Objective: In addition to controlling seasonal and circadian rhythms, melatonin has been recognized as a potential gene associated with type 2 diabetes (T2D). This study aimed to investigate the impact of resistance and interval training on serum melatonin and its receptors expression (MTNR1A, MTNR1B) in pancreatic tissue of type 2 diabetic rats. Materials and Methods: To achieve this, T2D was established in 21 male Wistar rats through an 8-week high-fat diet followed by an intraperitoneal injection of STZ (25 ml/kg), then were divided to control (no exercise), resistance (resistance training), and interval (interval training) groups. Exercise interventions lasted 8 weeks (5 time/weekly). Fasting glucose, serum insulin and melatonin, beta cell function, MTNR1A and MTNR1B expression in pancreatic tissue were assessed 48 hours following lasting exercise and analyzed among groups using a one-way ANOVA test. Results: Both resistance and interval training led to significant increase in insulin and beta cell function and significant decrease in glucose, serum melatonin, MTNR1A and MTNR1B expression in pancreatic tissue compared with control group (P< 0.05). Significant difference were not observed in all variables between interval and resistance groups (P> 0.05). Conclusion: Resistance and interval training are associated with increased insulin in T2D rats, and this improvement may be attributed to decreased melatonin and its receptor expression in pancreatic beta cells. Additional research is required to elucidate alternative mechanisms that contribute to elevated insulin levels.
Objective: Knowledge of the current status of diabetes in Yazd is crucial for health policy planning, maintaining stable disease prevalence rates and risk factors, and establishing evaluation indicators. This study aimed to investigate the prevalence of diabetes in Yazd Province in accordance with acceptable international standards in 2018–2019. Materials and Methods: A cross-sectional descriptive study was conducted in Yazd Province in 2018 2019. The study population included all individuals living in the geographical areas of Yazd Province in 2018 2019 who had sought medical or preventive services at health centers or pharmacies. Data were obtained through collaboration with the Health Deputy (APPLE project), the Food and Drug Deputy (provincial pharmacies), insurance organizations (medical services, social security, relief committee, armed forces, banks, etc.), and the Diabetes Treatment Research Center. Results: After removing duplicate data, 95,798 diabetic patients were registered. Approximately 58% of the patients were female and 42% were male. The mean age of the patients was 59.2 ± 13.34 years. About 68% of the patients were receiving insulin treatment. Conclusion: Considering the importance of diabetes and its increasing prevalence globally and especially in Yazd Province, and in order to implement a monitoring and continuous care program for the disease, an effort was made to present the overall picture of diabetes in the province.
Objective: Among diabetic patients, diabetic retinopathy (DR) remains one of the most common causes ofpreventable blindness and vision loss, making its early detection crucial for preventing irreversiblecomplications. Manual evaluation of fundus photographs is a lengthy process. Additionally, it requiresspecialized training that is not always available in all clinical settings. Consequently, artificial intelligence-basedautomated retinal image analysis systems have emerged as complementary tools to enhance diagnostic accuracyand efficiency. This study proposes an ensemble learning-based framework to improve the accuracy androbustness of automated DR detection. In the first stage, pretrained convolutional neural network (CNN) modelsextract high-level features from fundus images, capturing complex patterns and DR-related lesions. Thesefeatures are then fed into several classical machine-learning classifiers, including Support Vector Machine(SVM), Random Forest, and XGBoost. To further boost discriminative power and reduce classification errors,a stacking ensemble strategy integrates the predictions of the individual classifiers within a meta-learningframework, enabling the model to learn the optimal combination for DR detection and grading. This hybridapproach effectively combines the strengths of deep learning and classical machine learning, yielding improvedperformance in DR detection and classification. Experimental results show that the stacking ensemble achieveshigher accuracy and F1-score compared to individual models, underscoring its potential as an auxiliary tool for early diabetic retinopathy detection.
Insulin resistance (IR) is a central pathophysiological hallmark of type 2 diabetes mellitus (T2D) and relatedcardio-metabolic disorders. This narrative review explores the impact of regular physical activity, particularlyaerobic and resistance exercise, on the mitigation of IR through various molecular mechanisms. Geneticpredispositions, chronic low-grade inflammation, dysregulated circulating metabolites, hormonal imbalances,oxidative stress, and abnormal enzymatic activities collectively contribute to the pathogenesis of IR. Physicalactivity, especially aerobic exercise, has significant anti-IR effects by modulating inflammatory processes.This includes suppression of pro-inflammatory cytokines (e.g., TNF-α, IL-6) and adipokines (e.g., resistin,visfatin), as well as an increase in anti-inflammatory myokines (e.g., irisin, muscle-derived IL-6) andadiponectin/emilin-1 profiles. These changes create an anti-inflammatory environment that enhances insulinsignaling in skeletal muscle, liver, and adipose tissue. Hormonal adjustments, such as improved insulinsecretion, beta-cell function, and tissue sensitivity, further support these metabolic adaptations. Additionally,exercise reduces oxidative stress by strengthening antioxidant defenses and inhibiting key IR-promotingenzymes like PTP1B and 11β-HSD1. This preservation of tyrosine phosphorylation of the insulin receptor anddownstream IRS-1/PI3K/Akt pathway activation leads to increased GLUT4 translocation and glucose uptake.In summary, regular exercise is a cost-effective, non-pharmacological intervention that targets interconnectedmolecular factors in the etiology of IR. These diverse effects highlight its therapeutic potential in personalizedprevention and management strategies for IR and associated metabolic diseases, warranting its integration intoclinical guidelines.
Objective: The development, industrialization, the nature of work, technical and economic reasons, and increasing demand for services jobs have made shift work common. The aim of this study was investigation of association between Prevalence of Diabetes Mellitus and Coronary Heart Disease (CHD) including Angina and Heart Failure with Shift Work in Adults of Shahedieh cohort study in Yazd. Materials and Methods: The data of this study were from the cross-sectional phase of the Shahedieh Cohort Study. The data of 9513 participants in the study were used to analyze the data. Data were analyzed using SPSS 22 software. Chi-square test was used to examine the relationship between independent and dependent variables and t-test was used to compare means. Binary logistic regression was also used for statistical modeling. Significance level less than 0.05 were considered. Results: Our subjects' shift work prevalence was 6.7% (n= 633). The crude odds ratio of shift work was calculated for diabetes mellitus and CHD (OR= 0.38, CI: 0.28-0.51) and (OR= 0.52, CI: 0.36-0.72) respectively, which were statistically significant. But by adjusting age and sex, the odds ratio reached (OR= 0.75, CI: 0.55-1.01) and (OR= 0.86, CI: 0.57-1.28) respectively which was not statistically significant. By adjusting other confounders, the odds ratio reached (OR= 0.76, CI: 0.55-1.04) for diabetes and (OR= 0.84, CI: 0.55-1.28) for CHD. Conclusion: No significant association was found between shift work with diabetes and CHD in our study. Age and gender were essential confounders in our study.
Obesity and inflammation are major risk factors for various diseases, and metabolic syndrome is a complex disorder characterized by insulin resistance, dyslipidemia, hypertension, and abdominal obesity. Aerobic exercise appears to reduce obesity-induced inflammation. The purpose of this study was to review the molecular mechanisms of aerobic exercise in modulating adipose tissue apoptosis and inflammation in individuals with metabolic syndrome. Studies related to the intrinsic apoptotic pathway in women with metabolic syndrome evaluated the effects of aerobic exercise on apoptotic signaling pathways and adipose tissue inflammation. Aerobic exercise appears to increase the expression of the BCL-2 gene and decrease the expression of BAX and caspase-3, thereby delaying the apoptotic process. In addition, aerobic exercise reduced body fat percentage, fasting insulin levels, insulin resistance, and was associated with decreased apoptosis and inflammation of adipose tissue in individuals with metabolic syndrome. The findings indicate that aerobic exercise exerts significant beneficial effects on factors associated with metabolic syndrome and may represent an appropriate and effective strategy for appetite regulation in individuals with metabolic syndrome.
Objective: The present study was conducted to make a comparison between the effectiveness of acceptance and commitment therapy and emotion-focused therapy on Physical-social anxiety in obese individuals. Materials and Methods: The research method was a quasi-experimental design with a pre-test/post-test design and follow-up with a control group. 45 women aged 20 to 30 were selected through convenience sampling and randomly assigned to two experimental groups and a control group (15 people in each group). Then, the experimental groups were treated for 8 treatment sessions, 90 minutes each week. Results: The results showed, there was a significant difference between the effectiveness of acceptance and commitment therapy and emotion- focused therapy on Physical-social anxiety in obese women. Accordingly, acceptance and commitment therapy was more effective than emotion-focused therapy in reducing Physical-social anxiety in obese individuals. Conclusion: Acceptance and commitment therapy and emotion-focused therapy can be effective strategies for reducing socio-physical anxiety in overweight women.
This study provides a systematic comparison of the mathematical properties, strengths, and limitations of traditional statistical methods and machine learning models in diabetes forecasting. While classical approaches like logistic regression and ANOVA offer interpretability and simplicity, their reliance on linear assumptions and sensitivity to heteroscedasticity limit their utility in modeling complex, nonlinear relationships inherent in diabetes data. In contrast, machine learning techniques-including neural networks, random forests, and gradient boosting-excel in capturing high-dimensional interactions and nonlinear dynamics, achieving superior predictive accuracy. However, these gains come at the cost of computational complexity, black box interpretability challenges, and ethical concerns around algorithmic bias. Through a detailed analysis of mathematical frameworks (e.g., activation functions, regularization, ensemble methods), we demonstrate how hybrid approaches integrating explainable AI (XAI) can bridge the gap between statistical rigor and clinical usability. Our findings highlight the critical trade-offs between model interpretability, predictive power, and scalability, offering actionable insights for optimizing diabetes risk prediction in precision medicine
Objective: The rising occurrence of type 2 diabetes mellitus in Iraq, impacted by changes in lifestyle and strain on the healthcare system, is worsened by the significant issue of inadequate treatment adherence. As a result, this scenario leads to inadequate glycemic control and an increased risk of severe disease complications. The objective of this research was to assess medication adherence and quality of life (QOL) in indivduals with type 2 diabetes at the Al-Hilla Diabetic Center in 2023. Materials and Methods: A cross-sectional study was carried out at diabetic centers and outpatient clinics in Marjan Hospital and Imam Al-Sadiq Hospital in Al-Hilla City, Babylon Province, Iraq. A total of 355 patients with T2DM who were attending diabetic centers and hospitals in Al-Hilla, Babylon were included in the study using a convenience sampling method. Regression linear tests were utilized to explore the factors that may influence adherence. Results: The data analysis showed that the QOL was relatively good (47.32± 22.13) and medication adherence was 4.64± 1.42. This study indicated that age significantly influences the QOL of patients with T2DM (P≤ 0.001). Additionally, medication adherence was found to be significantly associated with age, work, educational level, income, and living condition (P≤ 0.001), while there was no statistical significance observed with marital status and gender (P≥ 0.001). Conclusion: Diabetes Nurse Specialists need to consider factors that impact QOL and develop strategies to enhance both QOL and medication adherence.
Objective: This study aimed to investigate the relationship between particulate matter (PM) and electrocardiogram, blood pressure, and fasting blood sugar in people with type 2 diabetes mellitus. Materials and Methods: In this study, we collected laboratory and clinical information from 270 patients with type 2 diabetes (T2DM) who were hospitalized at educational hospitals affiliated with Abadan University of Medical Sciences from March 21, 2023, to March 19, 2024. Information related to the concentrations of PM10 and PM2.5 was received from the Khuzestan Environmental Organization. To explore the relationship between PM2.5 and PM10 with clinical and laboratory factors, the Pearson Correlation Coefficient was utilized. Results: The study showed that 53.3% of the patients were male, and the mean age was 60.32 (± 12.16) years. No significant relationship was observed between PM10 and PM2.5 with fasting blood sugar (P= 0.291), (P= 0.516), random blood sugar (P= 0.804), (P= 0.829), P-R interval (P= 0.289), (P= 0.163), S-T segment (P= 0.700), (P= 0.517), QRS voltage (P= 0.956), (P= 0.505), systolic blood pressure (P = 0.587), (P= 0.478) and diastolic blood pressure (P= 0.229), (P= 0.347). However, a significant relationship was observed between PM 10 and PM 2.5 with the Q-T interval (P= 0.042) and (P= 0.010). Conclusion: Based on the results of the present study, no significant relationship was observed between PM with Clinical and laboratory parameters in people with type 2 diabetes, and only the relationship between PM and Q-T interval, which is one of the electrocardiographic parameters, was significant.
Objective: To assess the feasibility of a nurse-led multidisciplinary intervention to improve self- management, psychological distress, and medication adherence in patients with type 2 diabetes (T2D) in Iran, informing a future definitive randomized controlled trial (RCT). Materials and Methods: This single-blind, parallel-group pilot RCT will recruit 60 adults with T2D (HbA1c> 6.5%) from the Yazd Diabetes Research Center, Iran. Participants will be randomized 1:1 to a 6‑month intervention or usual care. The intervention, grounded in self-efficacy theory and motivational interviewing, comprises 3 months of in-person/online counseling (three sessions targeting American Diabetes Association–endorsed self-care behaviors: diabetes knowledge, nutrition counseling, physical activity, glucose monitoring, medication adherence, and cardiovascular risk reduction) delivered by a nurse-led team (endocrinologist, dietitian, psychologist), followed by 3 months of biweekly telephone follow-ups. Feasibility outcomes include recruitment (>70%), retention (>80%), acceptability (Likert score >4/5), and data completeness (>90%). Exploratory outcomes include HbA1c, fasting blood sugar, low-density lipoprotein, blood pressure, anthropometric indices, dietary self-management assessed by the Diabetes Self-Management Questionnaire-Revised, diabetes-related distress measured by the Diabetes Distress Scale-17, and medication adherence evaluated by the Medication Adherence Report Scale-5, collected at baseline, 3 months, and 6 months. Data will be analyzed descriptively (proportions, means, 95% CIs) using SPSS v25. Results: It is merely a proposed research protocol that can be used in the future. Conclusion: This pilot will evaluate the feasibility of a culturally tailored, nurse-led multidisciplinary intervention for T2D management in Iran, providing data to refine a definitive RCT and inform care models in resource-constrained settings
Objective: The present study aimed to predict psychological distress based on mindfulness and resilience with the mediation of cognitive flexibility in diabetic patients. Materials and Methods: This study is descriptive-correlational in nature and was conducted using structural equation modeling. The statistical population consisted of all diabetic patients visiting hospitals in Mashhad city. Using purposive and volunteer sampling methods, 115 individuals were selected as the sample. Participants completed The Kessler Psychological Distress Scale (K10), The Five Facet Mindfulness Questionnaire (FFMQ), The Connor-Davidson Resilience Scale (CD-RISC), and Cognitive Flexibility Inventory (CFI). Inferential statistics were employed, utilizing structural equation modeling (SEM), while inferential analysis evaluated hypotheses and assessed the structural relationships using SPSS version 22 and LISREL version 3. Results: The descriptive results indicated the following scores for the study variables: psychological distress (M= 15.43± 10.81), mindfulness (M= 132.93± 36.30), resilience (M= 78.76± 15.95), and cognitive flexibility (M= 56.81± 20.91).The analyses confirmed significant relationships: resilience and mindfulness directly affect psychological distress and indirectly influence it through cognitive flexibility, with all effects being statistically significant (P< 0.05). Conclusion: In conclusion, fostering mindfulness and resilience, alongside enhancing cognitive flexibility, offers a promising approach for alleviating psychological distress in patients with diabetes. Future studies should explore targeted intervention strategies to effectively strengthen these psychological resources, ultimately contributing to better disease management and quality of life.
Objective: Bulimia nervosa is frequently associated with elevated rumination and early maladaptive schemas. The aim of this study was to investigate the effectiveness of compassion-focused therapy (CFT) in reducing rumination and early maladaptive schemas among women with bulimia nervosa. Materials and Methods: This quasi-experimental study utilized a pretest-posttest control group design. Fifty women with a confirmed DSM-5 diagnosis of bulimia nervosa were recruited via convenience sampling from the Ahvaz Eating Disorders Association and randomly assigned to either an experimental group (n= 25) receiving compassion-focused therapy (8 sessions, 90 minutes each) or a no-intervention control group (n= 25). Rumination was assessed using the Rumination Response Scale (RRS), and early maladaptive schemas were measured with the 75-item Early Maladaptive Schema Questionnaire-Short Form. Data were analyzed using analysis of covariance (ANCOVA) in SPSS-25. Results: After controlling for pretest scores, women who received CFT showed significantly greater reductions in both rumination (P< 0.001) and early maladaptive schemas (P< 0.001) compared to the control group. Large effect sizes were observed for both outcomes (η²> 0.70). Conclusion: CFT is an effective intervention for reducing rumination and early maladaptive schemas in women with bulimia nervosa. These findings support the clinical utility of CFT in targeting core cognitive- emotional maintenance factors in this population and suggest that it may be a valuable treatment option for bulimia nervosa
Diabetes prevalence and mortality are rising worldwide. Despite multiple treatments, optimal blood sugarcontrol in type 2 diabetes remains challenging. This has prompted interest in whether antidepressants couldinfluence glycemic management. However, studies examining their effects on blood glucose have reportedinconsistent and sometimes conflicting results. This article will discuss the effects that different anti-depressants may have on blood sugar and lipid levels. We plan to focus chiefly on tricyclic antidepressants(TCAs), selective serotonin reuptake inhibitors (SSRIs) and serotonin/norepinephrine reuptake inhibitors(SNRIs). To achieve the aim of the present study, we searched PubMed using separate strategies thatcombined Title/Abstract keywords and MeSH terms related to type 2 diabetes and different classes ofantidepressants (SSRIs, SNRIs, TCAs, agomelatine, and benzodiazepines) to ensure comprehensive coverageof relevant evidence. For type 2 diabetic patients, the principal achievement was that SSRIs of all types couldreduce blood sugar, and they particularly had been shown to stimulate the body’s own insulin response.Patients lost weight and blood sugar control improved with fluoxetine. The purpose of this review is todescribe the existing information and also point out shortcomings in previous studies, as well as providingdirections for future research on how various antidepressants affect their patients' metabolic outcomesalongside potential mental status changes. These relationships are important to understand, not only forplanning effective treatments for diabetes but also in order to manage the complicated metabolic-psychiatriccontinuum
Type 2 diabetes mellitus (T2DM) is a long-term metabolic condition marked by reduced insulin release, decreased sensitivity to insulin, and hyperglucagonemia. In recent years, dipeptidyl peptidase-4 (DPP-4) inhibitors have become increasingly significant within the newer classes of antidiabetic medications, thanks to their distinct mechanism of action, advantageous safety profile, and the convenience of oral administration. In contrast to sulfonylureas, which have a significant risk of causing hypoglycemia, DPP-4 inhibitors offer insulin stimulation that depends on glucose levels, making them a safer choice for many patients. The aim of this study is to investigate the mechanisms and efficacy of DPP-4 inhibitors in clinical practice. The incretin effects of DPP-4 inhibitors are mediated by the hormone glucagon-like peptide-1 (GLP-1) and glucose- dependent insulinotropic polypeptide (GIP). GLP-1 and GIP stimulates insulin secretion. Furthermore, DPP-4 inhibitors hinder apoptosis in cells. For example, suppressing apoptosis in cardiac, renal, and pancreatic beta cells may be advantageous for enhancing insulin secretion and minimizing complications related to diabetes. DPP-4 inhibitors reduce inflammatory cytokines and chemokines by inhibiting nuclear factor kappa-light- chain-enhancer of activated B cells (NF-κB). In addition, they mitigate inflammation through modulation of immune cell activity and upregulation of anti-inflammatory chemokines and adipokines. Also, DPP-4 inhibitors have antioxidant roles, such as improving antioxidant factors and downregulating oxidant agents. Considering that T2DM is characterized as an inflammatory disease, DPP-4 inhibitors elevate insulin secretion and sensitivity, improve glycemic indices, and mitigate diabetic complications through incretin, anti- inflammatory, and antioxidant effects
Objective: Obesity and sleep disorders are major health concerns in children, with long-term consequences for physical and mental health. Numerous studies have shown a correlation between poor sleep quality and obesity, highlighting the importance of a deeper investigation into this matter. This study aims to examine the association between sleep quality and obesity in elementary school children in Kerman in 2023. Materials and Methods: This cross-sectional study was conducted on 384 children aged 7-13 years. Demographic data and sleep quality were gathered using the Pittsburgh Sleep Quality Index (PSQI). Weight status was assessed by appropriate anthropometric measurements. Data were analyzed with SPSS software version 29, using T-tests and ANOVA. Results: Sleep quality in obese children was significantly lower than in children with normal or overweight status (P< 0.001). Additionally, sleep quality decreased with age (P< 0.001). Gender (P= 0.222), family income (P= 0.625), and chronic illness (P= 0.664) had no significant effect on sleep quality. Conclusion: While obesity and age were significant indications of poor sleep quality, gender, income level, and health history were not. These results highlight the importance of obesity management and awareness among parents and educators regarding the importance of sleep quality in children's academic performance and mental health.
This review investigates the vital role of resistance training as a therapeutic method for women with metabolicsyndrome, a condition characterized by insulin resistance, high blood pressure, abnormal lipid levels, andcentral obesity. The primary goal of the review is to consolidate existing research on how resistance trainingimpacts metabolic health in this group. A thorough review of peer-reviewed studies was conducted, especiallythose published in the last twenty years. The analysis focused on studies exploring how resistance traininginfluences metabolic factors such as insulin sensitivity, glucose metabolism, lipid profiles, and bodycomposition in women with metabolic syndrome. The literature indicates that resistance training significantlyincreases muscle mass, improves blood sugar regulation, and positively affects lipid profiles, reducing waistsize, total cholesterol, and LDL cholesterol levels. Furthermore, the review emphasizes that resistance trainingenhances insulin sensitivity and decreases serum triglyceride levels. The review concludes that resistancetraining is crucial for managing metabolic syndrome in women, helping to improve metabolic health andoverall well-being.
Objective: SIRT1 is a key regulator of adipose tissue's energy balance, inflammation, and mitochondrial function. This study was designed to investigate the effect of different training modalities, Moderate-Intensity Aerobic Training (MIAT), High-Intensity Aerobic Training (HIAT), and High-Intensity Interval Training (HIIT), on SIRT1 gene expression in subcutaneous adipose tissue of male Wistar rats. Materials and Methods: Thirty-two 8-week-old male Wistar rats (237 ± 33 g) were randomly assigned to four groups (n= 8): Control, MIAT, HIAT, and HIIT. Animals were housed under controlled conditions and had free access to food and water. Training protocols were performed five times per week for eight weeks. After 12 hours of fasting and 24 hours post-intervention, subcutaneous abdominal adipose tissue was collected. SIRT1 gene expression was analyzed using RT-PCR. Data were statistically evaluated using one-way ANOVA and LSD post hoc test (P< 0.05) in SPSS-22. Results: The results showed that all three training models - MIAT (P= 0.023), HIAT (P= 0.001), and HIIT (P= 0.003) - significantly increased SIRT1 gene expression compared to the control group. Conclusion: Although all training modalities significantly increased SIRT1 gene expression compared to the control group, the HIAT group showed the highest mean expression level. However, no statistically significant difference was observed between the training groups.
Objective: Foeniculum vulgare has been suggested as a potential option for the management of hyperglycemia. This study aimed to evaluate the anti-hyperglycemic effects of the hydro-ethanolic extract of Foeniculum vulgare seeds (HEEFVS) in alloxan-induced diabetic rats. Materials and Methods: Thirty-six male rats were randomly divided into six groups (I–VI). Diabetes was induced by intraperitoneal injection of alloxan (175 mg/kg) in groups II–VI. Groups I and II received distilled water; groups III, IV, and V were treated with HEEFVS at doses of 100, 200, and 400 mg/kg body weight/day, respectively; and group VI received glibenclamide (5 mg/kg body weight/day). Serum glucose, total cholesterol (TC), triglycerides (TG), aspartate transaminase (AST), alanine transaminase (ALT), and histological analysis of the liver were assessed. Results: Administration of HEEFVS at 200 and 400 mg/kg significantly decreased ALT and AST activities (P< 0.001). Total cholesterol levels were significantly reduced (P< 0.001) at all tested doses (100, 200, and 400 mg/kg). Triglyceride levels showed a significant reduction (P< 0.01) only at the 400 mg/kg dose. During the second and third weeks, administration of 200 and 400 mg/kg markedly reduced glucose levels (P< 0.001). Complete regeneration of liver tissue was observed in the 400 mg/kg group, while partial restoration was seen in the 100 mg/kg and 200 mg/kg groups. DPPH radical scavenging and α-amylase inhibitory activities of HEEFVS demonstrated IC50 values of 146.6 µg/ml and 8.47 µg/ml, respectively. The LD50 of HEEFVS was greater than 3500 mg/kg. Conclusion: HEEFVS exhibits strong hepato-protective, hypolipidemic and anti-hyperglycemic effects.
