Objective This study aimed to evaluate the effects of intermittent energy restriction (IER; only for 2‐3 d/wk) versus continuous energy restriction (CER) on weight loss and metabolic outcomes in adults with overweight or obesity. Methods Methods included searching databases from the last decade to December 18, 2019, for randomized controlled trials (RCTs) that assessed weight loss and metabolic outcomes in IER and CER. RevMan version 5.3 software was used for statistical analysis of the data. The effect sizes were expressed as weight mean differences and 95% CI. Results This review included 11 RCTs (n = 850). Meta‐analysis showed that IER had greater effects on absolute weight loss, the percentage of weight loss, and improving insulin sensitivity than CER. In the subgroup analysis, short‐term (2‐3 months) intervention (P < 0.0001) was associated with weight loss. Conclusions This systematic review shows that IER (2‐3 d/wk) had greater effects on short‐term weight loss than CER and that IER results in comparative metabolic improvements. Furthermore, longer RCTs are needed to validate these findings.

A lthough eating disorders are common in late adolescent diabetic patients, the occurrence in younger populations, particularly male diabetic patients, is not well documented (1,2). The prevalence was studied in 60 boys and 38 girls (13.78 Ϯ 1.05 years of age, range 12-16) with diabetes duration 1.5 Ϯ 3.35 years and in 321 boys and 254 girls as nondiabetic peers (13.73 Ϯ 0.63 years of age, 12-16).Patients and peers completed the Spanish validated version of the Eating Attitudes Test (EAT-40) (3). The semistructured Eating Disorder Examination (EDE) interview (4) was held for those with an EAT-40 Ͼ30 (13 diabetic patients and 57 nondiabetic peers) and an additional randomly selected population (24 diabetic patients and 57 nondiabetic peers) with an EAT-40 score Ͻ30. Eating disorders were classified as clinical (5) and subthreshold (1). SPSS version 9.0 was used for statistical analysis.No cases of anorexia or bulimia were found. Eating disorders not otherwise specified (EDNOS) were more prevalent in diabetic patients than in peers: boys (1.7 vs. 0.9%, odds ratio 1.7, CI 95% 0.2-17.6) and girls (5.3 vs. 1.6%, 3.2, 0.62-17.2). Subthreshold eating disorders were more prevalent in male diabetic patients than in nondiabetic peers (10 vs. 4.4%, 2.4, 0.9 -6.6), with no differences between female diabetic patients and nondiabetic peers (10.5 vs. 9.9%, 1.1, 0.4 -3.2). Male diabetic patients had 2.4 times increased risk for subthreshold eating disorders than nondiabetic peers. No eating disorders were observed in the 24 diabetic patients and 57 nondiabetic peers with EAT-40 scores Ͻ30. Glycated hemoglobin values were higher in diabetic patients with eating disorders (9.8 Ϯ 0.42 and 5.63 Ϯ 2.76%, n ϭ 13) than in those without (8.4 Ϯ 1.5 and 5.09 Ϯ 2.73%, n ϭ 85) (P ϭ 0.049).Although no cases of anorexia or bulimia were found, EDNOS and subthreshold eating disorders were detected in younger diabetic patients of both sexes. The higher glycated hemoglobin levels found in diabetic patients with eating disorders suggest poor metabolic control and increased risk for later vascular complications (6). Further studies including large series of patients are necessary to confirm these preliminary results; however, our data underline the need for careful surveillance in young diabetic patients of both sexes in order to promptly detect and prevent these incipient eating disorders.

Aim Diabetic foot has become the main cause of non-traumatic amputation. Stem cell therapy, especially mesenchymal stem cells (MSCs), holds a great promise as a therapy for diabetic foot with ischemia limb arterial disease. The aim of this pilot study is to evaluate the safety and efficacy of placenta-derived MSCs (P-MSCs) treatment for diabetic patients with critical limb ischemia (CLI). Methods Four eligible diabetic patients with CLI were consecutively enrolled in this pilot study. On the base of the standard-of-care treatment, these patients accepted P-MSCs treatment by intramuscular injection for successive 3 times at an interval of 4 weeks, and the safety and efficacy of placenta-derived MSCs (P-MSCs) treatment were evaluated. Results There were no serious adverse events during the period of P-MSCs injection and the 24-weeks follow-up period. The clinical ischemic features of patients were improved 24 weeks after P-MSCs treatment. The scores of resting pain and limb coldness significantly decreased, and pain-free walking distance significantly increased from baseline to 24 weeks after P-MSCs therapy. The resting ankle brachial index increased, but no statistically significant difference was found. The findings of magnetic resonance angiography showed the increase of collateral vessel formation in one patient, but there were no significant changes observed in the other patients. Conclusions The data in this pilot study indicated that multiple intramuscular P-MSCs injections may be a safe and effective alternative therapy for diabetic patients with CLI, and larger, placebo-controlled, perspective studies are needed to prove these results.

This study aimed to explore the associations between gut microbiota characteristics and glycometabolic profiles in mice fed diets high in advanced glycation end products (AGEs). Methods: C57BL/6 mice were exposed to a heat-treated diet or exogenous AGEs for 24 weeks, and glucose metabolism was assessed via the intraperitoneal glucose-tolerance test (IPGTT). Serum AGE and lipopolysaccharide-binding protein (LBP) levels were quantified using ELISA kits. 16S rDNA sequencing was performed to analyze the changes in gut microbiota according to α-and βdiversity. Key operational taxonomic units (OTUs) were evaluated, and co-abundance groups (CAGs) were delineated using weighted correlation network analysis. Associations between CAGs and clinical parameters were analyzed using Spearman correlation; predictive functional analysis of gut microbiota was performed using Kyoto Encyclopedia of Genes and Genomes data. Results: We identified significant increases in fasting blood glucose (FBG) and fasting insulin levels, as well as homeostatic model assessment insulin resistance (HOMA-IR) and glucose area under the receiver operating characteristic curve from IPGTT, in the high-AGE diet groups relative to controls at week 24. Serum AGE and LBP levels were elevated, and the α-and β-diversity of gut microbiota reduced in high-AGE diet groups. We identified 92 key OTUs that clustered into six CAGs, revealing positive correlations between CAG2/3/5 and insulin levels and mice weight and negative correlations between CAG1/3/4/5 and AGE, FBG, and LBP levels and HOMA-IR in mice fed high-AGE diets. We observed a reduced abundance of butyrate-producing bacteria, including Bacteroidales_S24-7, Ruminococcaceae, and Lachnospiraceae, in mice fed high-AGE diets, with pathway analysis of gut microbiota revealing significantly enriched fructose and mannose metabolism. Conclusion: High-AGE diets altered the gut microbiota composition and structure, and induced insulin resistance in mice. In the pathogenesis of insulin resistance, the loss of butyrate-producing bacteria might impair the colonic epithelial barrier, thereby triggering chronic low-grade inflammation.

Obstructive sleep apnea (OSA), characterized by recurrent episodes of apnea during sleep and daytime sleepiness, seriously affects human health and may lead to systemic organ dysfunction. The pathogenesis of OSA is complex and still uncertain, but multiple surveys have shown that obesity is an important factor, and the incidence of OSA in people with obesity is as high as 30%. Adipokines are a group of proteins secreted from adipocytes, which are dysregulated in obesity and may contribute to OSA. Here, we review the most important and representative research results regarding the correlation between obesity-related adipokines including leptin, adiponectin, omentin-1, chemerin, and resistin and OSA in the past 5 years, provide an overview of these key adipokines, and analyze possible intrinsic mechanisms and influencing factors. The existing research shows that OSA is associated with an increase in the serum levels of leptin, chemerin, and resistin and a decrease in the levels of adiponectin and omentin-1; the findings presented here can be used to monitor the development of OSA and obesity, prevent future comorbidities, and identify risk factors for cardiovascular and other diseases, while different adipokines can be linked to OSA through different pathways such as insulin resistance, intermittent hypoxia, and inflammation, among others. We hope our review leads to a deeper and more comprehensive understanding of OSA based on the relevant literature, which will also provide directions for future clinical research.