Type 2 diabetes mellitus (T2DM) is strongly associated with obesity. The adipose tissue secretes bioactive adipokines leading to low grade inflammation, amplified by oxidative stress, which promotes the formation of advanced glycation end products and eventually leads to dyslipidemia and vascular complications. The aim of this study was to correlate anthropometric, biochemical and oxidative stress parameters in newly diagnosed (ND) T2DM patients and to investigate the role of oxidative stress in T2DM associated with obesity. A group of 115 ND- T2DM patients was compared to a group of 32 healthy subjects in terms of clinical, anthropometric, biochemical and oxidative stress parameters. ND-T2DM patients had significantly lower adiponectin, glutathione (GSH) and gluthatione peroxidase (GPx) and elevated insulin, proinsulin, HOMA-IR index, proinsulin/insulin (P/I) and proinsulin/adiponectin (P/A) ratio, fructosamine, and total oxidant status (TOS). The total body fat mass was positively correlated with total oxidant status (TOS). Positive correlations were found between TOS and glycated hemoglobin (HbA1c), and between TOS and glycaemia. Negative correlations were identified between: GPx and glycaemia, GPx and HbA1c, and also between GSH and fructosamine. The total antioxidant status was negatively correlated with the respiratory burst. The identified correlations suggest the existence of a complex interplay between diabetes, obesity and oxidative stress.

Metabolic syndrome (MetSyn) has a rapidly growing worldwide prevalence, affecting over 1 billion people. MetSyn is clustering many pathological conditions, which, untreated, could increase the risk and often lead to more severe metabolic defects such as type 2 diabetes and non-alcoholic fatty liver disease. Many data demonstrate the complex role of gut microbiota in the host metabolism, and hence, deciphering the microbiome patterns linked to MetSyn could enable us for novel diagnosis and monitoring markers and for better disease management. Moreover, interventions designed to alter patient microbiome composition may help prevent or decrease morbidity linked with MetSyn. However, the microbiome composition is largely different across geographically distinct populations. Our study investigated the microbiota and mycobiome patterns in Romanian metabolic syndrome patients. We also correlated the identified microbiome–mycobiome patterns with levels of metabolites important for host health such as short chain fatty acids, organic acids, and taurine. We found that MetSyn patients are harboring a microbiome enriched in Enterobacteriaceae, Turicibacter sp., Clostridium coccoides, and Clostridium leptum, while beneficial taxa such as Butyricicoccus sp., Akkermansia muciniphila, and Faecalibacterium prausnitzii were decreased. These microbiome changes were correlated with lower butyrate levels and increased succinate. In terms of mycobiome signatures, MetSyn was associated with a high abundance of Saccharomyces and Aspergillus species. Our data are the first reported on a Romanian population and confirming that the pathogenesis of MetSyn is closely related to gut microbiome and homeostasis.

The prevalence of type 2 diabetes mellitus (T2D) is alarmingly increasing worldwide, urgently calling for a better understanding of the underlying mechanisms in order to step up prevention and improve therapeutic approaches. It is becoming evident that the gut microbiota seem to have an endless capacity to impact T2D. In this study, we profile the gut microbiome patterns in T2D patients from Romania, by using quantitative Real-Time PCR and next generation sequencing. We enrolled a total of 150 individuals (105 T2D patients, 50 of them without metformin treatment and 45 healthy volunteers). The levels of potentially beneficial butyrate-producing bacteria were significantly reduced, while potentially pathogenic microorganisms such as Enterobacteriaceae and Fusobacterium were enriched in T2D patients. We evaluated the correlation between clinical parameters and gut microbiota and identified the genera Bacteroides, Alistipes, Dialister, Bilophila and Sutterella as possible detrimental factors in T2D. Our findings suggest that the gut microbiota may be a potential target in novel approaches to halt the development of T2D-associated complications.

Geography is one of the key drivers of the significant variation in the etiopathogenic profile and prevalence of type 2 diabetes mellitus (T2DM) and obesity, therefore geographically based data are fundamental for implementing the appropriate interventions. Presently, the selection criteria of T2DM and obesity patients for laparoscopic sleeve gastrectomy (LSG) have not reached a worldwide consensus—highlighting the need for sharing experts’ guidance in the preoperative evaluation, choice of the interventional procedure, perioperative management and patient long-term care. The aim of the current study was to evaluate the impact of LSG on T2DM (T2DM) remission in Romanian obese male patients, based on a multiparametric, prospective investigation. We have conducted a randomized controlled study on 41 obese male participants with the body mass index (BMI) ≥ 30 kg/m², aged 30–65 years, which were randomly divided in two study groups: one receiving conventional treatment and the second undergoing LSG. The clinical and anthropometrical parameters, resting metabolic rate, general biochemical status, adipocytes profile, gastrointestinal hormones levels, proinflammatory, oxidant and antioxidant profiles were determined at three time points: V1 (baseline), V2 (after six months) and V3 (after 12 months). Glycated hemoglobin (HbA1c), blood glucose levels, BMI, weight, visceral fat level, HDL-cholesterol, incretin hormones, proinflammatory and the oxidative stress status were significantly improved in the LSG versus conventional treatment group. This is the first study reporting on the evaluation of metabolic surgery impact on Romanian obese male patients with T2DM. Our results confirm that LSG could contribute to T2DM remission in patients with diabesity, but this beneficial effect seems to be critically influenced by the duration of T2DM rather than by the obesity status. Our results show that, in addition to the parameters included in the prediction algorithm, the proinsulin levels, proinsulin/insulin ratio and the visceral fat percentage could bring added value to the assessment of metabolic status.

Background and Aims: Resting metabolic rate (RMR) is important to estimate energy requirements. Our aim was to investigate the RMR in newly diagnosed type 2 diabetic (T2DM) patients with metabolic syndrome (MS) in relation with obesity, gender, some adipokines and insulin resistance parameters. Material and Methods: 138 newly diagnosed T2DM adults were evaluated for anthropometric, clinical, biochemical parameters, and RMR. The group was subdivided according to body mass index and MS presence. Results: Determined RMR (RMRd), predicted RMR (RMRp), oxygen consumption and carbon dioxide production at rest were significantly lower for subjects with BMI < 30 kg/m² compared to subjects with BMI ≥ 30 kg/m² (p<0.001). RMRd positively correlated with fat-free mass (p < 0.001), waist (p < 0.001), BMI (p < 0.001), insulinemia (p = 0.021) and negatively with age (p < 0.001) and adiponectin (p = 0.027). The percent of determined from predicted RMR in subjects with MS was lower than in those without MS, but only for men (p< 0.005). Conclusions: Subjects with T2DM and MS have significantly lower than predicted RMR, compared to those without MS, indicating that they may have an energy sparing metabolism. Gender influences the energy metabolism and may play a particular role in energy the metabolism of people with T2DM and MS.

Background and Aims. Diabetes mellitus and obesity modify the resting metabolic rate (RMR) in opposite directions. This study aimed to evaluate the relationship between RMR, insulin activity and adipocytokines in type 2 diabetes patients with associated obesity. Material and Method. Anthropometric and biochemical measurements, bioimpedance body composition, C peptide, insulin, proinsulin, adiponectin, leptin, indirect calorimetry measured RMR were determined in 306 (53% male, 54.9% obese) diabetic patients. Results. RMR, C peptide, insulin, proinsulin, Homeostasis Model Assessment (HOMA) IR, HOMA %B, leptin increased and adiponectin decreased with body mass index (BMI). BMI had a statistical significant higher effect size on fat mass (FM), leptin (0.652-0.339 eta squared), moderate positive effect size on fat-free mass (FFM), insulin, C peptide, RMR, HOMA %B (0.228 - 0.155 eta squared) and lower effect size on HOMA-IR, adiponectin, proinsulin-to-adiponectin ratio, proinsulin (0.098-0.062 eta squared). RMR had positive correlations with FFM (r=0.633), BMI (r=0.300), proinsulin-to-adiponectin ratio (r=0.218), HOMA1-IR (r=0.176), proinsulin (r=0.151), insulin (r=0.144), fasting plasma glucose (r=0.132), fat mass (r= 0.131), triglycerides (r = 0.119), proinsulin-to-insulin ratio (r= 0.117) and negative with age (r=-0.368), HDL cholesterol (r=-0.284), adiponectin(r=-0.282) and leptin (r=-0.178). Conclusions RMR was correlated with HOMA IR and insulin resistance biomarkers, but not with HOMA %B and C peptide