Introduction: Metabolic syndrome amplifies the risk of gestational diabetes, preeclampsia, and preterm labor in pregnant women. Similarly, women with substance use disorder have worsened obstetric and birth outcomes. Despite these two conditions being major healthcare disparities in Appalachia, the health outcomes of this cohort have not been studied thus far. This study looks at the health outcomes of this cohort. Method and Results: In this retrospective cohort study, we analyzed 27,955 mothers who delivered at Cabell Huntington Hospital between January 2010 and November 2021. We implemented Chi-square tests to determine the associations and multiple logistic regression methods for comparison after controlling for other factors, and found that MetS, together with SUD, significantly increases the risk as well as the number of pregnancy complications such as gestational diabetes (p-value < 0.001), preeclampsia (p-value < 0.001), premature rupture (p-value < 0.001), preterm labor (p-value < 0.001), and newborn disorder (p-value < 0.001) compared to the women who had none or had either MetS or SUD alone. Conclusion: Women with both metabolic syndrome and substance abuse had worsened pregnancy and neonatal outcomes compared to women with metabolic syndrome or SUD alone. In conclusion, analysis of all the variables is crucial to strategically planning and implementing health interventions that will positively influence the health outcome of the pregnant woman as well as the child.

Background/Objectives: Dysfunctions of metabolic syndrome (MetS) have been identified as a significant risk factor for colorectal cancer (CRC). However, current colon cancer guidelines do not classify patients with MetS as high risk, thereby leaving these individuals vulnerable. Consequently, we explored the relationship between MetS, its individual components, and the development of CRC in a cohort of patients with MetS to assess the necessity for CRC screening in these individuals. Methods: This study included patients ages 18 and older that received a service from the Marshall-Health (MH) practice plan, Cabell-Huntington Hospital (CHH), MU/JCESOM’s Edwards Comprehensive Cancer Center (ECCC), or the University of Kentucky HealthCare (UKHC) system between 2010 and 2018. We implemented log-binomial regression models to assess the individual and collective effects of MetS components after adjusting other CRC risk factors. Results: Given that CRC prevalence increases in the older population (aged 65 years and above), and that multiple components of MetS are observed within the same population, we analyzed the concurrent impact of all MetS components on CRC. Log-binomial regression models were implemented to assess the risk of CRC due to MetS components after adjusting other risk factors. Conclusions: We identified specific components that markedly increased CRC risk, suggesting that individuals with these components should be prioritized for early screening. These findings could significantly influence early CRC screening protocols, with the ultimate aim to reduce mortality associated with the disease.

Actinomycin D (Act D) was the first FDA-approved anticancer antibiotic. However, its widespread application was hindered by dose-limiting toxicities. In the current study, we investigated the in vitro and in vivo anticancer efficacy of the combination of Act D with resveratrol. We found that the combination of Act D and resveratrol has better in vitro efficacy than any of the single agent. We also explored the underlying mechanism by investigating the activation of the p53 pathway. Consistent with the cell growth inhibition, Act D, resveratrol, and their combination activated p53 and induced the expression of p21, PUMA, and GDF15 mRNA and proteins. The combination had better effects than any of the single agents alone. Ablation of p53 significantly protected cells and confirmed p53-dependent expression of these genes. Finally, we investigated the in vivo efficacy of these agents and their combination using xenograft model. Act D, resveratrol, and their combination significantly inhibited the growth of xenografts. The in vivo efficacy was further supported by Ki-67 expression in tumor tissues. Taken together, our findings demonstrated that although the combination of Act D and resveratrol showed better efficacy in vitro than any of the single agent, the in vivo efficacy was not improved.

Metabolic dysfunction of metabolic syndromes (MetS) has been widely reported to be a significant risk factor for heart failure (HF). While this interaction is well studied, what combinations of MetS factors pose the greatest risk for HF are not well defined. We hypothesize that some components of MetS are of higher risk of HF compared to others. We explored the relationship between the independent components of MetS and their combinatory effect on the risk of HF. All metabolic syndrome components except hypertriglyceridemia were significant individually (P-value<0.001), while hypertension (HTN) and diabetes or insulin resistance (IR) had the higher risk of developing heart failure when taken collectively. The odds of heart failure among the individuals who had HTN and IR was 7.7 times those who didn’t have any MetS components. We observed the additive effect of number of metabolic components on HF, for the individuals who had only one MetS symptom, the odd of HF was 5.4 time compared to those who didn’t have any of MetS symptoms. Similarly, these odds of HF were 6.4 and 7.4 times for those who had at least 2 or at least 3 symptoms respectively. Even though obesity is a significant risk factor for cardiovascular diseases, we found the protective effect of obesity on heart failure, which is an interesting result and needs further investigation.