-1082024-RGG018the Student Innovation and Entrepreneurship Training Program of Zunyi Medical University,No.2024106610923.
文摘Metabolic dysfunction-associated steatotic liver disease,characterized by pathological intracellular triglyceride(TG)accumulation,is mechanistically associated with the disrupted spatiotemporal regulation of hepatocyte nuclear factor(HNF)-dependent transcriptional programs.HNFs,including key members such as HNF-1α,HNF-4α,and HNF-6,constitute a liver-enriched family of transcription factors that govern hepatic lipid metabolism through hierarchical transcriptional regulatory networks.These networks critically regulate the dynamic equilibrium of TG metabolism,encompassing TG synthesis,storage,lipolysis,and lipoprotein-mediated export.This review comprehensively deciphers the molecular cascades through which HNF dysfunction exacerbates TG metabolic disorder in metabolic dysfunction-associated steatotic liver disease.Additionally,we evaluate emerging translational strategies targeting key HNF regulatory nodes and discuss current clinical challenges as well as potential solutions.
基金Supported by Austrian Federal Ministry of ScienceResearch and Economy and the National Foundation for ResearchTechnology and Development
文摘Hepatic steatosis defined as lipid accumulation in hepatocytes is very frequently found in adults and obese adolescents in the Western World. Etiologically, obesity and associated insulin resistance or excess alcohol intake are the most frequent causes of hepatic steatosis. However, steatosis also often occurs with chronic hepatitis C virus(HCV) infection and is also found in rare but potentially life-threatening liver diseases of pregnancy. Clinical significance and outcome of hepatic triglyceride accumulation are highly dependent on etiology and histological pattern of steatosis. This review summarizes current concepts of pathophysiology of common causes of hepatic steatosis, including non-alcoholic fatty liver disease(NAFLD), alcoholic fatty liver disease, chronic HCV infections, drug-induced forms of hepatic steatosis, and acute fatty liver of pregnancy. Regarding the pathophysiology of NAFLD, this work focuses on the close correlation between insulin resistance and hepatic triglyceride accumulation, highlighting the potential harmful effects of systemic insulin resistance on hepatic metabolism of fatty acids on the one side and the role of lipid intermediates on insulin signalling on the other side. Current studies on lipid droplet morphogenesis have identified novel candidate proteins and enzymes in NAFLD.
基金the BRET (Bardhan Research Education Trust) charity, which has supported funding for materials and equipment costs
文摘Bile acids(BAs) are essential for the absorption of lipids. BA synthesis is inhibited through intestinal farnesoid X receptor(FXR) activity. BA sequestration is known to influence BA metabolism and control serum lipid concentrations. Animal data has demonstrated a regulatory role for the FXR in triglyceride metabolism. FXR inhibits hepatic lipogenesis by inhibiting the expression of sterol regulatory element binding protein 1c via small heterodimer primer activity. Conversely, FXR promotes free fatty acids oxidation by inducing the expression of peroxisome proliferator-activated receptor α. FXR can reduce the expression of microsomal triglyceride transfer protein, which regulates the assembly of very low-density lipoproteins(VLDL). FXR activation in turn promotes the clearance of circulating triglycerides by inducing apolipoprotein C-Ⅱ, very low-density lipoproteins receptor(VLDL-R) and the expression of Syndecan-1 together with the repression of apolipoprotein C-Ⅲ, which increases lipoprotein lipase activity. There is currently minimal clinical data on triglyceride metabolism in patients with bile acid diarrhoea(BAD). Emerging data suggests that a third of patients with BAD have hypertriglyceridemia. Further research is required to establish the risk of hypertriglyceridaemia in patients with BAD and elicit the mechanisms behind this, allowing for targeted treatment.
基金supported by grants from Qingdao Diabetes Prevention Program and World Diabetes Foundation[WDF05–108 and WDF07–308]Qingdao Science & Technology department program [19-6-1-5-nsh]+1 种基金Qingdao Outstanding Health Professional Development FundQingdao Medical Research Guidance Program in 2017 [2017-WJZD129 and 2017-WJZD134]
文摘Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aimed to evaluate the ability of TG and TC to predict T2DM incidence.Methods Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012–2015.TG,TC,and T2DM status were measured.Cox proportional hazards models were used to estimate the association between TG,TC,and T2DM incidence.The receiver operating characteristic(ROC)curve was used to evaluate the ability of TG and TC to identify T2DM participants.Results The incidence of T2DM significantly increased with TG in women and TC in both men and women(Ptrend<0.05).Univariate Cox regression indicated that higher TG{borderline high TG[hazards ratio(HR):2.05;95%confidence interval(CI):1.40,3.00]and hypertriglyceridemia[HR:2.64;95%CI:1.68,4.15]}and TC[hypercholesterolemia(HR:2.05;95%CI:1.43,2.95)]were significantly associated with increased risk of T2DM incidence in women but not in men.Multivariate Cox regression showed that hypertriglyceridemia in women(HR:1.78,95%CI:1.07,2.97),borderline high TC in men(HR:1.61,95%CI:1.04,2.48),and hypercholesterolemia in women(HR:1.68,95%CI:1.81,2.61)had a higher significant risk of T2DM incidence.The optimal cutoff values of TG were>1.15 and>1.23 mmol/L in men and women,respectively.For TC,they were>5.17 and>5.77 mmol/L in men and women,respectively.The area under the ROCs of TG and TC were 0.54(0.51–0.57)and 0.55(0.52–0.58),respectively,in men,and 0.60(0.58–0.62)and 0.59(0.56–0.61),respectively,in women.Conclusion Elevated TG and TC were risk factors for T2DM incidence.However,no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women.Hence,TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.
文摘Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.However the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.
基金Supported by a Grant-in-Aid for Scientific Research from the Ministry of Education,Science,Sports and Culture of Japan and by a Grant from the Ministry of Health and Welfare of Japan
文摘AIM： To determine the real association between serum lipid levels and colonic polyp formation. METHODS： We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol （TC） and triglycerides （TG） in patients who underwent total colonoscopy for screening for colon cancer. RESULTS： Both levels were significantly elevated in patients with adenomas as compared with patients without any neoplastic lesion （TC 207.6 ± 29.5 vs 199.5 ±34.3, n= 4883, p〈 0.001; TG 135.0 ± 82.2 vs 108.7± 71.5, n= 4874, p〈 0.001）. The difference was significant in patients with tubular adenoma but not in those with villous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was an independent correlation factor in male （p〈0.01）, but not in female patients. The level of TG in patients with invasive carcinoma did not show a significant elevation from that in patients with adenoma. These findings suggest that hypertriglyceridemia is an independent risk factor for colonic adenoma in men. CONCLUSION： Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy may have benefit in men with hypertriglyceridemia.
基金supported by the grants from the project supported by the State Key Program of National Natural Science of China (No.31330060)the National Natural Science Foundation of China (Nos.31301446,31371757)the Program for New Century Excellent Talents in University (No.NCET-13-0534)
文摘The bioavailability of docosahexaenoic acid(DHA) and eicosapentaenoic acid(EPA) depends on their chemical forms. This study investigated the long-term effects of DHA-bound triglyceride(TG-DHA), DHA-bound phospholipid(PL-DHA), and the combination of TG-DHA and egg yolk phospholipid(Egg-PL) on lipid metabolism in mice fed with a high-fat diet(fat levels of 22.5%). Male C57BL/6J mice were fed with different formulations containing 0.5% DHA, including TG-DHA, PL-DHA, and the combination of TG-DHA and Egg-PL, for 6 weeks. Serum, hepatic, and cerebral lipid concentrations and the fatty acid compositions of the liver and brain were determined. The concentrations of serum total triglyceride(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-c), and hepatic TG in the PL-DHA group and the combination group were significantly lower than those in the high-fat(HF) group(P < 0.05). Atherogenic index(AI) of the PL-DHA group was significantly lower than that of the combination group(P < 0.05). Hepatic TC level in the combination group was significantly lower than that in the HF group(P < 0.05), but no significant difference was observed between the combination group and the PL-DHA group. Both the PL-DHA and the combination groups showed significantly increased DHA levels in the liver compared with the HF group(P < 0.05). However, there were no obvious increases in the cerebral DHA levels in all DHA diet groups. These results suggest that PL-DHA was superior to the combination of TG-DHA and Egg-PL in decreasing the AI. Long-term dietary supplementation with low amount of DHA(0.5%) may improve hepatic DHA levels, although cerebral DHA levels may not be enhanced.
基金supported by the Key Program of the National Natural Science Foundation of China(31230061)the special fund for Agro-scientific Research in the Public Interest,China(201103021)+1 种基金the Key Technologies R&D Program of China during the 12th Five-Year Plan period(2012BAD19B06)the Natural Science Foundation of Fujian Province,China(2013J01086)
文摘After exposure to mixed environments with multiple hosts, the frequency of flight take-offs for Plutella xylostella(L.) is known to increase with a concomitant decrease in female fecundity. The objective of the present study was to elucidate the physiological mechanism underlying the increased flight activity and decreased fecundity of P. xylostella in mixed-host environments. We measured ovariole length, and triglyceride and vitellogenin(Vg) content in P. xylostella females after they were released into different host environments consisting of either a single host(Brassica campestris, Brassica oleracea or Brassica juncea) or a mixture of all three hosts. Our results indicated that ovariole length varied significantly between female adults from different host environments. Females from the B. campestris environment had the longest ovarioles, whereas those from the mixed environment had the shortest ones. A negative correlation was found between ovariole length and the flight take-off frequency of P. xylostella adults. Additionally, there were significant differences in the triglyceride content of P. xylostella females from different host environments. Our data revealed that more triglyceride was consumed by P. xylostella female adults from B. oleracea and the mixed environments than those from environments containing only B. campestris or B. juncea. In contrast, the relative Vg content in P. xylostella females from the mixed environment was lower than that in females from the B. campestris-, B. juncea-or B. oleracea-only environments. In conclusion, the mixed environment caused increased consumption of available energy resources(triglyceride) at the cost of retarding ovarian development and decreasing the amount of Vg produced.
文摘BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are lacking.Reducing serum triglyceride(TG)levels quickly is crucial in the early treatment of HTG-AP.Decreased serum TG levels are treated by non-invasive methods,which include anti-lipidemic agents,heparin,low-molecular weight heparin,and insulin,and invasive methods,such as blood purification including hemoperfusion(HP),plasmapheresis,and continuous renal replacement therapy.However,authoritative guidelines have not been established.Early selection of appropriate treatment is important and beneficial in controlling the development of HTG-AP.AIM To evaluate the effect between patients treated with intravenous insulin(INS)and HP to guide clinical treatment.METHODS We retrospectively reviewed 371 patients with HTG-AP enrolled in the Department of Fujian Provincial Hospital form April 2012 to March 2021.The inpatient medical and radiologic records were reviewed to determine clinical features,severity,complications,mortality,recurrence rate,and treatment.Multivariate logistic regression analyses were used to analyze risk factors for severe HTG-AP.Propensity score matching was used to compare the clinical outcomes of INS and HP.RESULTS A total of 371 patients met the HTG-AP criteria.The incidence of HTG-AP was increased by approximately 2.6 times during the 10 years(8.4%in April 2012-March 2013 and 22.3%in April 2020-March 2021).The highest incidence rate of acute pancreatitis was observed for men in the age group of 30-39 years.The amylase level was elevated in 80.1%of patients but was only three times the normal value in 46.9%of patients.The frequency of severe acute pancreatitis(26.9%),organ failure(31.5%),rate of recurrence(32.9%),and mortality(3.0%)of HTG-AP was high.Improved Marshall score,modified computed tomography severity index score,baseline TG,baseline amylase,C-reactive protein(CRP),albumin,aspartate aminotransferase,low-density lipoprotein cholesterol,urea nitrogen,creatinine,calcium,hemoglobin,free triiodothyronine,admission to intensive care unit,and mortality were significantly different between patients with different grades of severity(P<0.050).Multivariate logistic regression analysis confirmed that high CRP[P=0.005,odds ratio(OR)=1.011,95%CI:1.003-1.019],low calcium(P=0.003,OR=0.016,95%CI:0.001-0.239),and low albumin(P=0.023,OR=0.821,95%CI:0.693-0.973)were risk factors of severe HTG-AP.After propensity score matching adjusted by sex,age,severity of HTG-AP,and baseline TG,the serum TG significantly decreased in patients treated with INS(P<0.000)and HP(P<0.000)within 48 h.However,the clearance rate of TG(57.24±33.70%vs 56.38±33.61%,P=0.927)and length of stay(13.04±7.92 d vs 12.35±6.40 d,P=0.730)did not differ between the two groups.CONCLUSION The incidence of HTG-AP exhibited a significant increase,remarkable severity,and recurrent trend.Patients with mild and moderately severe acute pancreatitis can be treated effectively with INS safely and effectively without HP.
文摘We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels.The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis.Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal symptoms.As in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.
基金This work was funded by the National Key Research and Development Program of China(2017YFD0200900)the Natural Science Foundation of Guangdong Province,China(2017A030310210).
文摘The brown planthopper(BPH),Nilaparvata lugens,an important rice insect pest,can enhance its virulence to BPH-resistant rice within as short a span as several generations.Here,we cloned a pancreatic triglyceride lipase(PTL)gene(NlPTL)in N.lugens,and found that its mRNA level was higher in the high virulence population(fed on variety Rathu Heenati,P-RH)than in the low virulence population(fed on variety Taichung Native 1,P-TN1).Knocking down NlPTL caused BPH individuals to spend more time in non-penetration and the pathway phases and less time feeding on the phloem of rice plants;these changes consequently decreased food intake,lipid content,survival rate,and fecundity in the insects.These findings reveal for the first time that PTL in BPH is involved in its virulence to rice plants.
