The present study evaluated the predictive ability of five known “best” obesity and lipid-related parameters, including body mass index (BMI), waist-to-height ratio (WHtR), triglyceride-to-high-density-lipoprotein-cholesterol (TG/HDL-C), lipid accumulation product (LAP) and visceral adiposity index (VAI), in identifying metabolic syndrome (MetS) in Chinese elderly population. A total of 6722 elderly Chinese subjects (≥60 years) were recruited into our community-based cross-sectional study from April 2015 to July 2017. The anthropometrics, blood pressure, fasting plasma glucose, blood lipid profiles, family history and health-related behaviours were assessed. The prevalence of MetS was 40.4% (32.5% in males and 47.2% in females). With the increase in the number of MetS components (from 0 to 5), all the five parameters showed an increase trend in both genders (all P for trend < 0.001). According to receiver operating characteristic curve (ROC) analyses, all the five parameters performed high predictive value in identifying MetS. The statistical significance of the areas under the curves (AUCs) differences suggested that the AUCs of LAP were the greatest among others in both genders (AUCs were 0.897 in males and 0.875 in females). The optimal cut-off values of LAP were 26.35 in males and 31.04 in females. After adjustment for potentially confounding factors, LAP was strongly associated with the odds of having MetS in both genders, and ORs for MetS increased across quartiles using multivariate logistic regression analysis (P < 0.001). LAP appeared to be a superior parameter for predicting MetS in both Chinese elderly males and females, better than VAI, TG/HDL-C, WHtR and BMI.

The purpose of this study was to compare the predictive ability of five obesity indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR) and body adiposity index (BAI), to predict multiple non-adipose metabolic risk factors, including elevated blood pressure (BP), elevated fasting plasma glucose (FPG), elevated triglyceride (TG), reduced high-density lipoprotein cholesterol (HDL-C), elevated serum uric acid (SUA) and non-alcoholic fatty liver disease (NAFLD), in an elderly Chinese population. A total of 5685 elderly Chinese subjects (≥60 years) were recruited into our community-based cross-sectional study. Receiver operating characteristic curve (ROC) analyses were used to compare the predictive ability as well as determine the optimal cut-off values of the obesity indices for multiple metabolic risk factors. According to the areas under the receiver operating characteristic curve (AUC), BMI, WC and WHtR were able to similarly predict high metabolic risk in males (0.698 vs. 0.691 vs. 0.688), while in females, BMI and WC were able to similarly predict high metabolic risk (0.676 vs. 0.669). The optimal cut-off values of BMI, WC and WHtR in males were, respectively, 24.12 kg/m², 83.5 cm and 0.51, while in females, the values were 23.53 kg/m² and 77.5 cm.

Recent studies have revealed the pivotal role of gut microbiota in the progress of liver diseases including non-alcoholic steatohepatitis (NASH). Many natural herbs, such as Gynostemma pentaphyllum (GP), have been extensively applied in the prevention of NASH, while the bioactive components and underlying mechanism remain unclear. The aim of this study was to investigate whether the polysaccharides of GP (GPP) have a protective effect on NASH and to explore the potential mechanism underlying these effects. C57BL/6 male mice were fed with a methionine-choline-deficient (MCD) diet for 4 weeks to induce NASH and administered daily oral gavage of sodium carboxymethylcellulose (CMC-Na), low dose of GPP (LGPP), high dose of GPP (HGPP), and polyene phosphatidylcholine capsules (PPC), compared with the methionine-choline-sufficient (MCS) group. Our results showed that the symptoms of hepatic steatosis, hepatocyte ballooning, liver fibrosis, and oxidative stress could be partially recovered through the intervention of GPP with a dose-dependent effect. Furthermore, gut microbiome sequencing revealed that HGPP altered the composition of gut microbiota, mainly characterized by the enrichment of genera including Akkermansia, Lactobacillus, and A2. Moreover, hepatic transcriptome analysis indicated that the anti-inflammatory effect of HGPP might be associated with toll-like receptor (TLR) and nod-like receptor (NLR) signaling pathways. HGPP could inhibit the expression of TLR2 and downregulate the expression of the NLRP3 inflammasome, as well as the pro-inflammatory cytokine tumor necrosis factor (TNF)-α and interleukin (IL)-1β. In summary, GPP could ameliorate NASH possibly mediated via the modulation of gut microbiota and the TLR2/NLRP3 signaling pathway, indicating that GPP could be tested as a prebiotic agent in the prevention of NASH.

Background: Metabolomics has immense research value in coronary artery disease and has drawn increasing attention over the past decades. Many articles have been published in this field, which may challenge researchers aiming to investigate all the available information. However, bibliometrics can provide deep insights into this research field.Objective: We aimed to qualitatively and quantitatively study metabolomics and coronary artery disease research, visually analyse the development status, trends, research hotspots, and frontiers of this field, and provide a reference for research on coronary artery disease.Methods: Articles were acquired from the Web of Science Core Collection. VOSviewer and CiteSpace software were used to analyse publication growth, country/region, institution, journal distribution, author, reference, and keywords, and detected the keywords with strong citation burstness to identify emerging topics.Results: A total of 1121 references were obtained, and the annual number of publications increased over the past 16 years. Metabolomics research has shown a gradual upward trend in coronary artery disease. The United States of America and China ranked at the top in terms of percentage of articles. The institution with the highest number of research publications in this field was Harvard University, followed by the University of California System and Brigham Women’s Hospital. The most frequently cited authors included Hazen SL, Tang WH, and Wang ZN. Ala-Korpela M was the most productive author, followed by Clish CB and Adamski J. The journal with the most publications in this field was Scientific Reports, followed by PLoS One and the Journal of Proteome Research. The keywords used at a high frequency were “risk,” “biomarkers,” “insulin resistance,” and “atherosclerosis.” Burst detection analysis of top keywords showed that “microbiota,” “tryptophan,” and “diabetes” are the current research frontiers in this field.Conclusion: This study provides useful information for acquiring knowledge on metabolomics and coronary artery diseases. Metabolomics research has shown a gradual upward trend in coronary artery disease studies over the past 16 years. Research on tryptophan metabolism regulated by intestinal flora will become an emerging academic trend in this field, which can offer guidance for more extensive and in-depth studies in the future.

Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease characterized by excessive fat accumulation in the liver. One of the underlying pathophysiological mechanisms is insulin resistance (IR). Traditional Chinese medicine (TCM) has showed potential benefits in the management of NAFLD. Lingguizhugan decoction (LGZG) is a representative Chinese herbal formula; however, there is still no rigorous clinical trial supporting its application. Methods/design: This study will be a three-arm, dose-optimization, randomized, double-blinded, placebo-controlled clinical trial. A total of 243 patients with NAFLD will be recruited and randomly assigned to the standard dose LGZG (SLGD) group, low dose LGZG (LLGD) group, or the placebo group based on a ratio of 1:1:1. The treatment period will be 12 weeks and the follow-up period will last 4 weeks. The primary outcome will be the proportions of participants with at least a 1-unit decrease of HOMA-IR from baseline to 12 weeks. Secondary outcomes will include the changes of body weight, body mass index, liver function, blood lipid metabolism, blood glucose metabolism, inflammatory responses, liver-kidney echo ratio by ultrasound, and various scales. Biological samples will also be collected for future researches on mechanism exploration. Discussion: This study will provide initial evidence regarding the efficacy and safety of LGZG in the treatment of NAFLD with spleen-yang deficiency pattern and promote its application in community healthcare centers. In addition, potential mechanisms will be explored based on studies of oral and gut microbiota. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800014364. Registered on 1 January 2018. The final protocol version was V3.0.