Panax ginseng, as the king of Chinese herb, has significant therapeutic effects on obesity, type 2 diabetes mellitus, fatty liver disease, colitis, diarrhea, and many other diseases. This review systematically summarized recent findings, which show that ginseng plays its role by regulating gut microbiota diversity, and gut microbiota could also regulate the transformation of ginsenosides. We conclude the characteristics of ginseng in regulating gut microbiota, as the potential targets to prevent and treat metabolic diseases, colitis, neurological diseases, cancer, and other diseases. Ginseng treatment can increase some probiotics such as Bifidobacterium, Bacteroides, Verrucomicrobia, Akkermansia, and reduce pathogenic bacteria such as Deferribacters, Lactobacillus, Helicobacter against various diseases. Meanwhile, Bacteroides, Eubacterium, and Bifidobacterium were found to be the key bacteria for ginsenoside transformation in vivo. Overall, ginseng can regulate gut microbiome diversity, further affect the synthesis of secondary metabolites, as well as promote the transformation of ginsenosides for improving the absorptivity of ginsenosides. This review can provide better insight into the interaction of ginseng with gut microbiota in multiple disorders and ginsenoside transformation.

Ferroptosis is characterized by the accumulation of iron and lipid peroxidation products, which regulates physiological and pathological processes in numerous organs and tissues. A growing body of research suggests that ferroptosis is a key causative factor in a variety of skeletal muscle diseases, including sarcopenia, rhabdomyolysis, rhabdomyosarcoma, and exhaustive exercise-induced fatigue. However, the relationship between ferroptosis and various skeletal muscle diseases has not been investigated systematically. This review’s objective is to provide a comprehensive summary of the mechanisms and signaling factors that regulate ferroptosis, including lipid peroxidation, iron/heme, amino acid metabolism, and autophagy. In addition, we tease out the role of ferroptosis in the progression of different skeletal muscle diseases and ferroptosis as a potential target for the treatment of multiple skeletal muscle diseases. This review can provide valuable reference for the research on the pathogenesis of skeletal muscle diseases, as well as for clinical prevention and treatment.

Content: The correlation between visceral obesity index (VAI) and diabetes and accuracy of early prediction of diabetes are still controversial. Objective: This study aims to review the relationship between high level of VAI and diabetes and early predictive value of diabetes. Data Sources: The databases of PubMed, Cochrane, Embase, and Web of Science were searched until October 17, 2023. Study Selection: After adjusting for confounding factors, the original study on the association between VAI and diabetes was analyzed. Data Extraction: We extracted odds ratio (OR) between VAI and diabetes management after controlling for mixed factors, and the sensitivity, specificity, and diagnostic 4-grid table for early prediction of diabetes. Data Synthesis: Fifty-three studies comprising 595 946 participants were included. The findings of the meta-analysis elucidated that in cohort studies, a high VAI significantly increased the risk of diabetes mellitus in males (OR = 2.83 [95% CI, 2.30-3.49]) and females (OR = 3.32 [95% CI, 2.48-4.45]). The receiver operating characteristic, sensitivity, and specificity of VAI for early prediction of diabetes in males were 0.64 (95% CI, .62–.66), 0.57 (95% CI, .53–.61), and 0.65 (95% CI, .61–.69), respectively, and 0.67 (95% CI, .65–.69), 0.66 (95% CI, .60–.71), and 0.61 (95% CI, .57–.66) in females, respectively. Conclusion: VAI is an independent predictor of the risk of diabetes, yet its predictive accuracy remains limited. In future studies, determine whether VAI can be used in conjunction with other related indicators to early predict the risk of diabetes, to enhance the accuracy of prediction of the risk of diabetes.

Background: Type 2 diabetes mellitus (T2DM) and Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) are mutually causal, which can jointly promote the development of the disease. As an important means to evaluate the steatosis of MAFLD, Controlled Attenuation Parameter (CAP) can also evaluate the metabolism related fat parameters. Whether Traditional Chinese Medicine preparation (TCM-preparation) can improve CAP has not been reported yet, so the purpose of this meta-analysis is to evaluate the effect of TCM-preparation on CAP in T2DM patients with MAFLD.Methods: In this meta-analysis, eight databases were searched from the establishment of the database to 23 April 2025, to obtain clinical randomized controlled trials of TCM-preparation or TCM-preparation combined with Standard Biomedical Treatment in the treatment of T2DM complicated with MAFLD. After screening the literature and extracting the data, Meta-analysis was conducted using RevMan5.4 software, with results presented in the form of a forest plot. This study was registered with PROSPERO (CRD42024569613).Results: A total of 599 papers were retrieved, and the papers were screened according to the nadir and ranking criteria, and finally 8 trials (648 participants) were included in this study. Meta-analysis showed that TCM-preparation significantly reduced CAP values in patients with T2DM combined with MAFLD compared with TCM-preparation (MD = −15.19, CI [−22.53, −7.85], P < 0.0001).Conclusion: TCM-preparation can reduce the CAP value of T2DM combined with MAFLD and can have a good therapeutic effect on glucose-lipid metabolism level and liver function, indicating that TCM-preparation can reduce the deposition of hepatic fat, restore the function of hepatocytes, and have a positive effect on T2DM combined with MAFLD; however, due to the heterogeneity of the included literature, it needs to be further validation by high-quality trials.