The sulfur microbial diet (SMD), characterized by high intake of processed meats, alcohol, and artificially sweetened beverages, has been suggested to be associated with gut microbial dysbiosis by influencing sulfur-reducing bacterial activity. These microbial changes may be associated with altered production of hydrogen sulfide (H₂S) and lipopolysaccharide (LPS), potentially contributing to systemic inflammation, metabolic disorders, alterations in gut-related biomarkers such as nerve growth factor (NGF). However, the metabolic and neuroimmune consequences of this dietary pattern in overweight and obese individuals remain unclear. In the current study we aimed to examine the association between adherence to the SMD and metabolic risk factors, gut-brain axis biomarkers (LPS and NGF), and adiposity indicators in a population of overweight and obese adults. In this cross-sectional study, 633 overweight and obese adults (BMI ≥ 25 kg/m²) aged 20-60 years were recruited from outpatient nutrition clinics. Dietary intake was assessed using a previously validated food frequency questionnaire, and SMD scores were calculated based on the intake of eight food groups included in the original SMD scoring methodology. Participants were categorized into quartiles of SMD adherence. Anthropometric measures and fasting blood samples were collected to assess metabolic markers, LPS, and NGF. Participants with higher SMD scores had significantly higher total cholesterol levels (adjusted P = 0.028), while adjusted comparisons showed a significant difference in circulating NGF levels between SMD quartiles (adjusted P = 0.047). LPS concentrations differed significantly across SMD quartiles after multivariable adjustment (adjusted P = 0.037), with a significant linear trend across quartiles (P for trend = 0.011). No significant differences were observed for fasting glucose, insulin, triglycerides, or blood pressure. Higher adherence to the sulfur microbial diet was associated with differences in total cholesterol, NGF, and LPS concentrations among adults with overweight and obesity. These findings suggest that greater adherence to this dietary pattern may be accompanied by alterations in metabolic and gut-related biomarkers. Given the cross-sectional design of the study, causal relationships cannot be inferred, and prospective studies are needed to confirm these associations.

Aim: This study is a cross-sectional study that aimed to assess the frequency of type 2 diabetes (T2D) risk variables among Egyptian college students. The Finnish Diabetes Risk Score (FINDRISC), originally used in middle-aged groups, was used in a college (young-aged) student group to identify early risk behaviors. Materials and Methods: We assessed the risk of T2D in 377 college students aged 18 to 22 years old. Inquiries were made about family history, personal history, and lifestyle patterns. Laboratory tests, blood pressure readings, and anthropometric data were also gathered. Results: A total of 61% of participants were female, mean body weight was 71.6 +/- 14.4 kg, and mean body mass index was 25 +/- 4.5 kg/m(2). The average FINDRISC for the entire group was 6.5 +/- 3.7. Fifty-two percent belonged to the low-risk (LR) group, and 48% to the greater-risk (GR) group. The GR group was further separated into three risk categories: significantly elevated risk (9.8%), highly elevated risk (1.9%), and slightly elevated risk (36.3%). HDL-C, VLDL-C, triglycerides, fasting serum insulin, fasting plasma glucose, and homeostatic model assessment for insulin resistance (HOMA-IR) did not differ between the two groups; however, the GR group had significantly greater total cholesterol (P < 0.01) and LDL-cholesterol (P < 0.05) than the LR group. The GR group consumed fast food more frequently (P < 0.05). Social stress was an independent predictor of worsening FINDRISC (beta = -1.04, P < 0.01) and was substantially higher in GR compared to LR (P < 0.05). Conclusion: The increased risk of T2D in this population is alarming and warrants implementing a diabetes prevention program.

Background:Citrus oils (COs) are consumed as herbal tea in traditional medicine to ameliorate the obesity-induced consequences. Citrus limon oil (CLO), C. aurantiifolia oil (CAO), and C. japonica oil (CJO) are widely dispersed for their medicinal properties. However, it is yet unknown how these oils work to reduce obesity. This work investigates the potential beneficial effects of the nanoemulsions (NEs) of Citrus essential oils (EOs) on hepatic steatosis and cardiac and pancreatic injury in high-fat diet (HFD)-induced obese rats and the mechanisms behind these effects. Methods:EOs were formulated as NEs using the ultrasonic emulsification method. The three NEs (150 mg/kg) were orally and separately administered along with the standard metformin (500 mg/kg) for 30 days after prior induction of obesity by HFD for a period of 12 weeks. Results:Treatments with NEs improved HFD-induced obesity with different potentials. The NE of CJO represented more cytoprotective and antisteatotic activities. It resulted in a preferential reduction of body weight and serum levels of glucose and lipids, as well as tissue injury and oxidative stress biomarkers that were accompanied by improved tissue architectures. At the molecular level, it upregulated the antioxidants Nrf2, HO-1, and SIRT1. It also increased the levels of adiponectin while decreasing visfatin. Furthermore, it downregulated the apoptotic executor, active caspase-3. Conclusions:The CJO NEs have shown strong promise in lowering obesity-induced hepatic steatosis and mitigating cardiac and pancreatic injury via hypoglycemic, antidyslipidemic, cytoprotective, antioxidant, and antiapoptotic activities. These beneficial effects are collectively associated with modulating the adiponectin/SIRT1/Nrf2 signaling cascade.

Metabolic dysfunction-associated fatty liver disease (MAFLD) represents a highly prevalent liver disorder characterized by hepatic fat accumulation in the context of metabolic impairment. Persistent low-grade inflammation is recognized as a central mechanism underlying its development and progression. The Systemic Immune-Inflammation Index (SII), derived from circulating neutrophil, lymphocyte, and platelet counts, has emerged as a composite indicator of inflammatory and immune status. Nevertheless, limited evidence exists regarding its association with dietary quality and cardiometabolic features in individuals with MAFLD. This aim of this study was to investigate the relationship between SII levels, metabolic parameters and adherence to a Mediterranean-style dietary pattern in adults diagnosed with MAFLD. In this cross-sectional study, a total of 254 adults with confirmed MAFLD were enrolled in this cross-sectional analysis. Participants were stratified into tertiles according to SII values. Anthropometric measurements, biochemical parameters, and dietary data were obtained for all subjects. Habitual food consumption was evaluated using a validated food frequency questionnaire, and diet quality was quantified through the Mediterranean Dietary Quality Index (MED-DQI). Between-group differences were assessed using one-way analysis of variance and Chi-square tests. Partial correlation analysis was used to assess the association between SII, MED-DQI and metabolic variables adjusted for the confounders. Also, multivariable general linear models were applied to control for potential confounding variables. Participants within the highest SII tertile demonstrated significantly higher serum triglyceride concentrations (T3: 197.42 ± 108.83 mg/dL vs. T1: 147.55 ± 87.77 mg/dL; P < 0.05) and markedly lower HDL-C levels compared with those in lower tertiles (T1: 51.94 ± 13.34 mg/dL vs. T3: 45.28 ± 11.08 mg/dL; P < 0.001). Although overall MED-DQI scores were not significantly different between SII tertiles, poorer scores in the fruits and vegetables component were observed among individuals with elevated SII. A positive correlation was found between SII and neutrophil counts (r = 0.438), platelet counts (r = 0.309) and a negative correlation with lymphocyte counts (r = -0.466) and HDL cholesterol (r = -0.238; for all of them P < 0.001). Triglyceride levels was also positively correlated with SII (r = 0.214, P = 0.001). A significant positive correlation was observed between MED-DQI and lymphocyte counts (r = 0.215) and HDL (r = 0.158, P < 0.001 and P < 0.05 respectively). Higher systemic immune-inflammatory burden is associated with higher TG and lower HDL and lower dietary fruits and vegetables score in patients with MAFLD. These findings highlight a potential link between inflammatory activation, dietary inadequacy, and metabolic disturbances. Due to cross-sectional design of the current study, casualty cannot be directly inferred and prospective investigations are warranted to clarify the causal direction of these associations.

Objective: To evaluate the safety and health effects of Ramadan fasting among university students with type 1 diabetes (T1D) (frequency of fasting, incidence of hypoglycemia and hyperglycemia, and impact of different insulin types on glycemic control during Ramadan). Material and methods: This is a prospective observational study conducted on university students, during Ramadan 1444 Hijri (March 23-April 21, 2023). A total of 164 students with T1D (aged 18-24 years) were recruited. Participants were monitored for fasting duration, types of insulin adjustments, glycemic fluctuations, HbA1c levels, and LDL changes. Self-monitoring of blood glucose levels was measured, then data were statistically analyzed using SPSS software. Results: The study showed that fasting was generally well tolerated, with a median fasting duration of 26 days. However, glycemic fluctuations were common among participants. Hyperglycemia occurred most frequently 2 hours after Iftar (51.2%), while hypoglycemia was most prevalent before Iftar (43.3%). Participants using regular human insulin had a significantly higher risk of developing hypoglycemia compared to those using short-acting insulin analogs (OR = 1.45, 95% CI: 1.27-2.72, p = 0.007). No severe hypoglycemic episodes requiring assistance or hospitalization were reported. No significant changes were observed in HbA1c or LDL levels post-Ramadan. Conclusions: The risk of glycemic fluctuations in T1D during fasting remains high, particularly among those using regular human insulin. Standardized fasting recommendations for young adults with T1D require more research to maximize their safety and metabolic results, and pre-Ramadan education and structured insulin management regimens are essential to reducing these hazards. (Clin Diabetol 2025; 14, 5: 282-290)

The current study assessed the impact of cerium oxide nanoparticles (nanocerium, NC) on adriamycin (ADR)-induced nephropathy in addition to the physiological role of oxidative stress, Nrf2/HO-1 pathway, apoptosis, TGF-β, and Sirt-1 in its action. Forty adult male Sprague–Dawley rats were divided into four groups as follows: control, NC, ADR, and ADR + NC groups. At the end of the experiment, urine, blood samples, and kidney were taken for assessment of serum creatinine (Cr), blood urea nitrogen (BUN), and urinary protein. Also, malondialdehyde (MDA), reduced glutathione (GSH) and catalase (CAT) levels, histopathological examinations, immunohistochemical examinations for caspase-3, TGF-β, Sirt-1, and real-time PCR for the expression of Nrf2 and HO-1 antioxidant genes in kidney tissues were done. NC significantly improved the raised serum creatinine, BUN, and urinary proteins. Also, NC improved the expression of caspase-3 and markers of oxidative stress in kidney tissues, and it also reduced morphological renal damage. Moreover, NC caused a significant increase in the expression of SIRT1 and Nrf2/HO-1 in kidney tissues. Also, markedly decreased renal fibrosis. Nanocerium alleviates ADR nephropathy, which may be related to the antioxidant and anti-fibrotic action of NC. Also, upregulating and activating SIRT1, Nrf2/HO-1 signaling and reduction of apoptosis.

OBJECTIVES:The current study aims to investigate the impact of the GLP1 analog (semaglutide) and SGLT2 inhibitor (dapagliflozin) on nerve functions, morphology, and the underlying mechanisms involving nerve growth factor (NGF)/synaptophysin and Nrf2/HO-1 pathways in obese rats. METHODS:Forty male Sprague Dawley rats, aged six to eight weeks, were classified into five groups; normal group (high-fat diet {HFD} for 12 weeks, metformin group (HFD for 12 weeks + metformin in last four weeks), dapagliflozin group (HFD for 12 weeks +dapagliflozin in last four weeks, semaglutide group (HFD for 12 weeks + semaglutide in last four weeks). At the end of the experiment, the sciatic nerve was collected for nerve conduction study, oxidative stress marker (malondialdehyde, i.e., MDA), real-time polymerase chain reaction (PCR) study (for HO-1 and Nrf2), oil red O staining, electron microscopic examination and immunohistochemistry for NGF and synaptophysin. RESULTS:The HFD group showed a significant rise in blood glucose, serum lipids, homeostatic model assessment (HOMA) index, lipid deposition in nerve tissues, and lipid peroxidation (MDA) in nerve tissues with significant attenuation in nerve conduction velocity (NCV), the expression of Nrf2 and HO-1 genes and significant attenuation in area stained with NGF and synaptophysin. On the other hand, pretreatment with either dapagliflozin or semaglutide led to considerable enhancement in the deteriorated serum and nerve tissue parameters and reversed the pathological changes. CONCLUSION:New antidiabetic drugs like SGLT2 inhibitors (more powerful) and GLP1 analog might have neuroprotective beneficial effects besides controlling the glycemic state in obese rats. This effect may result from reduced oxidative stress and increased Nrf2 levels, HO-1, synaptophysin, and NGF in the nerve tissues of obese rats.

PurposeIntermittent fasting (IF) has been shown to induce a well-organized adaptive defense against stress inside the cells, which increases the production of anti-oxidant defenses, repair of DNA, biogenesis of mitochondria, and genes that combat inflammation. So, the goal of the current investigation was to identify the effects of IF on rats with adriamycin (ADR)-induced nephropathy and any potential underlying mechanisms.MethodsFour groups of 40 mature Sprague-Dawley male rats were allocated as follow; control, fasting, ADR, and ADR plus fasting. After 8 weeks of ADR administration urine, blood samples and kidneys were taken for assessment of serum creatinine (Cr), BUN, urinary proteins, indicators of oxidative damage (malondialdehyde (MDA), reduced glutathione (GSH) and Catalase (CAT) levels), histopathological examinations, immunohistochemical examinations for caspase-3, Sirt1, aquaporin2 (AQP2) and real time PCR for antioxidant genes; Nrf2, HO-1 in kidney tissues.ResultsIF significantly improved serum creatinine, BUN and urinary protein excretion, oxidative stress (low MDA with high CAT and GSH), in addition to morphological damage to the renal tubules and glomeruli as well as caspase-3 production during apoptosis. Moreover, IF stimulates significantly the expression of Sirt1 and Nrf2/HO-1 and AQP2.ConclusionAQP2, Sirt1, Nrf2/HO-1 signaling may be upregulated and activated by IF, which alleviates ADR nephropathy. Enhancing endogenous antioxidants, reducing apoptosis and tubulointerstitial damage, and maintaining the glomerular membrane's integrity are other goals.

Background: COVID-19 is a global pandemic that has affected millions of people all over the world since 2019. Infection with COVID-19 initiates a humoral immune response that produces antibodies against specific viral antigens, which in turn is supposed to provide immunity against reinfection for a period of time. The aim of this research was to study the kinetics of IgM and IgG antibodies against SARS-CoV-2. Methods: One hundred and seventeen post-COVID-19 participants were enrolled in the study. Qualitative assessment of IgM and IgG antibodies over six months (three visits) post recovery was conducted. Results: The current study revealed a significant reduction in IgM and IgG titers between the first and second visits (p <0.001). After six months, the antibody titer had declined by 78.8% from the first visit for IgM and by 49.2% for IgG antibodies. Regarding younger age and male sex, statistically significant persistence of IgM antibodies was noticed at the six months follow up. Also, statistically significant persistent IgG immunity was found in male patients and diabetics by the end of the six months follow up. Conclusions: We observed a significant waning of IgM and IgG titers over a period of six months follow up.. The persistence of positive IgM and IgG antibodies by the end of six months was variable due to differences in age, gender and presence of diabetes mellitus.

Background: COVID-19 is a global pandemic that has affected millions of people all over the world since 2019. Infection with COVID-19 initiates a humoral immune response that produces antibodies against specific viral antigens, which in turn is supposed to provide immunity against reinfection for a period of time. The aim of this research was to study the kinetics of IgM and IgG antibodies against SARS-CoV-2. Methods: One hundred and seventeen post-COVID-19 participants were enrolled in the study. Qualitative assessment of IgM and IgG antibodies over six months (three visits) post recovery was conducted. Results: The current study revealed a significant reduction in IgM and IgG titers between the first and second visits (p <0.001). After six months, the antibody titer had declined by 78.8% from the first visit for IgM and by 49.2% for IgG antibodies. Regarding younger age and male sex, statistically significant persistence of IgM antibodies was noticed at the six months follow up. Also, statistically significant persistent IgG immunity was found in male patients and diabetics by the end of the six months follow up. Conclusions: We observed a significant waning of IgM and IgG titers over a period of six months follow up.. The persistence of positive IgM and IgG antibodies by the end of six months was variable due to differences in age, gender and presence of diabetes mellitus.

Objectives: The current work was designed to study the effect of dehydroepiandrosterone (DHEA) on glucose homeostasis, liver functions and hemostatic disturbances in a rat model of bilateral orchidectomy (ORCH). Methods: 32 male rats (n = 8) were randomly assigned into 4 groups; (i) control (sham operated) group; were normal rats in which all surgical procedures were done without ORCH, (ii) Control + DHEA group: as control group but rats were treated with DHEA for 12 weeks, (iii) orchiectomized (ORCH) group: rats had bilateral orchidectomy and (iv) ORCH + DHEA group: orchiectomized rats treated with DHEA for 12 weeks. Four weeks after ORCH, DHEA treatment began and lasted for twelve weeks. By the end of the experiment, the parameters of glucose homeostasis, lipid profile, liver enzymes, bleeding and clotting times (B.T. and C.T.), prothrombin time (P.T.), activated partial thromboplastin time (aPTT), platelet count and aggregation, von-Willebrand factor (vWF), fibrinogen, plasminogen activator inhibitor (PAI-1), fibrin degradation products (FDP), intercellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), endothelin-1 were measured. Results: ORCH caused significant deteriorations in the parameters of glucose homeostasis, lipid profile, and liver functions (p < 0.05). In addition, lower androgenicity-induced by ORCH caused a significant rise in PAI-1, fibrinogen, FDPs, ET-1 (p < 0.01) with significant shortening of bleeding and clotting times. DHEA replacement therapy significantly decreased glucose, insulin, PAI-1, fibrinogen, ICAM-1, and VCAM-1 when compared to ORCH rats. Conclusion: DHEA ameliorated the metabolic, hepatic, hypercoagulable, and hypofibrinolysis disturbances induced by ORCH.

Background: Diabetic management during Ramadan fasting is a significant clinical challenge. Sodium glucose co-transporter -2 (SGLT-2) inhibitors are new class of antidiabetic medications known for low frequency of associated hypoglycemia. The present study aimed to evaluate efficacy, safety and tolerability of SGLT-2 inhibitors in diabetic patients practicing Ramadan fasting. Patients and Methods: The study included 94 patients. They comprised 51 patients who received metformin and sulfonylureas: Glimepiride (1mg-6mg/d) or Gliclazide MR (60-120mg/d) and 43 patients who received SGLT2 inhibitors: Empagliflozin (25 mg), Dapagliflozin (10 mg) or Canagliflozin (300 mg). The study outcome parameters were frequency of hypoglycemia episodes, volume depletion episodes, number of days with early breaking of fasting and missed fasting days. Results: It was found that patients in SGLTI group experiences significantly fewer symptomatic (9.3 % versus 35.3 %, p=0.003) and documented (7.0 % versus 25.5 %, p=0.017) hypoglycemic episodes as compared to the SU group. However, there were no significant differences between the studied groups regarding the frequency of patients with volume depletion episodes (5.9 % versus 16.3 %, p= 0.1). Moreover, there were no significant differences between groups regarding the frequency of patients with early breaking of fasting (11.8 % versus 9.3 %, p=0.7) or missed fasting (3.9 % versus 2.3 %, p=0.66). None of the studied patients discontinued the prescribed medications. Conclusions: SGLT-2 inhibitors combined with metformin for diabetic patients during Ramadan fasting are effective, safe and well-tolerated with the advantage of reduced hypoglycemic events. Disclosure E. M. A. Eid: None. A. Hussein: None. H. A. Ghazi: None.

Background: Diabetic management during Ramadan fasting is a significant clinical challenge. Sodium glucose co-transporter -2 inhibitors (SGLT2i) are new class of antidiabetic medications known for low frequency of associated hypoglycemia. The present study aimed to evaluate efficacy, safety and tolerability of SGLT2i in diabetic patients practicing Ramadan fasting. Patients and methods: The study included 94 patients. They comprised 51 patients who received metformin and sulfonylureas (SU): glimepiride (1-6 mg/d) or gliclazide MR (60-120mg/d) and 43 patients who received metformin and SGLT2i: empagliflozin (25 mg), dapagliflozin (10 mg) or canagliflozin (300 mg). The study outcome parameters were frequency of hypoglycemia episodes, volume depletion episodes, number of days with early breaking of fasting and missed fasting days. Results: It was found that patients in SGLTi group experiences significantly fewer symptomatic (9.3 % versus 35.3 %, p=0.003) and documented (7.0 % versus 25.5 %, p=0.017) hypoglycemic episodes as compared to the SU group. However, there were no significant differences between the studied groups regarding the frequency of patients with volume depletion episodes (5.9 % versus 16.3 %, p= 0.1). Moreover, there were no significant differences between groups regarding the frequency of patients with early breaking of fasting (11.8 % versus 9.3 %, p=0.7) or missed fasting (3.9 % versus 2.3 %, p=0.66). None of the studied patients discontinued the prescribed medications. Conclusions: SGLT2i combined with metformin for diabetic patients during Ramadan fasting are effective, safe and well-tolerated with the advantage of reduced hypoglycemic events.

Objective Limited literature has examined the epidemiology of non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt, a country with one of the highest obesity rates globally. We assessed the prevalence of steatosis and fibrosis among college students in Egypt. Design In this cross-sectional study, we recruited students unaware of having fatty liver via a call-for-participation at a private university in the Dakahlia governorate of Egypt. Primary outcomes were the prevalence of steatosis as determined by the controlled attenuation parameter component of transient elastography and fibrosis as determined by the liver stiffness measurement component of transient elastography. Secondary outcomes were clinical parameters and socioeconomic factors associated with the presence and severity of steatosis and fibrosis. Results Of 132 participants evaluated for the study, 120 (91%) were included (median (IQR) age, 20 (19-21) years; 65 (54.2%) female). A total of 38 participants (31.6%) had steatosis, among whom 22 (57.9%) had S3 (severe) steatosis. There was a higher risk for steatosis in persons with overweight (adjusted OR 9.67, 95% CI (2.94 to 31.7, p<0.0001) and obesity (adjusted OR 13.87, 95% CI 4.41 to 43.6, p<0.0001) compared with lean persons. Moreover, higher level of parental education was associated with progressing steatosis stages (S1-S3). Six (5%) participants had transient elastography values equivalent to F2-F3 fibrosis (four with F2 fibrosis (>= 7.9 kPa), and two with F3 fibrosis (>= 8.8 kPa)). Conclusion In this cohort of college students in Egypt, around 1 in 3 had steatosis, and 1 in 20 had moderate-to-advanced fibrosis, an established risk factor for hepatic and extrahepatic morbidity and mortality. These data underscore the urgency to address the silent epidemic of NAFLD among young adults in the Middle East-North Africa region.

Background: The present study examined the effect of intermittent fasting (IF) on bone mineral content (BMC) and bone mineral density (BMD) and the markers of bone remodeling in a glucocorticoid-induced osteoporosis (GIO) rat model.Methods: Forty male rats were allocated to 4 groups (N=10 per group): control group of normal rats; control+IF group (normal rats subjected to IF for 16-18 hr daily for 90 days); dexamethasone (DEX) group: (DEX [0.5 mg i.p.] for 90 days); and DEX+IF group (DEX and IF for 90 days). By the end of the experiment, BMD and BMC in the right tibia were measured. Serum levels of the following were measured: glucose; insulin; triglycerides (TGs); total cholesterol; parathyroid hormone (PTH); osteoprotegerin (OPG); receptor activator of nuclear factor-κB (RANK); bone-resorbing cytokines, including bone deoxypyridinoline (DPD), N-terminal telopeptide of collagen type I (NTX-1), and tartrate-resistant acid phosphatase 5b (TRAP-5b); and bone-forming cytokines, including alkaline phosphatase (ALP) and osteocalcin (OC).Results: DEX administration for 90 days resulted in significantly increased serum levels of glucose, insulin, TGs, cholesterol, PTH, OPG, DPD, NTX-1, and TRAP-5b and significantly decreased BMD, BMC, and serum levels of RANK, OC, and ALP (all P<0.05). IF for 90 days significantly improved all these parameters (all P<0.05).Conclusions: IF corrected GIO in rats by inhibiting osteoclastogenesis and PTH secretion and stimulating osteoblast activity.

Objectives: In the current work, we studied the effects of exercise and stevia extracts on diabetic cardiomyopathy in type 2 diabetic rats and their possible underlying mechanisms. Methods: Thirty-two male Sprague Dawley rats were randomly allocated into 4 equal groups; a) normal control group, b) DM group, type 2 diabetic rats received 2ml oral saline daily for 4 weeks, c) DM+ Exercise, type 2 diabetic rats were treated with exercise for 4 weeks and d) DM+ stevia extracts: type 2 diabetic rats received methanolic stevia extracts. By the end of experiment, serum blood glucose, HOMA-IR, insulin and cardiac enzymes (LDH, CK-MB), cardiac histopathology, oxidative stress markers (MDA, GSH and CAT), myocardial fibrosis by Masson trichrome, the expression of p53, α-SMA and tyrosine hydroxylase (TH) by immunostaining in myocardial tissues were measured. Also, the expression of nuclear factor erythroid-like factor 2 (nrf2) was measured in myocardial tissues. Results: We found that T2DM caused significant increase in blood glucose, HOMA-IR index, serum CK-MB and LDH, myocardial damage and fibrosis, myocardial MDA, myocardial α-SMA, p53, nrf2 and TH density with significant decrease in serum insulin and myocardial GSH and CAT. On the other hand, treatment with either exercise or stevia extracts caused in significant improvement in studied parameters. Conclusions: exercise and methanolic stevia extracts have cardioprotective effects against DCM, which might be due to attenuation of fibrosis, oxidative stress, p53, TH and upregulation of nrf2. Moreover, stevia extracts offered more protective effect than exercise. Disclosure A. Hussein: None. E.A. Eid: None. M. Taha: None. L. Lashin: None.

Objectives: The present study examined the effect DHEA (dehydroepiandrosterone) on bone mineral content (BMC) and bone mineral density (BMD) and biomarkers of bone remodeling in orchidectomized male rats. Material and Methods: A total of 32 male rats were divided equally into four groups (n = 8): (i) control group (C), (ii) control treated with DHEA (Control + DHEA), (iii) orchidectomized (ORCH) group that underwent bilateral orchidectomy and (iv) orchidectomized (ORCH) rats treated with DHEA (ORCH+DHEA). DHEA treatment started 4 weeks after orchidectomy and continued for 12 weeks. After 12 weeks the bone mineral density (BMD) and bone mineral content (BMC) were assayed in the tibia and femur of the right hind limb of each rat. We also measured the serum levels of the bone turnover markers deoxypyridinoline (Dpd), N-telopeptide of type I collagen (NTx), alkaline phosphatase (ALP), tartrate-resistant acid phosphatase 5b (TRAP-5b) and osteocalcin (OC) as well as receptor activator of nuclear factor kappa B (RANK) and osteoprotegerin (OPG). Results: Orchidectomy in rats caused significant reduction in BMD, BMC, serum levels of testosterone, PTH (parathyroid hormone), OPG, OC and ALP with significant rise in serum levels of TRAP-5B, RANK, Dpd and NTx1 (p < 0.05). On the other hand, DHEA therapy for 12 weeks caused significant improvement in all studied parameters except NTx1 (p < 0.05). Conclusions: DHEA corrected hypogonadism-induced osteoporosis in male rats probably via inhibiting osteoclastogenesis, stimulating the activity of osteoblasts and stimulating the secretion of PTH and testosterone.

The present study investigated the possible cardioprotective effects of GLP1 and SGLT2i against diabetic cardiomyopathy (DCM) in type 2 diabetic rats and the possible underlying mechanisms. Methods: Thirty-two male Sprague Dawley rats were randomly subdivided into 4 equal groups: (a) control group, (b) DM group, type 2 diabetic rats with saline daily for 4 weeks, (c) DM + GLP1, as DM group with GLP1 analogue (liraglutide) at a dose of 75 µg/kg for 4 weeks, and (d) DM + SGLT2i as DM group with SGLT2 inhibitor (dapagliflozin) at a dose of 1 mg/kg for 4 weeks. By the end of treatment (4 weeks), serum blood glucose, homeostasis model assessment insulin resistance (HOMA-IR), insulin, and cardiac enzymes (LDH, CK-MB) were measured. Also, the cardiac histopathology, myocardial oxidative stress markers (malondialdehyde (MDA), glutathione (GSH) and CAT) and norepinephrine (NE), myocardial fibrosis, the expression of caspase-3, TGF-β, TNF-α, and tyrosine hydroxylase (TH) in myocardial tissues were measured. Results: T2DM caused significant increase in serum glucose, HOMA-IR, serum CK-MB, and LDH (p < 0.05). Also, DM caused significant myocardial damage and fibrosis; elevation of myocardial MDA; NE with upregulation of myocardial caspase-3, TNF-α, TGF-β, and TH; and significant decrease in serum insulin and myocardial GSH and CAT (p < 0.05). Administration of either GLP1 analog or SGLT2i caused a significant improvement in all studied parameters (p < 0.05). Conclusion: We concluded that both GLP1 and SGLT2i exhibited cardioprotective effects against DCM in T2DM, with the upper hand for SGLT2i. This might be due to attenuation of fibrosis, oxidative stress, apoptosis (caspase-3), sympathetic nerve activity, and inflammatory cytokines (TNF-α and TGF-β).

Background and Aims: In the current work, we studied the effects of exercise and stevia rebaudiana (R) extracts on diabetic cardiomyopathy (DCM) in type 2 diabetic rats and their possible underlying mechanisms. Methods: : Thirty-two male Sprague Dawley rats were randomly allocated into 4 equal groups; a) normal control group, b) DM group, type 2 diabetic rats received 2 ml oral saline daily for 4 weeks, c) DM+ Exercise, type 2 diabetic rats were treated with exercise for 4 weeks and d) DM+ stevia R extracts: type 2 diabetic rats received methanolic stevia R extracts. By the end of the experiment, serum blood glucose, HOMA-IR, insulin and cardiac enzymes (LDH, CK-MB), cardiac histopathology, oxidative stress markers (MDA, GSH and CAT), myocardial fibrosis by Masson trichrome, the expression of p53, caspase-3, α-SMA and tyrosine hydroxylase (TH) by immunostaining in myocardial tissues were measured. Results: T2DM caused a significant increase in blood glucose, HOMA-IR index, serum CK-MB and LDH, myocardial damage and fibrosis, myocardial MDA, myocardial α-SMA, p53, caspase-3, Nrf2 and TH density with a significant decrease in serum insulin and myocardial GSH and CAT (p< 0.05). On the other hand, treatment with either exercise or stevia R extracts significantly improved all studied parameters (p< 0.05). Moreover, the effects of stevia R was more significant than exercise (p< 0.05). Conclusion: Both exercise and methanolic stevia R extracts showed cardioprotective effects against DCM and Stevia R offered more cardioprotective than exercise. This cardioprotective effect of these lines of treatment might be due to attenuation of oxidative stress, apoptosis, sympathetic nerve density and fibrosis and upregulation of the antioxidant transcription factor, Nrf2.