The gut–adipose tissue axis plays a crucial role in metabolic health. It is a two-way communication pathway between the gastrointestinal tract and adipose tissue. This axis influences physiological processes vital for maintaining metabolic health, including energy homeostasis, lipid metabolism, and inflammation. Emerging research suggests that the gut microbiota, composed of trillions of microorganisms residing in the intestines, significantly impacts this axis by modulating host metabolism. An imbalance in the gut microbiota (dysbiosis) has been linked to obesity, insulin resistance, and other metabolic disorders. Innovative therapeutic strategies and dietary interventions aimed at modulating the gut–adipose tissue axis have shown encouraging results in improving metabolic health. A deeper critical understanding of the gut–adipose tissue axis is, therefore, essential in understanding the pathophysiology of metabolic disorders so that targeted interventions can be developed to prevent and treat these metabolic disorders. This article highlights the need for integrative approaches that consider both gastrointestinal and adipose functions in metabolic health management.

The gut-adipose tissue axis plays a crucial role in metabolic health. It serves as a two-way communication pathway between the gastrointestinal tract and adipose tissue. This axis influences various physiological processes that are vital for maintaining metabolic health including energy homeostasis, lipid metabolism, and inflammation. Emerging research suggests that the gut microbiota, composed of trillions of microorganisms residing in the intestines, significantly impacts this axis by modulating host metabolism. An imbalance in the gut microbiota (dysbiosis), has been linked to obesity, insulin resistance, and other metabolic disorders. Innovative therapeutic strategies and dietary interventions aimed at modulating the gut-adipose tissue axis, have shown encouraging results in improving metabolic health. A deeper critical understanding of the gut-adipose tissue axis is, therefore, essential in understanding the pathophysiology of metabolic disorders so that targeted interventions could be developed to prevent and treat these metabolic disorders. The article highlights the need for integrative approaches that consider both gastrointestinal and adipose functions in metabolic health management.

Purpose of Review: Hypertension remains a major chronic disease morbidity across the world, even in the twenty-first century, affecting ≈40% of the global population, adversely impacting the healthcare budgets in managing the high incidence of cardiovascular disease (CVD) complications and mortality because of elevated blood pressure (BP). However, evaluation and management of endocrine hypertension are not optimal in clinical practice. With three unique clinical case scenarios, we update the evidence base for diagnostic evaluation and management of endocrine hypertension in this review to inform appropriate day-to-day clinical practice decisions. Recent Findings: Although most individuals with high BP suffer from essential hypertension (≈85%), some patients may have a clear underlying etiology (termed secondary hypertension), and a significant proportion of these patients have endocrine hypertension (≈10%) consequent to hormone excess from dysfunction of one or more endocrine glands. Even if a relatively common disease in the general population, the correct diagnosis and appropriate treatment of endocrine hypertension is often delayed because of poor awareness among clinicians, including primary care providers and physicians in the secondary care settings. Summary: An accurate and timely diagnosis of endocrine hypertension is crucial to potentially cure or at least properly manage these patients because the consequences of delays in diagnosis can be catastrophic, with markedly higher end-organ complications such as CVD, chronic kidney disease, and even premature mortality among sufferers.

Aims/Background Data from randomized controlled trials (RCTs) comparing the efficacy and safety of thrice-weekly insulin degludec (IDeg 3TW) versus once-daily insulin glargine (IGlar OD) in patients with type 2 diabetes mellitus (T2DM) are scarce and not uniform. Moreover, no systematic review and meta-analysis (SRM) is available for such a comparison. This SRM aimed to compare the effectiveness and safety of IDeg 3TW versus IGlar OD in the available RCTs in T2DM. Methods Electronic databases and registers, which include MEDLINE (via PubMed), Scopus, Cochrane Central Register, and ClinicalTrials.gov, were searched for RCTs conducted among T2DM subjects with IDeg 3TW as intervention and IGlar OD as control from inception to 30 July 2024. The primary outcome was glycated haemoglobin (HbA1c) reduction from baseline; secondary outcomes were the changes in other glycemic parameters and adverse events (AEs). RevMan web was used to conduct meta-analysis using random-effects models. Outcomes were presented as mean difference (MD), odds ratio (OR), or risk ratio (RR) with 95% confidence intervals (CIs). Results Three RCTs (N = 1171) with study durations ranging from 16–26 weeks and minimal risk of bias were included. IDeg 3TW was less effective than IGlar OD in HbA1c reduction (MD 0.27%, 95% CI [0.14, 0.39], p < 0.0001), reduction in mean nine-point self-monitored capillary blood glucose profile (MD 0.45 mmol/L, 95% CI [0.22, 0.67], p < 0.0001), and HbA1c reduction <7% (OR 0.69, 95% [0.53, 0.89], p = 0.005). IDeg 3TW outperformed IGlar OD regarding the mean daily insulin dose (MD –0.07 U, 95% CI [–0.13, –0.01], p = 0.02). However, both groups achieved comparable fasting plasma glucose reduction (MD 0.37 mmol/L, 95% [–0.19, 0.93], p = 0.19), changes in body weight (MD 0.04 kg, 95% CI [–0.46, 0.55], p = 0.86), and overall physical (MD 0.21, 95% CI [–0.62, 1.04], p = 0.62) and mental health scores (MD –0.02, 95% CI [–1.05, 1.01], p = 0.97). The risks for confirmed hypoglycemia (RR 1.16, 95% CI [0.83, 1.62], p = 0.38), nocturnal hypoglycemia (RR 1.18, 95% CI [0.49, 2.84], p = 0.71), any AEs (RR 1.04, 95% CI [0.84, 1.30], p = 0.71), serious AEs (RR 1.43, 95% CI [0.77, 2.65], p = 0.25), and injection-site reactions (RR 1.29, 95% CI [0.56, 2.96], p = 0.55) were identical in the two groups. Conclusion In short-term follow-up, IDeg 3TW was less effective than IGlar OD in glycaemic control; however, their safety profile was comparable. Larger multicenter RCTs comparing the overall benefit-risk ratio are necessary for appropriate clinical practice decisions. Systematic Review Registeration PROSPERO: CRD42024593493 .

Objective: To present a case of colopathy related to the use of diclofenac in a patient with a positive immunochemical faecal occult blood test (iFOBT) and to discuss the influence of nonsteroidal anti-inflammatory drugs (NSAIDs) on iFOBT specificity. Clinical Presentation and Intervention: A colonoscopy in a 56-year-old female presenting with a positive iFOBT revealed diaphragm-like strictures and ulcers in the right colon. While carrying out a detailed retrospective interview, she reported a chronic backache requiring long-term NSAID treatment. Conclusion: No association has been established between chronic use of NSAID and a false-positive iFOBT. There is no need to stop NSAIDs before performing an iFOBT in a colorectal cancer screening program.