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The brain, particularly the hypothalamus and brainstem, monitors and integrates circulating metabolic signals, including gut hormones. Gut–brain communication is also mediated by the vagus nerve, which transmits various gut-derived signals. Recent advances in our understanding of molecular gut–brain communication promote the development of next-generation anti-obesity medications that can safely achieve substantial and lasting weight loss comparable to metabolic surgery. Herein, we comprehensively review the current knowledge about the central regulation of energy homeostasis, gut hormones involved in the regulation of food intake, and clinical data on how these hormones have been applied to the development of anti-obesity drugs. Insight into and understanding of the gut–brain axis may provide new therapeutic perspectives for the treatment of obesity and diabetes.

A retrospective cohort study from Korea found that simvastatin/ezetimibe combination therapy was linked to a reduced rate of major adverse cardiovascular events (MACE) compared with simvastatin monotherapy and was more effective in individuals with T2DM than in those without T2DM [7]. [...]a meta-analysis encompassing seven randomized clinical trials (RCTs) revealed that a combination of statins and ezetimibe reduced the incidence of MACEs more effectively than statins alone, especially in patients with T2DM compared to those without T2DM [8]. Patients with T2DM have been shown to exhibit a notable increase in the expression of NPC1L1 mRNA in the duodenum compared to those without T2DM [11]. [...]a significant association has been established between chylomicron cholesterol level and NPC1L1 mRNA expression in patients with T2DM [11]. The potential mechanisms underlying the greater reduction of atherosclerotic plaque progression attributed to ezetimibe have been explained by not only its cholesterol-lowering effects, but also its pleiotropic effects such as anti-inflammatory effects, reduction of the absorption of plant sterols, inhibition of smooth muscle cell proliferation, and anti-platelet effects [19]. [...]the addition of ezetimibe to statin therapy is anticipated to significantly improve the pathogenesis of atherosclerosis, especially in individuals with T2DM. [...]the duration of the study was relatively short. [...]extended long-term studies are required to confirm the influence of statin/ezetimibe combination therapy on insulin sensitivity and vascular inflammation in comparison with statin monotherapy.

Accumulated evidence from genetic animal models suggests that the brain, particularly the hypothalamus, has a key role in the homeostatic regulation of energy and glucose metabolism. The brain integrates multiple metabolic inputs from the periphery through nutrients, gut-derived satiety signals and adiposity-related hormones. The brain modulates various aspects of metabolism, such as food intake, energy expenditure, insulin secretion, hepatic glucose production and glucose/fatty acid metabolism in adipose tissue and skeletal muscle. Highly coordinated interactions between the brain and peripheral metabolic organs are critical for the maintenance of energy and glucose homeostasis. Defective crosstalk between the brain and peripheral organs contributes to the development of obesity and type 2 diabetes. Here we comprehensively review the above topics, discussing the main findings related to the role of the brain in the homeostatic regulation of energy and glucose metabolism. Metabolism: Stability maintained by the brain Highly coordinated interactions between the brain and other organs of the body are critical for controlling the supply of energy from food. Min-Seon Kim and colleagues at the University of Ulsan in South Korea review these interactions, particularly the role of hypothalamus, a part of brain. They focus on the processes that keep energy supply and glucose metabolism within appropriate limits. The brain monitors energy intake by sensing gut hormones released when we eat, and by detecting nutrients in the blood. The brain also receives signals reporting the amounts of fatty or “adipose” tissue in the body. In response to these and other signals the brain controls food intake and metabolism. Understanding the systems that control glucose and energy balance will help to develop new drugs to combat obesity and diabetes.

The ORs of moderate/severe NAFLD were significantly higher in the lowest quartile than in the highest quartile for SMA/ BMI, NAMA/BMI, and NAMA/TAMA in men. [...]the ORs of intermediate/high liver fibrosis scores as assessed by NFS and FIB-4 scores increased linearly with decreasing quartile for SMA/BMI, NAMA/BMI, and NAMA/TAMA in each sex (P for trend <0.001 for all). Myosteatosis results from ectopic fat accumulation in skeletal muscle when available lipids exceed the disposal capacity of adipose tissue. Since intramyocellular fat serves as an energy source to promote muscle contraction, it is not necessarily abnormal. Extramyocellular fat accumulation is mostly pathologic and involves either intramuscular (between muscle fibers) or intermuscular (between muscle bundles) accumulation. Since myosteatosis increases with age and increase in visceral adipose tissue, it is characteristically associated with insulin resistance and liver steatosis [9].

Intervertebral disc (IVD) degeneration can cause chronic lower back pain (LBP), leading to disability. Despite significant advances in the treatment of discogenic LBP, the limitations of current treatments have sparked interest in biological approaches, including growth factor and stem cell injection, as new treatment options for patients with chronic LBP due to IVD degeneration (IVDD). Gene therapy represents exciting new possibilities for IVDD treatment, but treatment is still in its infancy. Literature searches were conducted using PubMed and Google Scholar to provide an overview of the principles and current state of gene therapy for IVDD. Gene transfer to degenerated disc cells in vitro and in animal models is reviewed. In addition, this review describes the use of gene silencing by RNA interference (RNAi) and gene editing by the clustered regularly interspaced short palindromic repeats (CRISPR) system, as well as the mammalian target of rapamycin (mTOR) signaling in vitro and in animal models. Significant technological advances in recent years have opened the door to a new generation of intradiscal gene therapy for the treatment of chronic discogenic LBP.

Background Elevated remnant cholesterol (remnant-C) is considered a risk factor for cardiovascular disease (CVD); however, whether this notion applies to the East Asian population with type 2 diabetes (T2D) has not been established. This study investigated the association between remnant-C concentrations and the risk of CVD in Korean patients with T2D. Methods By using the Korean National Health Insurance Service database, 1,956,452 patients with T2D and without atherosclerotic CVD who underwent regular health checks between 2009 and 2012 were included. Cox regression analyses were conducted to assess the association between remnant-C concentrations and incident CVD comprising myocardial infarction (MI) and ischemic stroke. Results In total, 50,120 (2.56%) cases of MI and 73,231 (3.74%) cases of ischemic strokes occurred during a median follow-up of 8.1 years. The adjusted hazard ratios for MI and stroke in the highest remnant-C quartile were 1.281 (95% confidence interval [CIs], 1.249–1.314) for MI and 1.22 (1.195–1.247) for ischemic stroke, compared to those in the lowest quartiles. The results were similar, based on stratified analysis by age, sex, use of statin or fibrate, and levels of other cholesterol. The increased risk of CVD in the highest remnant-C quartile was profound in patients who had a longer T2D duration. A remnant-C concentration ≥ 30 mg/dL differentiated patients who were at a higher risk of CVD, compared to patients with a lower concentrations, regardless of whether LDL-C levels were or were not on target at ≤ 100 mg/dL. Conclusion In Korean patients with T2D, remnant-C was associated with CVD, independent of the LDL-C level or other conventional CVD risk factors. Our finding confirmed evidence of the causal role of remnant-C on CVD, as a residual risk of CVD, in East Asian patients with T2D.

Possible links between periodontitis and various cardiometabolic and autoimmune diseases have been advocated on the basis of chronic inflammation or oxidative stress. However, the association between periodontitis and thyroid dysfunction is under-researched. Participants without previous thyroid disease or ongoing thyroid-related medication were included from a nationwide population-level survey. Participants were categorized into tertiles of thyroid stimulating hormone (TSH) levels (first tertile < 1.76 mIU/L; second tertile 1.76–2.83 mIU/L; third tertile > 2.83 mIU/L), and periodontal condition was assessed using the Community Periodontal Index. Of the total of 5468 participants, 1423 had periodontitis (26%). A significant difference in the weighted prevalence of periodontitis according to TSH tertiles was observed, with the highest prevalence in the first tertile (26.5%) and the lowest prevalence in the third tertile (20.9%, p  = 0.003). Subjects in the first TSH tertile had higher odds for periodontitis than those in the third tertile (OR 1.36, 95% CI 1.10–1.68; p for trend = 0.005) after adjusting for covariates. This association was consistent across subgroups and within sensitivity analyses among subjects without specific factors affecting thyroid function or diseases reported to be related to periodontitis. The present study demonstrated that low TSH levels were associated with significantly higher odds for periodontitis.

The triglyceride-glucose (TyG) index is a simple surrogate marker of insulin resistance. We evaluated the association of the TyG index with low muscle mass using a nationwide population-based representative data. This is a cross-sectional study that included 9477 participants aged ≥ 40 years from the Korea National Health and Nutrition Examination Survey between 2008 and 2011. The TyG index was calculated as ln[triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. Dual-energy X-ray absorptiometry was used to measure appendicular lean mass (ALM). Low muscle mass was defined an ALM/weight of 2 standard deviations (SD) below of young participants. The overall prevalence of low muscle mass was 4.7%. The prevalence of low muscle mass increased linearly with the quartiles of the TyG index, 2.5%, 4.2%, 5.6%, and 6.7% in Q1–Q4, respectively. The TyG index was negatively associated with ALM/weight both in men ( r  = − 0.302) and women ( r  = − 0.230). The odds ratio (OR) for low muscle mass was 2.08 in the highest quartile compared to the lowest quartile. High TyG index was associated with an increased risk of low muscle mass (OR for 1SD increase: 1.13). Increased TyG index was associated with the risk of low muscle mass independent of confounding factors.

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This study investigates how university students perceive the ecosystem services provided by gardens, utilizing Q methodology to categorize subjective viewpoints and analyze distinct perception types. Thirty-two students majoring in forest and landscape architecture at Wonkwang University (Iksan, Republic of Korea) participated, sorting 30 Q-statements each for provisioning, regulating, cultural, and supporting services. Principal component analysis identified three factors for provisioning and regulating services, and two factors for cultural and supporting services. The findings reveal that students’ perceptions are primarily based on generalized, idealized expectations, while their understanding of specific practices, such as food production, distribution, and community economic integration, remains insufficient. This indicates that their perceptions are more conceptual than practical, reflecting themes such as eco-friendly resource sharing, environmental regulation, nature experience, biodiversity enhancement, and sustainability. These results suggest the need for enhanced educational efforts to improve students’ understanding of the role of ecosystem services in urban contexts. The study highlights the importance of bridging the gap between theoretical knowledge and practical recognition to foster more comprehensive perceptions, ultimately informing future garden design, management strategies, and environmental education programs.