The influence of preoperative psychological profiles on weight loss following sleeve gastrectomy (SG) has not been thoroughly examined, particularly with respect to sex differences. To analyze the preoperative psychological profiles of individuals with obesity and explore whether sex differences exist in the associations between preoperative psychological factors and weight loss after SG. This prospective cohort study involved participants scheduled for SG at an affiliated hospital between November 2020 and September 2022, with a follow-up period of 1-year post-surgery. Preoperative psychological profiles were assessed using validated scales, covering anxiety, depression, self-esteem, internalized weight bias, eating behaviors, sleep quality, and quality of life. Independent t-tests and Pearson correlation analyses were used to assess sex differences and associations between psychological factors and

BackgroundAfter a myocardial infarction (MI), one of the major factors responsible for bad outcomes is systemic inflammation. It is known that diet and physical activity (PA) have separate effects on inflammation, but it is still unclear what the combined effects are in patients who have already suffered a heart attack.MethodsOver 6 months, 1,700 post-MI patients in this retrospective cohort study were monitored. The validated questionnaires assessed dietary intake and physical activity adherence, and patients were classified by DII (high vs. low) and PA adherence (high vs. low). Important biomarkers included high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and a composite inflammation score. Multivariable regression analyses were performed.ResultsThe group of patients classified as having low DII and high PA, showed the least amount of inflammation (hs-CRP: 2.31 ± 1.12 mg/L; IL-6: 3.8 ± 1.4 pg./mL; TNF-α: 4.7 ± 1.7 pg./mL; composite score: −0.72 ± 0.55), while the group with high DII and low PA (n = 470) exhibited inflammation at its highest level (hs-CRP: 4.89 ± 2.05 mg/L; IL-6: 6.4 ± 2.3 pg./mL; TNF-α: 7.1 ± 2.5 pg/mL; composite score: +0.89 ± 0.74; p < 0.001). The multivariable analysis provided evidence of independent relationships between DII (β = +0.18; p < 0.001) and PA (β = −0.14; p < 0.001) and the composite inflammation score, as well as a notable interaction effect (β = −0.07; p = 0.001).ConclusionThe dietary inflammatory potential and PA adherence of the patients, both independently and in combination, could predict the level of systemic inflammation in post-MI patients. These findings support lifestyle interventions as the primary component of post-MI secondary prevention.

INTRODUCTION: Inadequate weight loss (IWL) after sleeve gastrectomy may lead to persistent obesity-related comorbidities and adversely affect long-term health outcomes. Evidence suggests that preoperative metabolic status and body fat distribution are closely associated with postoperative weight loss outcomes. This study aimed to identify preoperative predictors of IWL 1 year after laparoscopic sleeve gastrectomy (LSG) and to develop a clinically applicable nomogram for risk stratification. METHODS: A total of 1,111 patients were initially included. Due to unavailable follow-up data, 989 patients were included in the final analysis. Patients were randomly allocated into training (70%) and validation (30%) sets. Predictor selection used least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable logistic regression. The nomogram was evaluated via discrimination (area under the receiver operating characteristic (AUC) curve) and calibration plots. RESULTS: Four independent predictors of IWL were identified: fasting plasma glucose (FPG) [odds ratio (OR) = 1.09, P = 0.02], visceral fat area (VFA) (OR = 1.01, P < 0.001), fatty liver index (FLI) (OR = 1.02, P < 0.001), and body roundness index (BRI) (OR = 1.28, P = 0.04). The nomogram demonstrated moderate discriminative ability, with an AUC of 0.79 in the training set and 0.77 in the validation set and calibration was excellent (Hosmer-Lemeshow test P > 0.05). CONCLUSION: FPG, VFA, FLI, and BRI were identified as key predictors of IWL after LSG. The developed nomogram may serve as a preliminary tool for preoperative risk stratification of patients with obesity at risk for IWL, although further external validation is required before clinical implementation, enabling personalized intervention strategies.

Oral squamous cell carcinoma (OSCC) undergoes significant metabolic reprogramming. Adopting metabolomics to identify altered metabolic enzymes and metabolites holds promise for the early and precise diagnosis of OSCC. However, most current workflows rely on single-perspective modeling and lack task-aware prioritization. They underextract metabolomic signals, limit classification robustness, and impede a traceable transition from untargeted discovery to targeted panels. Therefore, we propose Metabolomics-based Integrated Information Learning (MIIL), an interpretable framework for OSCC diagnosis and premalignant screening. MIIL prioritizes task-relevant metabolites to derive a compact biomarker panel for targeted assay development, while strengthening classification via decision-level fusion of heterogeneous learners. Initially, we collect 120 oral mucosa tissues from 40 OSCC patients, including 40 Cancer (CA) samples, 40 Margin-1 specimens (M1), and 40 Margin-2 tissues (M2). Moreover, MIIL conducts untargeted metabolomics analysis to identify the most significant differential metabolites contributing to OSCC diagnosis. Subsequently, targeted metabolomics techniques are exploited for in-depth analysis of amino acid metabolites. Finally, integrated learning models are combined via decision-level fusion of linear, probabilistic, and margin-based signals, supporting accurate OSCC classification. The final results demonstrate that this method excels in the CA.vs.M1, CA.vs.M2, and M1.vs.M2 diagnostic tasks, achieving mean accuracies of 88.33%, 91.67%, and 85.00%, respectively. Trial registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR2200064861; registered on 2023-04-23.

OBJECTIVES:The correlation between fatty pancreas (FP) and metabolic-associated steatotic liver disease (MASLD), diabetes and other metabolic diseases is still controversial, and it is crucial to recognize the risk factors of FP to prevent its clinical complications. METHODS:Retrospective collection of clinical, pathologic, and imaging data of people with obesity attending Qilu Hospital of Shandong University from January 1, 2020 to October 1, 2022. FP was diagnosed by non-enhanced computed tomography with the ratio of pancreas/spleen <0.7. Using binary logistics regression analysis to construct an FP prediction nomogram model, bootstrap repeated sampling internal validation and temporal external validation were used to test the predictive performance of the model. RESULTS:In this cohort, the average age of the participants was 32.2 years, and the average BMI was 41.3 Kg/m2. The prevalence of FP 23.3% (144/617). People with obesity with or without comorbid FP have partial differences in blood glucose, lipid. Independent factors for FP were body mass index (BMI) (OR = 1.97, 95% CI 1.29-3.01; P = 0.002), diastolic blood pressure (DBP) (OR = 1.55, 95% CI 1.03-2.33; P = 0.035), high-density lipoprotein (HDL) (OR = 1.67, 95% CI 1.11-2.52; P = 0.014), HbA1C (OR = 1.99, 95% CI 1.19-3.34; P = 0.009). This study constructed a nomogram containing these four indicators for FP, and receiver operating characteristic curve analysis indicated that the nomogram has moderate predictive performance. CONCLUSIONS:This study identified key risk factors and developed a validated prediction nomogram for FP in adults with obesity. This model may facilitate early identification of FP and the prevention of related metabolic disorders.

Background: The relationship between remnant-like particle cholesterol (RLP-C) and cardiovascular disease risk and prognosis has been established, but its effect on the prognosis of ischemic heart failure (IHF) patients undergoing percutaneous coronary intervention (PCI) remains uncertain. Method: In this study, 2036 patients with IHF who underwent PCI were included. Patients were categorized into tertiles based on their RLP-C levels. The primary outcome was major adverse cardiovascular events (MACE). Kaplan-Meier survival analysis was used to assess the incidence of MACE and other outcomes. Multivariate Cox regression models were employed to investigate the correlation between RLP-C and the studied outcomes. The nonlinear relationship between RLP-C and MACE was examined through the restricted cubic spline (RCS). Subgroup analyses were performed and interactions were assessed. Result: The study results showed a clear association between higher RLP-C levels and an increased incidence of MACE in the participants. This association was validated by Kaplan-Meier analyses. The multivariate Cox regression demonstrated RLP-C was an independent risk factor for MACE, whether assessed as a continuous variable[hazard ratio (HR), 95% confidence interval (CI): 1.50, 1.15-1.98, p=0.003] or categorized into tertiles[HR, 95% CI: 2.57, 2.03-3.26, p<0.001, tertile 3 vs tertile 1]. A nonlinear relationship between RLP-C and MACE was observed, indicating that the risk of MACE increased with higher RLP-C levels(Nonlinear p<0.001). This association remained consistent across various subgroups, as no significant interactions were found. Conclusion: There was an independent and positive correlation between RLP-C and MACE in patients with IHF who underwent PCI.

This study aims to examine the temporal Trends in the burden of lip and oral cavity cancer in China from 1990 to 2021, stratified by age and sex. Key indicators—including prevalence, incidence, mortality, and disability-adjusted life years (DALYs)—are analyzed and compared with corresponding global metrics. Using data from the Global Burden of Disease (GBD) database spanning 1990 to 2021, we conducted a systematic analysis of trends in the burden of lip and oral cavity cancer in China and worldwide. The average annual percent change (AAPC) was estimated using Joinpoint regression analysis to quantify the magnitude of temporal trends. Differences in cancer burden across age groups and sexes were evaluated, and the ARIMA model was employed to project future trends. Finally, we conducted a decomposition analysis to determine the percentage contribution of factors affecting the burden of lip and oral cancer. From 1990 to 2021, the age-standardized incidence rate (ASIR) of lip and oral cavity cancer in China increased from 1.704 to 2.681 per 100,000 population, while the global ASIR rose from 4.270 to 4.880 per 100,000. The age-standardized prevalence rate (ASPR) in China increased from 4.168 to 10.158 per 100,000, compared to a rise from 13.888 to 17.706 per 100,000 globally. The age-standardized mortality rate (ASMR) in China declined from 1.224 to 1.152 per 100,000, while the global ASMR decreased slightly from 2.454 to 2.424 per 100,000. The age-standardized disability-adjusted life years rate (ASDR) in China fell from 32.086 to 29.205 per 100,000, whereas the global ASDR decreased from 69.266 to 67.714 per 100,000. Between 1990 and 2021, the average annual percent changes (AAPCs) in China were 1.487

Background:The atherogenic index of plasma (AIP) is calculated as the logarithm of the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio. While previous studies suggested that TG and HDL-C levels were linked to the prognosis in various cardiovascular conditions, including ischemic heart failure (IHF), there is limited research specifically examining AIP in the context of IHF. Therefore, our study sought to explore the association between AIP and the prognosis of IHF and to compare the predictive value of AIP, HDL-C, and TG levels for identifying patients with poor outcomes. Methods:This retrospective cohort study was conducted at a single institution involving 2036 IHF patients with post-percutaneous coronary intervention (PCI) who were followed for 36 months. Patients were divided into four groups categorized according to AIP quartiles. The primary outcome of interest was major adverse cardiovascular events (MACEs), while secondary outcomes included all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Kaplan-Meier survival curves were used to evaluate the occurrence of endpoints across the four groups. Multivariate Cox regression analysis reinforced that AIP independently predicted primary and secondary outcomes. Restricted cubic spline (RCS) method was employed to examine the non-linear association between AIP and endpoints. Receiver operating characteristic (ROC) curves, combined with the Delong test, were used to assess and compare the predictive accuracy of AIP, TG, and HDL-C. Result:The incidence of MACEs (Q4:Q1 = 50.6:23.0, p < 0.001), all-cause death (Q4:Q1 = 25.0:11.6, p < 0.001), and any revascularization (Q4:Q1 = 21.6:9.6, p < 0.001) were significantly higher in patients with elevated AIP. The Kaplan- Meier curve analysis further supported a positive association between AIP and MACEs (p log-rank < 0.001). Multivariate Cox analysis showed that AIP was independently associated with the increased risk of MACEs (Q4:Q1 (HR (95% CI)): 2.84 (2.25-3.59), p trend < 0.001), all-cause death (Q4:Q1 (HR (95% CI)): 2.76 (1.98-3.84), p trend < 0.001), non-fatal MI (Q4:Q1 (HR (95% CI)): 3.01 (1.32-6.90), p trend < 0.001), and any revascularization (Q4:Q1 (HR (95% CI)): 2.92 (2.04-4.19), p trend < 0.001). In RCS, higher AIP was non-linearly relevant to an increased risk of MACEs (p non-linear = 0.0112). In subgroup analysis, the predictive value of AIP for MACEs was more pronounced in the younger patient subgroup (p interaction = 0.003). The ROC curves showed the predictive value of AIP (area under curve [AUC] = 0.641), HDL-C (AUC = 0.600), and TG (AUC = 0.629), and AIP had the best predictive value among TG (AIP:TG: difference in AUC (95% CI), 0.012 (0.001-0.024), p for Delong test = 0.028) and HDL-C (AIP:HDL-C: difference in AUC (95% CI), 0.041 (0.018-0.064), p for Delong test <0.001). Conclusion:In IHF patients after PCI, AIP was strongly relevant to an increased risk of MACEs and had the best predictive validity compared with TG and HDL-C.

Objectives This study aimed to evaluate the impact of the Charlson Comorbidity Index (CCI) on in-hospital outcomes in patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR) and to compare the efficacy of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with different comorbidity burdens.Setting The National Clinical Research Center for Cardiovascular Diseases.Participants A retrospective analysis was conducted on 3380 AS patients who underwent AVR in Beijing Anzhen Hospital from January 2015 to October 2021.Interventions Patients were stratified into low (0–1) and high (≥2) CCI groups.Primary and secondary outcome measures The primary outcome was Valve Academic Research Consortium-2 (VARC-2) composite early safety endpoints.Results Patients with high CCI scores exhibited significantly higher rates of VARC-2 composite adverse outcomes compared with those with low scores (50.3% vs 44.2%, p=0.001). After adjusting for confounding factors, high CCI scores were independently associated with the VARC-2 composite adverse outcomes (OR=1.36, 95% CI 1.17 to 1.58, p<0.001). In patients aged ≥65 years, TAVR demonstrated lower composite event rates compared with SAVR, regardless of CCI score (low CCI: 17.6% vs 54.3%, p<0.001; high CCI: 33.7% vs 62.8%, p<0.001).Conclusions CCI is a significant predictor of in-hospital composite adverse events in AS patients undergoing AVR. TAVR may be preferred over SAVR for patients aged ≥65 years, irrespective of comorbidity burden, to minimise composite events risk. These findings underscore the importance of considering comorbidity burden in treatment decision-making for AS patients.Trial registration number NCT05797402.

BackgroundLipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). However, the association between Lp(a) and adverse outcomes in patients with ischemic heart failure (IHF) remains unclear. This study aimed to investigate the relationship between serum Lp(a) levels and the incidence of major adverse cardiovascular events (MACE) in IHF patients.MethodsIn this single-center, retrospective cohort study, 1,168 IHF patients who underwent elective percutaneous coronary intervention (PCI) were enrolled. Patients were divided into four groups based on Lp(a) quartiles. The primary endpoint was MACE, defined as a composite of all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Cox proportional hazards models were used to evaluate the association between Lp(a) quartiles and adverse outcomes. Restricted cubic spline (RCS) curve were constructed to explore the nonlinear relationship between Lp(a) levels and MACE risk. Subgroup analyses were performed to investigate the association in different subgroups.ResultsThe incidence of MACE increased significantly across Lp(a) quartiles (Quartile 4 vs. Quartile 1: 46.4% vs. 22.9%, P < 0.001). After adjusting for confounding factors, the highest Lp(a) group remained independently associated with an increased risk of MACE (HR, 95% CI: 2.28, 1.69–3.07, P < 0.001, P for trend <0.001), all-cause mortality (HR, 95% CI: 2.33, 1.54–3.54, P < 0.001, P for trend = 0.01), and any revascularization (HR, 95% CI: 2.18, 1.35–3.53, P = 0.002, P for trend = 0.001). The RCS model demonstrated a nonlinear positive relationship between Lp(a) levels and MACE risk. Subgroup analysis revealed a significant interaction with body mass index (BMI), with a more pronounced association observed in patients with higher BMI (P for interaction <0.001).ConclusionElevated Lp(a) levels were independently associated with an increased risk of MACE, mortality, and revascularization in IHF patients, with a stronger effect in obese individuals.

BACKGROUND:This study aims to evaluate the integration of optical coherence tomography (OCT) and peripheral blood immune indicators for predicting oral cancer prognosis by artificial intelligence. METHODS:In this study, we examined patients undergoing radical oral cancer resection and explored inherent relationships among clinical data, OCT images, and peripheral immune indicators for oral cancer prognosis. We firstly built a peripheral blood immune indicator-guided deep learning feature representation method for OCT images, and further integrated a multi-view prognostic radiomics model incorporating feature selection and logistic modeling. Thus, we can assess the prognostic impact of each indicator on oral cancer by quantifying OCT features. RESULTS:We collected 289 oral mucosal samples from 68 patients, yielding 1,445 OCT images. Using our deep radiomics-based prognosis model, it achieved excellent discrimination for oral cancer prognosis with the area under the receiver operating characteristic curve (AUC) of 0.886, identifying systemic immune-inflammation index (SII) as the most informative feature for prognosis prediction. Additionally, the deep learning model also performed excellent results with 85.26% accuracy and 0.86 AUC in classifying the SII risk. CONCLUSIONS:Our study effectively merged OCT imaging with peripheral blood immune indicators to create a deep learning-based model for inflammatory risk prediction in oral cancer. Additionally, we constructed a comprehensive multi-view radiomics model that utilizes deep learning features for accurate prognosis prediction. The study highlighted the significance of the SII as a crucial indicator for evaluating patient outcomes, corroborating our clinical statistical analyses. This integration underscores the potential of combining imaging and blood indicators in clinical decision-making. TRIAL REGISTRATION:The clinical trial associated with this study was prospectively registered in the Chinese Clinical Trial Registry with the trial registration number (TRN) ChiCTR2200064861. The registration was completed on 2021.

Hollow carbon-nitrogen nanoreactors constitute a class of porous materials that have widespread application owing to their large inner cavities, low densities, core-shell interfaces, and enrichment effects. Direct carbonization of precursors is the simplest and most economical method to prepare porous carbon-nitrogen materials; however, this method requires high temperatures, thus yielding nonoxide structures. In this study, CuO-ZnO@CN (CN: carbon-nitrogen layers) is prepared using the two-step heating of zeolitic imidazolium skeleton-8 (ZIF-8) coated with CuO-ZnO precursors. During carbonization, the ZIF-8 nanoparticles are converted into carbon-nitrogen layers at high temperatures. Next, a heating process based on the autocatalytic effect of Cu can be used to etch the hollow structure prepared by the carbon-nitrogen layers. The CuO-ZnO@CN hollow composites fabricated using this method exhibit excellent catalytic properties for the ethynylation of formaldehyde. The proposed strategy can be used to develop techniques for syntheses of readily reducible carbon oxide claddings and their composites.

BackgroundAtherosclerosis and cardiovascular diseases are significantly affected by low-grade chronic inflammation. As a new inflammatory marker, the systemic inflammation response index (SIRI) has been demonstrated to be associated with several cardiovascular disease prognoses. This study aimed to investigate the prognostic impact of SIRI in individuals having ischemic heart failure (IHF) following percutaneous coronary intervention (PCI).MethodsThis observational, retrospective cohort study was conducted at a single site. Finally, the research involved 1,963 individuals with IHF who underwent PCI, with a 36-month follow-up duration. Based on the SIRI quartiles, all patients were classified into four groups. Major adverse cardiovascular events (MACEs) were the primary outcomes. Every element of the main endpoint appeared in the secondary endpoints: all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Kaplan–Meier survival analysis was conducted to assess the incidence of endpoints across the four groups. Multivariate Cox proportional hazards analysis confirmed the independent impact of SIRI on both the primary and secondary endpoints. The restricted cubic spline (RCS) was used to assess the nonlinear association between the SIRI and endpoints. Subgroup analysis was performed to confirm the implications of SIRI on MACE in the different subgroups.ResultsThe main outcome was much more common in patients with a higher SIRI. The Kaplan–Meier curve was another tool that was used to confirm the favorable connection between SIRI and MACE. SIRI was individually connected to a higher chance of the main outcome according to multivariate analyses, whether or not SIRI was a constant [SIRI, per one−unit increase, hazard ratio (HR) 1.04, 95% confidence interval (95% CI) 1.01–1.07, p = 0.003] or categorical variable [quartile of SIRI, the HR (95% CI) values for quartile 4 were 1.88 (1.47–2.42), p <0.001, with quartile 1 as a reference]. RCS demonstrated that the hazard of the primary and secondary endpoints generally increased as SIRI increased. A non-linear association of SIRI with the risk of MACE and any revascularization (Non-linear P <0.001) was observed. Subgroup analysis confirmed the increased risk of MACE with elevated SIRI in New York Heart Association (NYHA) class III–IV (P for interaction = 0.005).ConclusionIn patients with IHF undergoing PCI, increased SIRI was a risk factor for MACE independent of other factors. SIRI may represent a novel, promising, and low-grade inflammatory marker for the prognosis of patients with IHF undergoing PCI.

Aims:With an aging population and better survival rates, coronary artery disease (CAD) with multimorbidity has become more prevalent, complicating treatment and impacting life quality and longevity. This study identifies multimorbidity patterns in CAD patients and their effect on clinical outcomes, emphasizing treatment strategies.Methods and results:The study analysed data from the DCEM registry (173 459 patients) and BleeMACS cohort (15 401 patients) to categorize CAD patients into three multimorbidity patterns. The focus was on how these patterns influence outcomes, especially concerning the efficacy and safety of dual antiplatelet therapy (DAPT). The study identified three distinct multimorbidity patterns: Class 1 encompassed cardiovascular-kidney-metabolic comorbidities indicating the highest risk; Class 2 included hypertension-dyslipidaemia comorbidities, reflecting intermediate risk; and Class 3 involved non-specific comorbidities, indicating the lowest risk. Class 1 patients demonstrated a six-fold increase in in-hospital mortality and a four-fold increase in severe in-hospital complications compared with Class 3. Over a 1-year period, Class 1 was associated with the highest risk, displaying a significant increase in all-cause mortality [adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.52-2.31, P < 0.001] and a notable risk for major bleeding (adjusted HR 1.74, 95% CI 1.36-2.24, P < 0.001) compared with Class 3. The use of DAPT, particularly aspirin combined with clopidogrel, significantly reduced the 1-year all-cause mortality in Class 1 patients (adjusted HR 0.60, 95% CI 0.37-0.98, P = 0.04) without increasing in major bleeding.Conclusion:Coronary artery disease patients with a cardiovascular-kidney-metabolic profile face the highest mortality risk. Targeted DAPT, especially aspirin and clopidogrel, effectively lowers mortality without significantly raising bleeding risks.Registration:DCEM registry (NCT05797402) and BleeMACS registry (NCT02466854).

Abstract Background The atherogenic index of plasma (AIP) is considered an independent risk factor for coronary artery disease (CAD). The present study investigated whether AIP correlates with the formation of coronary collateral circulation (CCC) in CAD patients with chronic total occlusion (CTO). Methods This retrospective study included 1093 CAD patients with CTO confirmed by coronary angiography from January 2020 to December 2020 at Beijing Anzhen Hospital. Based on the Rentrop scoring system, the patients were divided into the good CCC group and the poor CCC group. AIP was calculated by log (triglyceride/high-density lipoprotein cholesterol). Meanwhile, the study population was further divided into four groups according to the quartiles of AIP. Results Patients in the poor CCC group exhibited significantly higher AIP compared to those in the good CCC group (0.31 ± 0.27 vs. 0.14 ± 0.24, p < 0.001). Multivariate logistic regression analysis revealed an independent association between AIP and poor CCC, regardless of whether AIP was treated as a continuous or categorical variable (p < 0.001), after adjusting for confounding factors. Besides, this association remained consistent across most subgroups. The incorporation of AIP into the baseline model significantly enhanced the accuracy of identifying poor CCC [area under the curve (AUC): baseline model, 0.661 vs. baseline model + AIP, 0.721, p for comparison < 0.001]. Conclusions Elevated AIP is independently associated with an increased risk of poor CCC in CAD patients with CTO, and AIP may improve the ability to identify poor CCC in clinical practice.

BackgroundPeriodontitis is a chronic inflammatory disease potentially associated with obesity and type 2 diabetes (T2D). Sleeve gastrectomy (SG) has shown substantial effect on weight loss and treatment of T2D. However, there is no direct evidence comparing the impact of SG on the periodontal status of patients with and without T2D.ObjectivesTo determine the impact of SG on the periodontal status of patients with and without T2D in a real-world setting.MethodsIn a prospective and two-armed cohort design, participants who were scheduled for SG at an affiliated hospital between April 2022 and December 2022 were approached for eligibility. After a clinical evaluation and oral examination, those with periodontitis were included and further divided into the DM group (diabetic) and the Control group (non-diabetic) with a 1-year follow-up after surgery. The primary outcome was the periodontal status of patients at 12 months after SG. The secondary outcomes included weight loss, diabetes remission, and alterations in inflammatory markers for up to 1 year after SG.ResultsFifty-seven and 49 patients were included in the DM and the Control group, respectively. Before surgery, patients in the DM group had further worsened periodontal condition compared with those in the Control group. Accompanied by weight loss and glucose reduction, patients in both groups demonstrated significant decreases in plaque index (PLI) and bleeding index (BI) with no alterations in probing depth or clinical attachment loss for up to 1 year after SG. Even patients in the DM group achieved less TWL% (32.79 ± 6.20% vs. 37.95 ± 8.34, P<0.01), their periodontal condition had more substantial improvement with no significant difference in PLI and BI between groups at 1 year after SG. We also observed a significant reduction in the levels of high sensitive C-reactive protein and interleukin-6 in both groups at 1 year after SG.ConclusionBoth patients with and without T2D demonstrated improved periodontal status for up to 1 year after SG. Patients with T2D achieved less weight loss but a more substantial improvement in periodontal condition. The significant reduction in inflammatory biomarkers contributed to the improvement of periodontal status after SG.

STUDY QUESTION:Does the concurrent type 2 diabetes mellitus (T2DM) aggravate the features and prognosis of PCOS in patients undergoing sleeve gastrectomy (SG)? SUMMARY ANSWER:For patients undergoing SG with obesity, concurrent T2DM is associated with aggravated metabolic but milder reproductive features of PCOS and did not attenuate the resumption of regular menstruation for up to 1 year after surgery. WHAT IS KNOWN ALREADY:Women with T2DM have an increased risk of PCOS. However, whether concurrent T2DM further increases the disease burden and treatment difficulty of PCOS in patients with obesity requires further investigation. STUDY DESIGN, SIZE, DURATION:This was a single-center, two-arm, prospective, cohort study enrolling a total of 329 women with PCOS and scheduled for SG because of obesity at an university-affiliated hospital between January 2020 and August 2023, with a 1-year follow-up after surgery. PARTICIPANTS/MATERIALS, SETTING, METHODS:Comparisons were made between patients with T2DM (PCOS+T2DM) and without (PCOS) to examine the impact of T2DM on the metabolic, reproductive, and psychological features of PCOS. The follow-up data of weight loss and menstruation were analyzed to determine the impact of T2DM on PCOS prognosis for up to 1 year after SG. MAIN RESULTS AND THE ROLE OF CHANCE:After controlling for confounders, patients in the PCOS+T2DM group (n = 98) showed more severe insulin resistance, glucose intolerance, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD) (NAFLD activity score 4.31 ± 1.15 versus 3.52 ± 1.42, P < 0.001) than those in the PCOS group (n = 149). In addition, the PCOS+T2DM group had a lower level of total testosterone (1.63 ± 0.69 versus 1.82 ± 0.76, P = 0.045), a lower ratio between luteinizing hormone and follicle-stimulating hormone (median 1.48 versus 1.68, P = 0.030), and a lower proportion of patients with polycystic ovarian morphology (88% versus 96%, P = 0.022) than the PCOS group. As a result, the two groups differed significantly in terms of the Rotterdam classification of PCOS (P = 0.009). No significant difference was detected by group in the psychological features of PCOS except a lower degree of emotional eating in the PCOS+T2DM group (P = 0.001). Although the PCOS+T2DM group took longer to resume regular menstruation after SG (P = 0.037), the two groups had similar proportions of patients with regular menstruation (85% versus 87%, P = 0.758) 1 year after SG, which was further confirmed by subgroup analyses by body mass index. LIMITATIONS, REASONS FOR CAUTION:The prognosis of PCOS after SG mainly focused on the results of menstruation rather than a complete evaluation of the remission of the disease. WIDER IMPLICATIONS OF THE FINDINGS:Our study showed that, for patients with obesity, concurrent T2DM is associated with aggravated metabolic but milder reproductive features of PCOS and did not attenuate the resumption of regular menstruation for up to 1 year after surgery. Our study also highlights the need for high-quality studies with a more comprehensive evaluation of the impact of T2DM on the prognosis of patients with PCOS after SG. STUDY FUNDING/COMPETING INTEREST(S):This study was funded by the National Natural Science Foundation of China Grants (82100853), the Natural Science Foundation of Shandong Province of China (ZR2021QH028), and the Clinical Research Project of Shandong University (2020SDUCRCC024). The authors have no conflicts of interest. TRIAL REGISTRATION:Chinese Clinical Trial Registry with No. ChiCTR1900026845.

Feeding sheep with high-concentrate diet (HCD) to shorten production cycle is a well-developed feeding strategy to increase lamb production. Here, metabolomics were performed to explore the mechanism that HCD changes lamb nutrition composition. Differential metabolites were enriched in primary bile acid biosynthesis. Significantly higher content of bile acids including taurodeoxycholic acid sodium salt (TDCA), taurochenodeoxycholic acid sodium salt (TCDCA) and taurocholic acid (TCA) was observed in lamb of HCD, while the content of lithocholic acid (LCA), cholic acid (CA), chenodeoxycholic acid (CDCA) and Chenodeoxycholic acid-3-beta-D-glucuronide (CDCA-3Gln) were higher in the controls. Furthermore, a significantly decreased content of fatty acids was observed in lamb of HCD group. Finally, primary skeletal cells treated with CA or TCA showed a significant decrease in contents of fatty acids, while TCA showed a stronger effect in decreasing fatty acid contents. Collectively, we suggest that HCD decreases lamb fatty acid contents by regulating bile acid composition.