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Open Access Review
Effects of GLP-1 receptor agonists and dual incretin agonists on adipocyte type and size
Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) and dual incretin agonists have demonstrated significant potential in improving adipose tissue function beyond their established effects on appetite suppression and weight loss. These agents not only reduce overall fat mass but also induce favorable changes in fat distribution and adipose tissue quality. Notably, they enhance brown adipose tissue (BAT) activity and promote the browning of white adipose tissue (WAT), thereby increasing energy expenditure. They are associated with reductions in adipocyte size, particularly within visceral fat depots, alongside improvements in metabolic health markers. The aim of this publication is to provide a literature review on the effects of GLP-1RAs and dual incretin agonists on adipocyte type and size, adipose tissue functional remodeling, and their implications for obesity management. These findings highlight the capacity of incretin-based therapies to modulate adipose tissue biology, offering metabolic benefits that extend beyond weight reduction.
Open Access Review
Psychotropic medications and metabolic side effects
Psychiatric medication is vital in the treatment of a wide range of mental and behavioral health conditions, but has moderate metabolic consequences. The common side effects are weight gain, dyslipidemia, increased adiposity, elevated body mass index, increased insulin resistance, and metabolic alterations. Metabolic risk is lower with antidepressants than with antipsychotics. The side effects are linked to the metabolic syndrome, increasing the risk of heart disease, stroke, and type 2 diabetes. Cardiovascular diseases, dysglycemia and diabetes, atherogenic dyslipidemia, and metabolic syndrome are common complications associated with the use of antipsychotics. Therefore, it is essential to comprehend the metabolic alterations and develop strategies for early detection and intervention to mitigate these effects. This review discusses the metabolic alterations associated with common antipsychotic medications, followed by strategies to attenuate the effects.
Open Access Original Article
Waist-to-height ratio as a novel marker of metabolic syndrome in patients with type 2 diabetes mellitus
Aim: Metabolic syndrome (MetS) is associated with chronic conditions, including type 2 diabetes mellitus (T2DM) and cardiovascular disorders. New markers are needed for the early detection and successful treatment of MetS, especially in patients with T2DM. The serum uric acid-to-creatinine ratio (UCR) and waist-to-height ratio (WHR) are novel markers in various chronic metabolic disorders. We aimed to compare WHR, UCR, and other metabolic and laboratory markers in T2DM patients with and without MetS. Methods: Patients with T2DM who visited the outpatient clinics of our institution were enrolled in the study. Total diabetic subjects were 239 of which 180 were in MetS group while 59 were in without MetS group. Data from both study groups were compared. Results: The serum UCR in the MetS and control groups was 6.3 ± 2.1 and 5.8 ± 1.6, respectively (p = 0.04). The WHR in the MetS and control groups was 0.65 (0.47–0.87) and 0.62 (0.35–0.84), respectively (p < 0.001). Significant positive correlations were observed between UCR and triglycerides (r = 0.17, p = 0.009), waist circumference (r = 0.13, p = 0.046), hip circumference (r = 0.18, p = 0.006), BMI (r = 0.2, p = 0.002), and GFR (r = 0.4, p < 0.001). Similarly, significant positive correlations were noted between WHR and systolic blood pressure (r = 0.12, p = 0.049), weight (r = 0.5, p < 0.001), BMI (r = 0.7, p < 0.001), and UCR (r = 0.12, p = 0.047). In the ROC analysis, the sensitivity and specificity of WHR (when higher than 0.64) in detecting MetS were 72% and 54%, respectively (AUC: 0.69, p < 0.001, 95% CI: 0.61–0.77). Conclusions: We propose that WHR and UCR could be valuable tools for the early detection of MetS in patients with T2DM. The ease and low cost of evaluating WHR and UCR make them practical markers for monitoring and diagnosing MetS.

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