Explore the vast range of titles available.

Aims While lifestyle modification is known to offer several metabolic benefits, there is paucity of comprehensive data on changes in biomarkers of adiposity, inflammation as well as gut hormones. We investigated these biomarkers in overweight/obese individuals with prediabetes randomized to either 4 months of a lifestyle improvement program or standard care and followed them up for a year. Methods Participants [standard care and intervention arm ( n  = 75 each)] were randomly selected from the Diabetes Community Lifestyle Improvement Program trial. Glycemic and lipid control and anthropometric measurements were assessed by standard protocols. Adipokines, inflammatory markers and gut hormones were measured using multiplex and standard ELISA kits. Results Along with modest benefits in primary outcomes (glycemic and lipid control and weight reduction), participants in the intervention group showed significant reductions ( p  < 0.001) in plasma levels of leptin (17.6%), TNF-α (35%), IL-6 (33.3%), MCP-1 (22.3%) and PYY (28.3%) and increased levels of adiponectin (33.1%) and ghrelin (23.6%) at the end of 4 months of lifestyle intervention. The changes were independent of weight and persisted even at 1 year of follow-up. In contrast, participants from the standard care arm did not show any statistically significant improvements on the above parameters. Conclusions Participants who underwent an intensive lifestyle improvement program showed metabolic benefits as well as favorable beneficial changes in systemic levels of adipokines, cytokines and gut hormones, not only during the intervention period, but also during 12-month follow-up period.

Neighborhoods encompass complex environments comprised of unique economic, physical, and social characteristics that have a profound impact on the residing individual’s health and, collectively, on the community’s wellbeing. Neighborhood disadvantage (ND) is one of several factors that prominently contributes to racial breast cancer (BC) health disparities in American women. African American (AA) women develop more aggressive breast cancer features, such as triple-negative receptor status and more advanced histologic grade and tumor stage, and suffer worse clinical outcomes than European American (EA) women. While the adverse effects of neighborhood disadvantage on health, including increased risk of cancer and decreased longevity, have recently come into focus, the specific molecular mechanisms by which neighborhood disadvantage increases BC risk and worsens BC outcomes (survivorship, recurrence, mortality) are not fully elucidated. This review illuminates the probable biological links between neighborhood disadvantage and predominantly BC risk, with an emphasis on stress reactivity and inflammation, epigenetics and telomere length in response to adverse neighborhood conditions.

Several studies reported the negative impact of elevated neutrophil/lymphocyte ratio (NLR) on outcomes in many surgical and medical conditions. Previous studies used arbitrary NLR cut-off points according to the average of the populations under study. There is no data on the average NLR in the general population. The aim of this study is to explore the average values of NLR and according to race in adult non-institutional United States individuals by using national data. The National Health and Nutrition Examination Survey (NHANES) of aggregated cross-sectional data collected from 2007 to 2010 was analyzed; data extracted included markers of systemic inflammation (neutrophil count, lymphocyte count, and NLR), demographic variables and other comorbidities. Subjects who were prescribed steroids, chemotherapy, immunomodulators and antibiotics were excluded. Adjusted linear regression models were used to examine the association between demographic and clinical characteristics and neutrophil counts, lymphocyte counts, and NLR. Overall 9427 subjects are included in this study. The average value of neutrophils is 4.3 k cells/mL, of lymphocytes 2.1k cells/mL; the average NLR is 2.15. Non-Hispanic Black and Hispanic participants have significantly lower mean NLR values (1.76, 95% CI 1.71-1.81 and 2.08, 95% CI 2.04-2.12 respectively) when compared to non-Hispanic Whites (2.24, 95% CI 2.19-2.28-p<0.0001). Subjects who reported diabetes, cardiovascular disease, and smoking had significantly higher NLR than subjects who did not. Racial differences regarding the association of smoking and BMI with NLR were observed. This study is providing preliminary data on racial disparities in a marker of inflammation, NLR, that has been associated with several chronic diseases outcome, suggesting that different cut-off points should be set according to race. It also suggests that racial differences exist in the inflammatory response to environmental and behavioral risk factors.

Background The Systemic Immune-Inflammation Index (SII) is a novel biomarker of systemic inflammation. We explored the association between the SII and metabolic syndrome (MetS) and its components in middle-aged and older adults. Methods We included 2755 participants (1305 men) aged 45–84 years from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort from examination 5 (2010–2012). Logistic regression was employed to assess the relationship between the SII and MetS, as well as its components. Results A total of 1082 participants (463 men) were diagnosed with MetS. On a continuous scale, the SII was positively associated with MetS (odds ratio (OR): 1.23, 95% confidence interval (CI): 1.05–1.46) and its components including hyperglycemia (1.23: 1.05–1.44) and elevated blood pressure (BP) (1.47: 1.14–1.89). When analyzed on a quartile scale, participants in the quartile 4 of SII had 32% and 63% higher prevalence of hyperglycemia and elevated BP, respectively, compared to those in the quartile 1 (P for trend: 0.021 and < 0.001, respectively). Additionally, we identified 40% higher prevalence of low HDL-C in quartile 2 of the SII compared to quartile 1 (1.40; 1.07–1.83) (P trend = 0.454). In subgroup analysis, general obesity status modified the relationship between SII and abdominal obesity, showing a positive association in obese individuals (1.72: 1.00-2.95) and a negative association (0.80: 0.66–0.97) in non-obese individuals (P for interaction = 0.009). Conclusions Higher SII scores were associated with an increased likelihood of MetS, hyperglycemia, and high BP among middle-aged and older adults. Longitudinal studies are needed to determine the causal relationships between SII and the development of MetS, as well as to assess the potential role of SII as a screening tool in clinical practice.

The genetic background of Brazilians encompasses Amerindian, African, and European components as a result of the colonization of an already Amerindian inhabited region by Europeans, associated to a massive influx of Africans. Other migratory flows introduced into the Brazilian population genetic components from Asia and the Middle East. Currently, Brazil has a highly admixed population and, therefore, the study of genetic factors in the context of health or disease in Brazil is a challenging and remarkably interesting subject. This phenomenon is exemplified by the genetic variant CCR5Δ32, a 32 base-pair deletion in the CCR5 gene. CCR5Δ32 originated in Europe, but the time of origin as well as the selective pressures that allowed the maintenance of this variant and the establishment of its current frequencies in the different human populations is still a field of debates. Due to its origin, the CCR5Δ32 allele frequency is high in European-derived populations (~10%) and low in Asian and African native human populations. In Brazil, the CCR5Δ32 allele frequency is intermediate (4-6%) and varies on the Brazilian States, depending on the migratory history of each region. CCR5 is a protein that regulates the activity of several immune cells, also acting as the main HIV-1 co-receptor. The CCR5 expression is influenced by CCR5Δ32 genotypes. No CCR5 expression is observed in CCR5Δ32 homozygous individuals. Thus, the CCR5Δ32 has particular effects on different diseases. At the population level, the effect that CCR5Δ32 has on European populations may be different than that observed in highly admixed populations. Besides less evident due to its low frequency in admixed groups, the effect of the CCR5Δ32 variant may be affected by other genetic traits. Understanding the effects of CCR5Δ32 on Brazilians is essential to predict the potential use of pharmacological CCR5 modulators in Brazil. Therefore, this study reviews the impacts of the CCR5Δ32 on the Brazilian population, considering infectious diseases, inflammatory conditions, and cancer. Finally, this article provides a general discussion concerning the impacts of a European-derived variant, the CCR5Δ32, on a highly admixed population.

Recently, many studies explored the role of inflammation parameters such as neutrophil-to-lymphocyte ratio (NLR) in the prognosis of urinary cancers, but the results were not consistent. We carried out a meta-analysis of published studies to assess the prognostic value of NLR in patients with urinary cancers. Hazard ratio (OR) with 95% confidence interval (CI) was used to assess the association of NLR and OS and RFS/CSS. The pooled results showed that high NLR was a poor predictor for OS with HR of 1.81 (95%CI: 1.48-2.21; Pheterogeneity = 0.005) and RFS/CSS (HR = 2.07, 95% CI: 1.65-2.6; Pheterogeneity = 0.849). Subgroup analyses revealed that high NLR yielded a worse OS in RCC (HR = 1.9, 95%CI: 1.47-2.45; Pheterogeneity = 0.003) and a poor RFS/CSS in RCC (HR = 1.83, 95%CI: 1.35-2.48; Pheterogeneity = 0.709), bladder cancer (HR = 2.2, 95%CI: 1.27-3.8; Pheterogeneity = 0.447) and urothelial carcinoma (HR = 2.58, 95%CI: 1.66-4.01; Pheterogeneity = 0.784). Our results showed that NLR could act as a significant biomarker in the prognosis of urinary cancers.

Hispanic adults have an increased incidence of type 2 diabetes (T2D) at a younger age and diagnosis of certain cancers, including liver, stomach, and colorectal, which may be attributed to metabolic health. Several key metabolic health indicators, such as hemoglobin A1c (HbA1c), body mass index (BMI), and waist-to-hip ratio (WHR), have been linked to obesity. The purpose of this pilot study was to explore the complex relationships between socio-behavioral factors that lead to the increased incidence of metabolic syndrome (e.g., HbA1c) and chronic inflammation (interleukins) in Hispanics. Two hundred and twelve Hispanic participants (Mage = 43.45, SD = 15.36) who identified predominantly as female (72.17%) were included in the study. Correlational analyses revealed that HbA1c was positively associated with age and negatively associated with several socio-behavioral factors, including overall health, quality of life, physical health, physical performance, social support, mother’s education, and father’s education. These findings highlight the importance of social support and parental involvement in diabetes management. The focused integration of socio-behavioral and biological data provides a powerful foundation for future research and the development of targeted interventions.

ObjectiveBariatric surgery has a significant impact on levels of thyroid hormones and various inflammatory markers in obesity. The relationship between changes in thyroid hormones and inflammatory markers after bariatric surgery is unknown. We aimed to investigate the changes in thyroid hormones and their relations to inflammatory changes after laparoscopic sleeve gastrectomy (LSG) in Chinese patients with morbid obesity.MethodsEighty-eight patients with morbid obesity (56.8% female; age 30.9 ± 9.5 years; BMI 39.9 ± 5.7 kg/m2) submitted to LSG were selected. Patients were subdivided into euthyroid group and subclinical hypothyroidism (SH) group. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), inflammatory markers, and related metabolic indexes were analyzed pre- and 12 months post-LSG.ResultsSH patients presented significantly higher interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) than euthyroid patients. Twelve-month post-surgery, the SH incidence decreased from 31.8 to 2.3% (P < 0.001). TSH levels were declined significantly in both groups but were more pronounced in SH group (P < 0.001), whereas no change in FT4 in either group. Additionally, we observed marked reduction of IL-6, TNF-α, and CRP in SH group, as well as TNF-α and CRP in euthyroid group. After adjusting for age, baseline BMI, and changes in BMI, decrease in TSH correlated significantly with decreased HOMA-IR and TNF-α in euthyroid group and decreased fasting insulin (FINS), IL-6, TNF-α, and CRP in SH group.ConclusionLSG promotes TSH reduction in patients with morbid obesity that is more pronounced in patients with SH and correlated with improved inflammatory state after surgery.

OBJECTIVE: Many studies have documented associations between inflammation and type 2 diabetes incidence. We assessed potential variability in this association in the major U.S. racial/ethnic groups. RESEARCH DESIGN AND METHODS: Incident type 2 diabetes was assessed among men and women aged 45-84 years without prior clinical cardiovascular disease or diabetes in the prospective Multi-Ethnic Study of Atherosclerosis. Interleukin (IL)-6, fibrinogen, and C-reactive protein (CRP) were measured at baseline (2000-2002); fasting glucose and diabetes medication use was assessed at baseline and three subsequent in-person exams through 2007. Type 2 diabetes was defined as use of diabetes drugs or glucose ≥126 mg/dl. Covariates included baseline demographics, clinic, smoking, alcohol, exercise, hypertension medication, systolic blood pressure, insulin resistance, and BMI. Cox proportional hazards regression was used to calculate hazard ratios (HRs) by quartiles of CRP, IL-6, and fibrinogen. RESULTS: Among 5,571 participants (mean age 61.6 years, 53% female, 42.1% white, 11.5% Chinese, 25.7% black, and 20.7% Hispanic), 410 developed incident diabetes during a median follow-up time of 4.7 years (incidence 16.8 per 1,000 person-years). CRP, IL-6, and fibrinogen levels were associated with incident diabetes in the entire sample. After adjustment, the associations were attenuated; however, quartile 4 (versus quartile 1) of IL-6 (HR 1.5 [95% CI 1.1-2.2]) and CRP (1.7 [1.3-2.4]) remained associated with incident diabetes. In stratified analyses, similar associations were observed among white, black, and Hispanic participants. CONCLUSIONS: Higher levels of inflammation predict short-term incidence of type 2 diabetes in a multiethnic American sample.

Obesity-driven Type 2 diabetes (T2D) is a systemic inflammatory condition associated with cardiovascular disease. However, plasma cytokines and tissue inflammation that discriminate T2D risk in African American women with obese phenotypes are not well understood. We analyzed 64 circulating cytokines and chemokines in plasma of 120 African American women enrolled in the Black Women's Health Study. We used regression analysis to identify cytokines and chemokines associated with obesity, co-morbid T2D and hypertension, and compared results to obese women without these co-morbidities, as well as to lean women without the co-morbidities. We then used hierarchical clustering to generate inflammation signatures by combining the effects of identified cytokines and chemokines and summarized the signatures using an inflammation score. The analyses revealed six distinct signatures of sixteen cytokines/chemokines (P = 0.05) that differed significantly by prevalence of T2D (P = 0.004), obesity (P = 0.0231) and overall inflammation score (P < E-12). Signatures were validated in two independent cohorts of African American women with obesity: thirty nine subjects with no metabolic complications or with T2D and hypertension; and thirteen breast reduction surgical patients. The signatures in the validation cohorts closely resembled the distributions in the discovery cohort. We find that blood-based cytokine profiles usefully associate inflammation with T2D risks in vulnerable subjects, and should be combined with metabolism and obesity counselling for personalized risk assessment.