Romanian Journal of Diabetes Nutrition and Metabolic Diseases

Long non-coding RNA-H19 and miRNA-29a expression in type 2 diabetes mellitus patients

Mohammed Abdulfatah Al-ayash — 2025-09-15

Diabetes mellitus type 2 is one of the most prevalent illnesses. This study aims to shed light on the expression levels of the long non-coding RNA H19 and miRNA-29a, which are important in the diagnosis and pathogenesis of T2DM. The study included the collection of samples from 100 patients with type 2 diabetes attending AL-Furat General Hospital in Baghdad, following medical investigation, and 100 apparently healthy individuals as a control group, from July 2023 to November 2023. The Relative H19 expression levels were increased in the patient’s group (fold 1.38) vs. controls (fold 1.00) with a highly significant difference (p≤0.01), similar to miRNA29-a levels, which were also increased in the patient’s group (fold 2.17) with a highly significant difference (p<0.01). The analysis of H19 revealed an area under the curve of 0.86 (p<0.001), with 68% sensitivity and 96% specificity. The positive predictive value was 84.6%. The results of the analysis of miRNA-29a showed that the area under the curve was 0.91 and p<0.001, with 86% sensitivity and 92% specificity. The positive predictive value was 98%. The severity of diabetes 2 patients is linked to high lncRNA H19 expression and increased miRNA-29a expression, suggesting a potential role for miRNA-29a in the disease’s etiology.

Association between nutritional status and food insecurity in adult HIV patients aged 18 to 60 at María Auxiliadora Hospital, Lima, Peru

Gladys Obregón — 2025-09-15

Food insecurity (FI) may have significant implications for people with Human Immunodeficiency Virus (HIV), potentially affecting nutritional status and treatment response. This study aimed to determine the association between food insecurity and the nutritional status of adult HIV patients receiving antiretroviral therapy in Lima, Peru. A descriptive cross-sectional study was conducted with 222 adult HIV patients receiving antiretroviral therapy for at least 6 months at María Auxiliadora Hospital. Anthropometric measurements and the Latin American and Caribbean Food Security Scale were applied. Chi-square and ordinal logistic regression were used to analyze associations. 78.4% of patients lived with FI, with higher prevalence in households without minors (48.2%) versus those with minors (30.2%). A significant association was found between BMI and food insecurity (p=0.023). While 7.2% presented caloric malnutrition and 22.5% protein malnutrition, 50.9% had overweight or obesity. Patients with severe FI had 1.57 times higher malnutrition prevalence, and those in families with >7 members showed 1.54 times greater prevalence. The findings suggest a considerable prevalence of food insecurity in the studied population, with significant associations with nutritional status. These results highlight the importance of considering nutritional and socioeconomic factors in HIV patient care.

Association of different vitamin D levels with metabolic syndrome components in type 2 diabetic patients in Gorgan

Karrar Jaber Hasan Al-hajmee — 2025-09-15

This study was designed to evaluate and compare different levels of serum VD in MetS and T2DM subjects, and without MetS subjects, and to determine its association with MetS components in Gorgan. The study included 270 type 2 diabetic patients in 3 groups: Patients with MetS and VD deficiency Group 1), patients with MetS and a normal level of VD (Group 2) and patients without MetS and a normal level of VD (Group 3). The MetS criteria were defined using the National Cholesterol Education Program’s Adult Treatment Panel III guidelines. Waist circumference (WC), systolic and diastolic blood pressure (SBP, DBP), fasting blood sugar (FBS) and triglyceride (TG) were significantly higher, and High-density lipoprotein cholesterol (HDL-C) and VD levels were significantly lower in Groups 1 and 2 than in Group 3. FBS and TG levels were significantly higher, and VD levels were significantly lower in Group 1 than in Group 3. Negative correlations exist between VD, FBS, and TG in group 1. Vitamin D deficiency may increase the risk of Mets. The relationship between VD deficiency and an increase in FBS and TG levels suggests that subjects in this group should manage their FBS and TG levels.

Association of visible fat intake with serum liver enzymes in obese individuals

Ashni Sangappan Jayakumar — 2025-09-15

Visible fat intake may adversely influence hepatic function and lipid metabolism. This study aimed to assess the association between visible fat consumption, liver enzyme biomarkers, and lipid profile in obese and non-obese individuals. A cross-sectional study was conducted from July to December 2023 in the Department of Biochemistry, Chettinad Hospital and Research Institute, Kelambakkam, India. One hundred subjects (20–70 years, both genders) were enrolled and stratified by BMI. Dietary visible fat intake, liver enzymes (ALT, AST, ALP, GGT), and lipid profile were analysed. Among obese males, AST (P=0.037) showed a significant correlation with visible fat, while ALP (P=0.01) correlated in obese females. Lipid analysis revealed associations in obese males with triglycerides (P=0.001), HDL (P=0.004), VLDL (P=0.001), and in obese females with triglycerides (P=0.003), HDL (P=0.043), LDL (P=0.039), and VLDL (P=0.003). Age-wise, ALT (P=0.048) and GGT (P=0.020) were significant in the 20–40 year group, ALP (P=0.000) in the 41–60 year group, and cholesterol, triglycerides, and VLDL in individuals over 60 years. ROC curve analysis revealed AST (AUC=0.95) and ALT (AUC=0.76) as accurate predictors. Visible fat intake is significantly linked with altered liver enzymes and lipid profile in obese individuals, highlighting dietary fat as a modifiable risk factor for hepatic and metabolic health.

Association of adiponectin concentration with acute coronary syndrome types in diabetes mellitus: A cross-sectional study

Indah Triayu Irianti — 2025-09-15

Diabetes Mellitus (DM) increases the risk of acute coronary syndrome (ACS). Adiponectin has been popular as a potential indicator for DM and ACS. Hypoadiponectinemia has an important role in the pathogenesis of cardiovascular disease associated with metabolic syndrome. A cross-sectional analytical study with simple random sampling was conducted at Dr. Wahidin Hospital. The study samples were diagnosed with DM and ACS. Data analysis was performed using chi-square tests and odds ratios (ORs). This study involved 88 subjects with DM and ACS who fulfilled the study’s eligibility criteria. The mean adiponectin concentration was 10.27 µg/ml. The subjects with the highest adiponectin concentration quartile (Q4) were those with STEMI (69.6%), and the difference was not statistically significant (chi-square, p>0.05). There is a significant association between dyslipidemia and adiponectin concentration (p<0.05), with the highest adiponectin concentration in the quartile (Q2) at 28.4%. Subjects with hypoadiponectinemia quartile (Q1–Q2) had 11.6 times higher risk of mortality (OR 11.647, 95% CI: 1.407–96.443, p=0.006). There is no significant association between adiponectin concentration and the type of ACS in DM subjects. Dyslipidemia was identified as the predominant risk factor affecting adiponectin concentration. A significant association was found between adiponectin concentration and mortality from acute coronary syndrome in diabetic subjects.

A cross-sectional anthropometric analysis of diabetic patients in a tertiary care facility: Implications for risk assessment and targeted interventions

Willy Barinem Vidona — 2025-09-15

Understanding how body measurements such as Body Mass Index (BMI), waist circumference, and waist-to-hip ratio correlate with diabetes can provide valuable insights for its management and prevention. This study evaluates the anthropometric parameters of patients with diabetes mellitus attending Irrua Specialist Teaching Hospital (ISTH) and assesses their association with diabetes type and risk. This cross-sectional study involved 200 adult patients with diabetes mellitus. Measurements included height, weight, BMI, waist and hip circumferences, and waist-to-hip ratio. Descriptive statistics, gender comparisons, Pearson correlation, and logistic regression analyses, using IBM SPSS version 26.0, evaluated the associations between these measurements and diabetes. The mean age of participants was 50.41 years, with a mean BMI of 27.92 and a waist circumference of 94.20 cm. Significant gender differences were observed in age, height, weight, waist and hip measurements, and waist-to-hip ratio (p<0.001). Patients with Type 2 diabetes showed higher anthropometric values than those with Type 1. BMI and waist circumference correlated with diabetes risk (p=0.004), with logistic regression identifying BMI as a significant predictor (p=0.015). Anthropometric factors, particularly BMI and waist circumference, are associated with diabetes risk and can be useful for screening purposes.

Correlation of steatosis degree with metabolic syndrome in patients with fatty liver disease-associated metabolic dysfunction (MAFLD)

Jonny Wafom — 2025-09-15

Metabolic-associated fatty Liver Disease (MAFLD) is a growing global health concern. Hepatic steatosis is frequently associated with metabolic syndrome, which consists of obesity, insulin resistance, and hypertension. Understanding the correlation between the stages of hepatic steatosis and metabolic syndrome is essential for risk stratification and therapeutic planning. To investigate the correlation between the stages of hepatic steatosis and the presence of metabolic syndrome in MAFLD patients. This study is a cross-sectional analytical study conducted at Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia, from 2024 to 2025. A total of 126 patients with MAFLD were selected. Metabolic parameters data were collected, including BMI, waist circumference, blood pressure, lipid profile, fasting blood glucose, HbA1c, and the presence of metabolic syndrome. Hepatic steatosis stages were assessed via imaging and classified into grades 1 to 3. Statistical associations were evaluated using the Chi-square test with significance at p<0.05. Most of the patients were obese (82.5%), had elevated waist circumference (93.7%), and fulfilled criteria for metabolic syndrome (75.4%). Grade 1 steatosis was most prevalent (79.4%), followed by grades 2 (13.5%) and 3 (7.1%). A statistically significant association was observed between the severity of hepatic steatosis and BMI (p=0.031), hypertension (p=0.011), and metabolic syndrome (p=0.021). No significant associations were found with waist circumference, triglycerides, HDL, fasting blood glucose, diabetes status, or HbA1c. Severe hepatic steatosis is strongly correlated with obesity, hypertension, and metabolic syndrome in MAFLD patients. These results emphasize the essential role of systemic metabolic dysfunction in developing hepatic steatosis and stress the importance of meticulous management of metabolic risk factors in treating MAFLD.

Analysis of melatonin levels in the saliva of patients with type 2 diabetes mellitus

Alina Urbanovych — 2025-09-15

Diabetes mellitus is a complex metabolic disorder characterized by chronic hyperglycemia. Melatonin, a hormone that regulates sleep and circadian rhythms, due to its anti-inflammatory and antioxidant effects, influences the pathogenetic component of diabetes mellitus. This study includes 77 patients with type 2 diabetes who were treated at the branch “Endocrine Health Center” of the State Clinical Hospital of the Lviv Regional Diagnostic Center during January to September 2024. Patients were divided into 2 groups according to the score of the Pittsburgh Sleep Quality Index: 41 patients with a score >5, and 36 with a score <5. Melatonin levels were lower in a group of patients with poor sleep quality. Additionally, melatonin exhibits a moderate correlation with glycated hemoglobin. It is important to test melatonin levels before prescribing it to patients with diabetes to ensure individualized treatment.

Association between vitamin D deficiency and insulin resistance assessed by the triglyceride-glucose index in type 2 diabetes mellitus adults in Northwest Algeria

Mohammed Salim Kalaidji — 2025-09-15

Vitamin D plays a role in glucose metabolism and insulin regulation. This study aimed to assess the association between vitamin D levels and the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance (IR), in Algerian adults with type 2 diabetes mellitus (T2DM). In this cross-sectional study, 105 patients with type 2 diabetes mellitus (T2DM) were evaluated. Clinical and biochemical data were collected, including fasting glucose, lipid profile, glycated hemoglobin (HbA1c), and 25-hydroxyvitamin D [25(OH)D] levels. The TyG index was calculated. Associations were analyzed using Spearman correlation and binary logistic regression. Patients with vitamin D deficiency exhibited significantly higher levels of fasting glucose and glycated hemoglobin, with P values of 0.015 and 0.013, respectively. A negative correlation was observed between vitamin D and the TyG index (r=–0.237; P=0.015). Vitamin D >20 ng/mL was associated with a lower risk of elevated TyG index (OR=0.246; 95% CI: 0.080–0.752; P=0.014). Low vitamin D levels were significantly associated with higher TyG index values in T2D patients, suggesting a potential link between vitamin D deficiency and IR in this population.

Adherence-related challenges and drug utilization in hypertension management

Viktor Meretskyi — 2025-09-15

Arterial hypertension is a major contributor to cardiovascular morbidity and mortality, with poor adherence to treatment remaining a key issue. This study aimed to evaluate medication use, adherence levels, and factors influencing compliance among patients with hypertension, as well as the role of pharmaceutical care in improving outcomes. A cross-sectional survey was conducted among 200 hypertensive outpatients using a structured questionnaire that assessed sociodemographic, clinical, and pharmacotherapeutic data. Adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Hypertension was more prevalent among married, employed individuals with higher education. Modifiable risk factors included smoking (40%), alcohol use (36.7%), low physical activity (66.7%), and high salt intake (53.3%). Common comorbidities included hypercholesterolemia, diabetes, and cardiovascular or cerebrovascular diseases. All patients received combination therapy, with diuretics being the most prescribed (96.7%). Only 10% showed high adherence, while over half had low adherence. Key barriers were treatment cost, reliance on phytotherapy, and irregular medication use. Participation in the national “Affordable Medicines” program was reported by 80% of respondents. Adherence to antihypertensive therapy remains low and is affected by both clinical and socioeconomic factors. Enhancing pharmaceutical care and ensuring access to affordable medications are vital to improving treatment compliance and achieving better blood pressure control.

Evaluation of the role of plasma glycated CD59 and FRMD3 variants as predictors of diabetic nephropathy

Bhagatsingh Chinta — 2025-09-15

Plasma glycated CD59 (gCD59) is evaluated as a predictor for diabetic nephropathy (DN), and the association between FRMD3 gene mutations and DN susceptibility in type 2 diabetes (T2D) patients is explored. This cross-sectional study included 320 patients with type 2 diabetes mellitus (T2DM), divided equally into two groups: those with and without microalbuminuria. Plasma gCD59 levels were measured using a sandwich ELISA, and FRMD3 gene mutations were identified via PCR and Sanger sequencing. Statistical analyses assessed biomarker levels and their association with DN. Plasma gCD59 levels were significantly higher in patients with microalbuminuria (mean 711.27 pg/mL) compared to those without (mean 424.06 pg/mL). The G allele of the FRMD3 gene was more prevalent in DN patients (51.7% versus 41.2%), with the GG genotype showing a strong association with DN. Plasma gCD59 and FRMD3 gene polymorphisms are promising biomarkers for the early detection of DN in T2DM patients. Integrating these markers into routine clinical assessments may enhance early diagnosis and facilitate the development of personalized management strategies.

Cognitive dysfunction in military personnel - combatants with metabolic syndrome

Serhii Stadnik — 2025-09-15

Cognitive dysfunction is a frequent yet underrecognized complication of metabolic syndrome (MS), with important medical and social implications. Impairment of cognitive abilities in these patients can reduce quality of life and increase the long-term risk of dementia and social maladaptation. This study evaluated the prevalence and clinical features of cognitive disorders (CDs) in military personnel—combatants—diagnosed with MS. Eighty-two patients with MS (main group) and 40 patients with arterial hypertension (AH) without MS (control group) underwent comprehensive assessment, including neuropsychological testing, biochemical analysis (lipid profile, glucose), blood pressure measurement, and statistical evaluation. Absence of cognitive impairment was significantly more frequent in the control group (χ2=11.7, p<0.01), whereas moderate CDs predominated in the MS group (χ2=4.2, p<0.05). The MS group demonstrated significantly lower performance across most neuropsychological measures, including screening scales, auditory-verbal memory, attention, processing speed, speech, and spatial orientation. Depression and anxiety scores correlated negatively with MMSE (r=–0.3, p<0.05) and positively with deficits in word memorization, naming, and attention tasks. Elevated triglycerides were associated with poorer attention and delayed recall (p<0.05), while low high-density lipoprotein (HDL) levels correlated with more errors in delayed reproduction (p<0.05). Findings indicate that in military personnel with MS, CDs are predominantly neurodynamic and, at present, do not result in complete social or domestic maladaptation. However, affected individuals remain at elevated risk for progression to severe cognitive impairment and dementia, underscoring the need for early detection and targeted preventive interventions.

Double diabetes in a newly diagnosed 19-year-old female with obesity: Case report and treatment strategies

Ivana Mickovski — 2025-09-15

Double diabetes (DD) is a complex metabolic condition where characteristics of both type 1 diabetes (T1D) and type 2 diabetes (T2D) coexist. It typically presents in individuals with autoimmune diabetes who also display significant insulin resistance due to obesity or other metabolic factors. It is increasingly identified in young adults due to the global rise in obesity. This article describes the case of a 19-year-old female with obesity who presented with newly diagnosed diabetes, showing features of both T1D and T2D, focusing on diagnostic approaches, treatment strategies, and the critical role of healthy lifestyle interventions, including weight loss and the use of metformin. Laboratory investigations, clinical presentations, and treatment strategies are outlined to highlight the complexity of managing DD in adolescents.

Necrotizing fasciitis associated with Enterococcus avium in a Type 2 Diabetes Mellitus patient: A case report

Brury Rosally — 2025-09-15

Necrotizing fasciitis (NF) is a rapidly progressive and life-threatening infection of the soft tissue. Diabetic patients are especially at risk due to impaired immunity and poor wound healing. We report a case of NF in a 60-year-old Indonesian man with poorly controlled type 2 diabetes. He presented with a rapidly worsening wound on his right foot following a minor abrasion, along with signs of sepsis and early organ dysfunction. His LRINEC score was 10. He underwent urgent surgical debridement and below-knee amputation. Despite initial improvement, he deteriorated and died from septic shock on day five. Wound culture revealed Enterococcus avium, a rare pathogen that is resistant to several antibiotics but sensitive to vancomycin and linezolid. This case highlights the severe progression of NF in diabetic patients and the need for early recognition and aggressive management. The presence of E. avium underscores the potential role of uncommon pathogens in serious infections among immunocompromised individuals. Delayed referral and lack of timely antibiotic adjustment may have contributed to the fatal outcome. Prompt diagnosis, early surgery, and appropriate antibiotics are crucial in managing NF. Clinicians should be vigilant in monitoring diabetic patients and consider rare pathogens, such as E. avium, in cases of severe infections.

Effects of a very low-calorie ketogenic diet on energy metabolism and inflammation in obesity management: A systematic review

Alberta Humolli — 2025-09-15

Obesity represents a long-term health issue that leads to body-wide inflammation, together with changes in metabolic operations. Bone metabolism and remodeling are indicated by osteocalcin, while high-sensitivity C-reactive protein (hs-CRP) functions as a crucial marker for inflammation. This review investigates how very low-calorie ketogenic diets affect obese patients’ hs-CRP and osteocalcin biomarker levels. Seven research articles from 2019 to 2024 were reviewed to analyze direct biomarker changes after VLCKD interventions. The research shows that VLCKD delivers substantial anti-inflammatory effects through hs-CRP level reductions between 30% and 50%. The research showed sex-related differences because men experienced a more significant reduction in hs-CRP levels at −41.42% compared to women who experienced −22.38%. The results suggest that hormonal or metabolic factors influence how individuals respond to this treatment. The research shows variable osteocalcin level changes between studies, with some trials reporting increases between 10% and 30% but other trials showing minimal changes. Research design, along with study duration and participant characteristics, might explain these inconsistent results. The anti-inflammatory effects of VLCKD appear beneficial for obese patients, but the impact on bone biomarkers remains unclear. Additional research using standardized methods across extended periods is needed to determine these effects precisely for clinical practice guidance.

Biochemical perspectives on food order: From postprandial glucose control to hormonal modulation

Rukayat Abiodun Oyegoke — 2025-09-15

The term “food order” refers to the sequence of nutrient consumption, with a profound impact on metabolic processes, including postprandial blood sugar levels, insulin regulation, and regulation of satiety hormones. In this review, an accent is placed on how meal ordering controls glucose homeostasis and its role in disease prevention, specifically in type 2 diabetes mellitus. Consuming foods high in protein and fiber before carbohydrates is seen to slow gastric emptying and modify hormonal feedback, resulting in reduced glucose and insulin spikes. All these effects occur through several metabolic processes, including glycolysis, gluconeogenesis, AMPK, and mTOR signaling processes. Recognizing these biochemistries highlights food ordering as a potential non-pharmacological intervention for optimizing metabolite function. Individualized nutritional approaches can optimize energy utilization and reduce the need for medication. The long-term benefits and the translation of these approaches for use in diverse groups must be determined in future studies.

Vitamin D: A vital micronutrient for periodontal health

Nina Shenoy — 2025-09-15

Vitamin D is a vital micronutrient essential for maintaining overall health. It plays a key role in modulating both cellular and humoral immune responses, supporting cardiovascular function, and regulating cell growth and differentiation. Deficiency in vitamin D—often due to inadequate dietary intake—has been linked to a range of systemic disorders and is particularly detrimental to oral and periodontal health. Lower serum levels of vitamin D are associated with increased severity of periodontitis and a reduced response to periodontal therapies. The active form of vitamin D, calcitriol, exhibits potent immunomodulatory and anti-inflammatory properties. Widespread vitamin D deficiency also compromises bone health by impairing calcium absorption in the gut and disrupting calcium homeostasis, leading to decreased bone density and a higher risk of fractures, especially in the elderly.

Contemporary view and clinical implications of thyroid autoimmunity interactions in female fertility, reproduction and pregnancy

Volodymyr Artyomenko — 2025-09-15

Thyroid autoimmunity (TAI) is known to influence female reproductive function and has been identified in 13–19% of infertile women, particularly in those with recurrent miscarriage, polycystic ovary syndrome (PCOS), diminished ovarian reserve, reduced embryo quality, or unexplained infertility. This review examines the relationship between TAI, including subclinical and overt hypothyroidism, as well as postpartum thyroiditis (PT), and female reproductive health, emphasizing the role of TAI in female subfertility. This narrative literature review draws on key medical databases to analyze recent and available evidence-based studies exploring the influence of TAI on ovarian function, fertility and pregnancy. TAI, even in its asymptomatic or subclinical forms, may impair fertility through direct ovarian mechanisms and immune-mediated pathways. Thyroid antibodies are associated with unexplained infertility and idiopathic low ovarian reserve that might be linked to one another. PT presents an additional challenge when pregnancy is followed by thyroid dysfunction, particularly in TPOAb-positive women. TAI should be considered in the diagnostic evaluation of subfertile women, especially those with unexplained subfertility or pregnancy loss/termination. Monitoring and individualized LT-4 therapy may improve reproductive outcomes and reduce pregnancy complications. Further research is needed to clarify the immune mechanisms linking TAI and reproductive failure.