Nutritional Status and Physical Activity Pattern as Risk Factors for Non-Communicable Diseases among Occupational Bus Drivers

It is anticipated that occupational bus drivers are at risk of non-communicable diseases. Present study aims at assessing the nutritional status and analyzing the risk factors associated, which could increase the probability of non-communicable diseases among bus drivers and conductors working for Karnataka State Road Transport Corporation.120 professional drivers and conductors who attended annual health checkup were included. A pre designed questionnaire elicited information about anthropometry, dietary, physical activity and sleep pattern of the subjects. Lipid profile and blood glucose levels were recorded from annual health check up reports. Mean age of the subjects was 44 years with BMI ranging between 25- 29.9Kg/m2. 73.3% had mixed diet pattern, 40% skip their meals sometime and majority eat their meals outside home most of the days in a week.74.2% didn’t indulge in physical activity. 56.7% subjects slept six to seven hours per day. 17.5% were diabetic, 52.5%, 80.8% and 17.5%had higher serum triglycerides, Low Density Lipoprotein and total cholesterol respectively. 57.5% had lower High Density Lipoprotein levels. 8.3%, 21.7% and 15% were smokers, alcoholic and tobacco chewers respectively. ‘t’ test analysis showed significant difference between energy, protein and visible fat intake with that of Recommended Dietary Allowance and Estimated Average Requirement. Total cholesterol, Low Density Lipoprotein and serum triglycerides had positive correlation with energy, protein and visible fat intake and BMI. Considerable risk factors for non-communicable diseases were observed among the subjects; effective diet counseling with regular follow up and monitoring is necessary to prevent the same. Key words: Occupational drivers, nutritional status, risk factors, dietary pattern, physical activity, Non Communicable Diseases, effective counseling.

Metabolic and Anti-Inflammatory Effects of Antidepressants in Patients Diagnosed with Major Depressive Disorder: A Prospective Cohort Study

Introduction: There is growing evidence showing a correlation between major depression disorder (MDD), metabolic syndrome and inflammation. To examine the influence of antidepressant medications on the metabolic, inflammatory profiles, oxidative stress and endothelial derangement of patients suffering from MDD. Results Depressive patients displayed significantly higher serum triglycerides than control group, which increased significantly during eight weeks of antidepressive treatment. In the patients' group, serum levels of ALT and AST increased significantly during treatment. Serum peroxide level was significantly higher in patients before and during treatment vs. controls and decreased significantly in the patients' group during treatment. Macrophage chemoattractant protein-1 and hs-CRP serum levels were higher in patients before treatment as compared with controls. The percentage of gated IgM CD19+ and CD14+ cells in depressive patients before treatment was significantly higher than in the control group. The percentage of T regulatory cells increased significantly during antidepressive treatment. Discussion MDD patients had increased oxidative stress, inflammatory responses, metabolic derangements and endothelial injury. Antidepressant medications increased the percentage of T regulatory cells. Methods Twenty-nine patients aged 22-58 who were diagnosed with MDD but not medicated, were selected for the study. During the 8-week duration of the research, patients received anti-depressant medication.

Hypertriglyceridemia-associated acute pancreatitis: Response to continuous insulin infusion

Objective To assess the response of serum triglycerides (TG) to continuous insulin infusion (CII) in adults with hypertriglyceridemia-associated acute pancreatitis (HTGP). Methods Retrospective analysis of TG response to standardized CII therapy in 77 adults admitted to intensive care with TG >1000 mg/dL and HTGP. Results Participants had initial TG 3869.0 [2713.5, 5443.5] mg/dL and were 39.3 ± 9.7 years old, 66.2% males, 58.4% Hispanic, BMI 30.2 [27.0, 34.8] kg/m2, 74.0% with diabetes mellitus (DM) and 50.6% with excess alcohol use. TG-goal, defined as ≤1,000 ± 100 mg/dL, was achieved in 95%. Among the 73 TG-goal achievers (responders), 53.4% reached TG-goal in <36 hours after CII initiation (rapid responders). When compared to slow responders taking≥36 hours, rapid responders had lower initial TG (2862.0 [1965.0, 4519.0] vs 4814.5 [3368.8, 6900.0] mg/dL), BMI (29.4 [25.9, 32.8] vs 31.9 [28.2, 38.3] kg/m2), DM prevalence (56.4 vs 94.1%), and reached TG-50% (half of respective initial TG) faster (12.0 [6.0, 17.0] vs 18.5 [13.0, 32.8] hours). Those with DM (n = 57) vs non-DM (n = 20) were obese (31.4 [28.0, 35.6] vs 27.8 [23.6, 30.3] kg/m2), took longer to reach TG-final (41.0 [25.0, 60.5] vs 14.5 [12.5, 25.5] hours) and used more daily insulin (1.7 [1.3, 2.1] vs 1.1 [0.5, 1.9] U/kg/day). Among those with DM, the rapid responders had higher daily use of insulin vs slow responders 1.9 [1.4, 2.3] vs 1.6 [1.1, 1.8] U/kg/day. All results significant. In multivariable analysis, predictors of faster TG response were absence of DM, lower BMI and initial TG. Conclusion CII was effective in reaching TG-goal in 95% of patients with HTGP. Half achieved TG-goal within 36 hours. Presence of DM, higher BMI and initial TG slowed the time to reach TG-goal. These baseline parameters and rate of decline to TG-50% may be real-time indicators to initiate and adjust the CII for quicker response.

Kalanchoe Pinnata aqueous extract has the potential to improve haematological profile and fatigue status of mice subjected to Free Swimming Endurance Test

Introduction: Kalanchoe pinnata extracts have been shown to possess beneficial cardiovascular effects, analgesic and myorelaxant activities. This study aimed at evaluating the haematological and anti-fatigue effects of its aqueous extract. Materials and methods: This was an in vivo pharmacological experiment, carried out in the Laboratory of Zoology, University of Buea, from January to May 2018. A total of 48 mice were subjected to a 90mins/day-free endurance swimming test for 14 days. Two groups of mice received distilled water and 12% NaCl solution, respectively. Five groups received the plant extract (25, 50, 100 and 200 mg/kg/day) and 200mg/kg/day+NaCl. One positive control group received 5% Vitamin C (1.97mg/kg/day). All administrations were by gavage. Maximum swimming time, glycaemia, lactatemia, uremia, triglyceridemia, haematological indices, tissue glutathion peroxidase, malondialdehyde, glucose and creatine kinase-MB in the heart or gastrocnemius muscle were measured. Results: K. pinnata (50 and 100mg/kg/day) induced a non-significant increase of the swimming duration, compared to neutral control. However, the 12%NaCl group recorded a significant (P<0.05) increase. In the blood, NaCl induced a decrease of platelets that was significantly reverted by the extract in the 200mg/kg+NaCl group. The extract prevented the increase of the level of CK-MB in NaCl group and decreased the serum triglycerides, glucose, urea nitrogen and Lactate levels. In the tissues, MDA and CK-MB levels significantly increased (P<0.001) in the negative control. These increases were significantly (P<0.001) prevented by K. pinnata (200mg/kg/day). Conclusions: Significant biochemical variations support the hypothesis that K. pinnata could be used to delay exercise induced fatigue.

Effect of Triphala Kajjali tablet - an Ayurvedic herbomineral formulation for the management of metabolic syndrome: a single case study

Metabolic syndrome (MS) is a group of disorders that includes abdominal obesity, diabetes, hypertension, and elevated cholesterol. Approximately 25% of the adult populations are affected by MS. Gradually this number is increasing because of poor lifestyles, faulty dietary pattern, physical inactivity, stressful life and rapid urbanization. A 50-year-old female patient visited to OPD of Kayachikitsa department ITRA, Jamnagar, with the complaints of gradual weight gain with excess body fat around the abdomen and waist region, numbness and burning sensation at bilateral feet, and breathlessness on exertion. After investigation, she was diagnosed as a case of MS as per National Cholesterol Education Program (NCEP), adult treatment panel III (revised in 2005) guideline. She was treated with Triphala Kajjali tablet for 12 weeks along with lifestyle modification. After completion of treatment, investigations revealed reduction in fasting blood sugar from 113 mg/dL to 80 mg/dL, serum cholesterol level was decreased to 148 mg/dl from 216 mg/dl, serum triglycerides level was reduced to 150 mg/dL from 187 mg/dL and serum LDL was reduced to 68.3 mg/dl from 118.7 mg/dl. Her weight reduced to75 kg from 85 kg, and waist circumference reduced to 92 cm from 100cm, and blood pressures also reduced up to 122/82 mmHg from 140/90 mmHg. Hence, it can be concluded that Triphala Kajjali tablet along with lifestyle modification are effective in the management of MS, as it possesses Kapha Medohara properties.

Endogenous Leptin Concentrations Poorly Predict Metreleptin Response in Patients with Partial Lipodystrophy

Context Leptin replacement with metreleptin improves glycemia and hypertriglyceridemia in severely hypoleptinemic patients with Generalized Lipodystrophy (GLD), but its effects are variable in partially leptin-deficient patients with Partial Lipodystrophy (PLD). Objective Compare three leptin assays (Study I); identify diagnostic performance of leptin assays to detect responders to metreleptin for each assay (Study II). Design Study I: cross-sectional analysis of average bias between leptin assays. Study II: retrospective analysis of diagnostic accuracy of potential leptin cut-points to detect clinical responders to metreleptin. Setting National Institutes of Health (NIH); University of Michigan. Participants and Interventions Study I: Metreleptin-naïve patients with lipodystrophy (GLD, n=33, PLD, n=67) and healthy volunteers (n=239). Study II: GLD (n=66) and PLD (n=84) patients treated with metreleptin for 12 months. Outcome Measures Leptin concentrations by Millipore RIA; Millipore ELISA (MELISA); R&D systems ELISA, (RDELISA). Response to metreleptin therapy was defined as either reduction ≥1.0% in A1c or ≥30% in serum triglycerides. Results RDELISA measured 3.0±9.5 ng/mL higher than RIA; MELISA measured 11.0±17.8 and 14.0±19.2 less than RIA and RDELISA, respectively. Leptin by RIA, MELISA, and RDELISA modestly predicted metreleptin response in GLD+PLD (ROC AUC 0.74, 0.69, and 0.71, respectively; p&lt;0.01 for all) with lower predictive power in PLD (ROC AUC 0.63, 0.61 and 0.65, respectively; p&gt;0.05 for all). The only reproducible cut-point identified on sensitivity analyses was RIA leptin 7.2 ng/mL (sensitivity 56%; specificity 78%). Conclusions Three common leptin assays are not interchangeable, and a reliable cut-point to select responders to metreleptin was not identified.

Genetic Polymorphisms and Clinical Features in Diabetic Patients With Fatty Liver: Results From a Single-Center Experience in Southern Italy

Genetic background may be involved in the promotion and progression of non-alcoholic fatty liver disease (NAFLD). Previous studies have suggested that the single nucleotide polymorphisms (SNPs) may be associated with the specific clinical features in the patients with hepatic steatosis; however, data on the patients with diabetes from Southern Italy are lacking. We enrolled 454 patients and 260 of them had type 2 diabetes. We studied the PNPLA3 rs738409, LPIN1 rs13412852, KLF6 rs3750861, SOD2 rs4880, TM6SF2 rs58542926, and ZNF624 rs12603226 SNPs and their distribution in the study population. Lipid profile, liver stiffness, and kidney function were also studied to understand the potential role of the SNPs in the development of clinical phenotypes. No differences were observed in the distribution of polymorphisms between the diabetic and non-diabetic subjects. Carriers of risk allele G for PNPLA3 rs738409 SNP showed a lower mean value of serum triglycerides and a higher liver stiffness. Risk allele for KLF6 rs3750861 and SOD2 rs4880 polymorphism had a lower estimated glomerular filtration rate (eGFR) value, whereas no differences in the glucose and glycated hemoglobin level were observed in the subgroups by the different genotypes. Genetic polymorphisms are useful to identify the patients at higher risk of development of liver fibrosis and lower eGFR values in the patients with diabetes and NAFLD. Their use in clinical practice may help the clinicians to identify the patients who require a more strict follow-up program.

The Ablation of T1R1 Reduces Lipid Accumulation Through Reducing the De Novo Lipid Synthesis and Improving Lipid Metabolism in Mice

Background: That cells sense extracellular amino acids to regulate intracellular lipid metabolism has been a heated debate in terms of the study on amino acid nutrition. T1R1 is a membrane G protein-coupled receptor that senses amino acids in a variety of cells. In our study, T1R1-KO mice was used to explore the function of umami taste receptor in lipid metabolism. Results: Compared with wild-type mice, T1R1-KO mice showed Significantly lighter adipose tissue weight, reduced serum triglycerides (TG) and total cholesterol (TC), as well as higher glucose tolerance on chow diet. Moreover, there were less lipid accumulation in adipose and liver tissue and shrink of the adipocyte size in T1R1-KO mice. And a decreased expression of lipogenesis genes (PPARγ, CEBPα, SREBP1) was found in both adipose and liver tissue. To further study the mechanism of T1R1 regulating liver lipid metabolism, proteomics analysis was introduced and the up-regulated proteins were enriched in lipid and steroid metabolism pathways of T1R1-KO mice. Further PRM verification analysis showed that the ablation of T1R1 reduced the de novo synthesis of lipids through BCKDHA and BCKDHB, and promoted lipid metabolism through CYP7B1 and IGFBP2. Conclusions: Our results showed that the disruption of T1R1 in mice could reduce body lipid accumulation, and our data clarifies the role of umami receptors in lipid metabolism and could provide a basis for the research on nutrition and obesity.

Ethanolic Extracts of the Gongronema latifolium Stem and Leaves Caused Mild Renal Injury and Modulated Serum Triglycerides in Rats

Gongronema latifolium is a tropical plant with verse traditionally and medicinal uses in mostly Africa and Asia. In this work, we determined the biochemical effects of G. latifolium ethanolic extracts in male Wistar rats. The G. latifolium stem and leaves were air-dried separately, macerated, and extracted in 80 % ethanol. The Wistar rats were assigned into three groups randomly; control was administered distilled water, the treatment groups respectively were given 200 mg/kg bw of the extracts of leaves or stem for twenty-eight (28) days. Data showed that the rat serum ALT and ALP activities were lower in the extract-treated group than in the control group administered distilled water. In the rat liver, there were significant differences (p<0.05) in biochemical parameters compared to the control group as the extract-treated group showed a reduction in ALT, AST, and ALP activities. Meanwhile, the oral administration of the G. latifolium extracts led to the elevated (p<0.05) level of serum urea, while the serum triglycerides and creatinine levels were reduced compared with the control. Together, the data suggest that G. latifolium extracts at the doses tested had minimal renal toxicity.