1 5725 178 SKIN MANIFESTATIONS OF INSULIN RESISTANCE: FROM A BIOCHEMICAL STANCE TO A CLINICAL DIAGNOSIS AND MANAGEMENT. WORLDWIDE, MORE THAN 1.9 BILLION ADULTS ARE OVERWEIGHT, AND AROUND 600 MILLION PEOPLE SUFFER FROM OBESITY. SIMILARLY, ~382 MILLION INDIVIDUALS LIVE WITH DIABETES, AND 40-50% OF THE GLOBAL POPULATION IS LABELED AT "HIGH RISK" (I.E., PREDIABETES). THE IMPACT OF THESE TWO CHRONIC CONDITIONS RELIES NOT ONLY ON THE BURDEN OF ILLNESSES PER SE (I.E., ASSOCIATED INCREASED MORBIDITY AND MORTALITY), BUT ALSO ON THEIR INCREASED COST, BURDEN OF TREATMENT, AND DECREASED HEALTH-RELATED QUALITY OF LIFE. FOR THIS REVIEW A COMPREHENSIVE SEARCH IN SEVERAL DATABASES INCLUDING PUBMED (MEDLINE), OVID EMBASE, WEB OF SCIENCE, AND SCOPUS WAS CONDUCTED. IN BOTH DIABETES AND OBESITY, GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS OVERLAP AND ARE INCLUSIVE RATHER THAN EXCLUSIVE. DE FACTO, 70-80% OF THE PATIENTS WITH OBESITY AND VIRTUALLY EVERY PATIENT WITH TYPE 2 DIABETES HAVE INSULIN RESISTANCE. INSULIN RESISTANCE IS A WELL-KNOWN PATHOPHYSIOLOGIC FACTOR IN THE DEVELOPMENT OF TYPE 2 DIABETES, CHARACTERISTICALLY APPEARING YEARS BEFORE ITS DIAGNOSIS. THE GOLD STANDARD FOR INSULIN RESISTANCE DIAGNOSIS (THE EUGLYCEMIC INSULIN CLAMP) IS A COMPLEX, INVASIVE, COSTLY, AND HENCE UNFEASIBLE TEST TO IMPLEMENT IN CLINICAL PRACTICE. LIKEWISE, LABORATORY MEASURES AND DERIVED INDEXES [E.G., HOMEOSTASIS MODEL ASSESSMENT OF INSULIN RESISTANCE (HOMA-IR-)] ARE INDIRECT, IMPRECISE, AND NOT HIGHLY ACCURATE AND REPRODUCIBLE TESTS. HOWEVER, SKIN MANIFESTATIONS OF INSULIN RESISTANCE (E.G., ACROCHORDONS, ACANTHOSIS NIGRICANS, ANDROGENETIC ALOPECIA, ACNE, HIRSUTISM) OFFER A RELIABLE, STRAIGHTFORWARD, AND REAL-TIME WAY TO DETECT INSULIN RESISTANCE. THE OBJECTIVE OF THIS REVIEW IS TO AID CLINICIANS IN RECOGNIZING SKIN MANIFESTATIONS OF INSULIN RESISTANCE. DIAGNOSING THESE SKIN MANIFESTATIONS ACCURATELY MAY CASCADE POSITIVELY IN THE PATIENT'S HEALTH BY TRIGGERING AN ADEQUATE METABOLIC EVALUATION, A TIMELY TREATMENT OR REFERRAL WITH THE ULTIMATE OBJECTIVE OF DECREASING DIABETES AND OBESITY BURDEN, AND IMPROVING THE HEALTH AND THE QUALITY OF CARE FOR THESE PATIENTS. 2017 2 5605 43 ROUTINE ASSESSMENT AND PROMOTION OF PHYSICAL ACTIVITY IN HEALTHCARE SETTINGS: A SCIENTIFIC STATEMENT FROM THE AMERICAN HEART ASSOCIATION. PHYSICAL INACTIVITY IS ONE OF THE MOST PREVALENT MAJOR HEALTH RISK FACTORS, WITH 8 IN 10 US ADULTS NOT MEETING AEROBIC AND MUSCLE-STRENGTHENING GUIDELINES, AND IS ASSOCIATED WITH A HIGH BURDEN OF CARDIOVASCULAR DISEASE. IMPROVING AND MAINTAINING RECOMMENDED LEVELS OF PHYSICAL ACTIVITY LEADS TO REDUCTIONS IN METABOLIC, HEMODYNAMIC, FUNCTIONAL, BODY COMPOSITION, AND EPIGENETIC RISK FACTORS FOR NONCOMMUNICABLE CHRONIC DISEASES. PHYSICAL ACTIVITY ALSO HAS A SIGNIFICANT ROLE, IN MANY CASES COMPARABLE OR SUPERIOR TO DRUG INTERVENTIONS, IN THE PREVENTION AND MANAGEMENT OF >40 CONDITIONS SUCH AS DIABETES MELLITUS, CANCER, CARDIOVASCULAR DISEASE, OBESITY, DEPRESSION, ALZHEIMER DISEASE, AND ARTHRITIS. WHEREAS MOST OF THE MODIFIABLE CARDIOVASCULAR DISEASE RISK FACTORS INCLUDED IN THE AMERICAN HEART ASSOCIATION'S MY LIFE CHECK - LIFE'S SIMPLE 7 ARE EVALUATED ROUTINELY IN CLINICAL PRACTICE (GLUCOSE AND LIPID PROFILES, BLOOD PRESSURE, OBESITY, AND SMOKING), PHYSICAL ACTIVITY IS TYPICALLY NOT ASSESSED. THE PURPOSE OF THIS STATEMENT IS TO PROVIDE A COMPREHENSIVE REVIEW OF THE EVIDENCE ON THE FEASIBILITY, VALIDITY, AND EFFECTIVENESS OF ASSESSING AND PROMOTING PHYSICAL ACTIVITY IN HEALTHCARE SETTINGS FOR ADULT PATIENTS. IT ALSO ADDS CONCRETE RECOMMENDATIONS FOR HEALTHCARE SYSTEMS, CLINICAL AND COMMUNITY CARE PROVIDERS, FITNESS PROFESSIONALS, THE TECHNOLOGY INDUSTRY, AND OTHER STAKEHOLDERS IN ORDER TO CATALYZE INCREASED ADOPTION OF PHYSICAL ACTIVITY ASSESSMENT AND PROMOTION IN HEALTHCARE SETTINGS AND TO CONTRIBUTE TO MEETING THE AMERICAN HEART ASSOCIATION'S 2020 IMPACT GOALS. 2018 3 6631 40 UNDERSTANDING THE MANIFESTATION OF DIABETES IN SUB SAHARAN AFRICA TO INFORM THERAPEUTIC APPROACHES AND PREVENTIVE STRATEGIES: A NARRATIVE REVIEW. BACKGROUND: GLOBALLY, THE BURDEN OF DIABETES MELLITUS HAS INCREASED TO EPIDEMIC PROPORTIONS. ESTIMATES FROM THE INTERNATIONAL DIABETES FEDERATION PREDICT THAT THE GREATEST FUTURE INCREASE IN THE PREVALENCE OF DIABETES MELLITUS WILL OCCUR IN AFRICA. METHODS: THIS ARTICLE REVIEWS LITERATURE ON THE MANIFESTATION OF DIABETES IN ADULT PATIENTS IN SUB-SAHARAN AFRICA HIGHLIGHTING THE DISTINCT PHENOTYPES, PLAUSIBLE EXPLANATIONS FOR THIS UNIQUE MANIFESTATION AND THE CLINICAL SIGNIFICANCE OF COMPREHENSIVELY DEFINING AND UNDERSTANDING THE AFRICAN DIABETES PHENOTYPE. RESULTS: THERE ARE FEW STUDIES ON THE MANIFESTATION OR PHENOTYPE OF DIABETES IN AFRICA. THE LIMITED DATA AVAILABLE SUGGESTS THAT, COMPARED TO THE WESTERN WORLD, THE MAJORITY OF PATIENTS WITH DIABETES IN AFRICA ARE YOUNG AND RELATIVELY LEAN IN BODY SIZE. IN ADDITION, HYPERGLYCAEMIA IN MOST CASES IS CHARACTERISED BY A SIGNIFICANTLY BLUNTED ACUTE FIRST PHASE OF INSULIN SECRETION IN RESPONSE TO AN ORAL OR INTRAVENOUS GLUCOSE LOAD AND PANCREATIC BETA CELL SECRETORY DYSFUNCTION, RATHER THAN PERIPHERAL INSULIN RESISTANCE PREDOMINATES. GENETIC AND ENVIRONMENTAL FACTORS LIKE CHRONIC INFECTIONS/INFLAMMATION, EARLY LIFE MALNUTRITION AND EPIGENETIC MODIFICATIONS ARE THOUGHT TO CONTRIBUTE TO THESE DISTINCT DIFFERENCES IN MANIFESTATION. CONCLUSIONS: WHILE PUBLISHED DATA IS LIMITED, THERE APPEARS TO BE DISTINCT PHENOTYPES OF DIABETES IN SUB-SAHARAN AFRICA. LARGE AND MORE DETAILED STUDIES ARE NEEDED ESPECIALLY AMONG NEWLY DIAGNOSED PATIENTS TO FULLY CHARACTERIZE DIABETES IN THIS REGION. THIS WILL FURTHER IMPROVE THE UNDERSTANDING OF MANIFESTATION OF DIABETES AND GUIDE THE FORMULATION OF OPTIMAL THERAPEUTIC APPROACHES AND PREVENTIVE STRATEGIES OF THE CONDITION ON THE CONTINENT. 2019 4 6380 36 THE ROLE OF OBESITY AND DIABETES IN DEMENTIA. CHRONIC CONDITIONS SUCH AS OBESITY, DIABETES, AND DEMENTIA ARE INCREASING IN THE UNITED STATES (US) POPULATION. KNOWLEDGE OF THESE CHRONIC CONDITIONS, PREVENTATIVE MEASURES, AND PROPER MANAGEMENT TACTICS IS IMPORTANT AND CRITICAL TO PREVENTING DISEASE. THE OVERLAP BETWEEN OBESITY, DIABETES, AND DEMENTIA IS BECOMING FURTHER ELUCIDATED. THESE CONDITIONS SHARE A SIMILAR ORIGIN THROUGH THE COMPONENTS OF INCREASING AGE, GENDER, GENETIC AND EPIGENETIC PREDISPOSITIONS, DEPRESSION, AND A HIGH-FAT WESTERN DIET (WD) THAT ALL CONTRIBUTE TO THE INFLAMMATORY STATE ASSOCIATED WITH THE DEVELOPMENT OF OBESITY, DIABETES, AND DEMENTIA. THIS INFLAMMATORY STATE LEADS TO THE DYSREGULATION OF FOOD INTAKE AND INSULIN RESISTANCE. OBESITY IS OFTEN THE CORNERSTONE THAT LEADS TO THE DEVELOPMENT OF DIABETES AND, SUBSEQUENTLY, IN THE CASE OF TYPE 2 DIABETES MELLITUS (T2DM), PROGRESSION TO "TYPE 3 DIABETES MELLITUS (T3DM)". OBESITY AND DEPRESSION ARE CLOSELY ASSOCIATED WITH DIABETES. HOWEVER, DEMENTIA CAN BE AVOIDED WITH LIFESTYLE MODIFICATIONS, BY SWITCHING TO A PLANT-BASED DIET (E.G., A MEDITERRANEAN DIET (MD)), AND INCREASING PHYSICAL ACTIVITY. DIET AND EXERCISE ARE NOT THE ONLY TREATMENT OPTIONS. THERE ARE SEVERAL SURGICAL AND PHARMACOLOGICAL INTERVENTIONS AVAILABLE FOR PREVENTION. CURRENT AND FUTURE RESEARCH WITHIN EACH OF THESE FIELDS IS WARRANTED AND OFFERS THE CHANCE FOR NEW TREATMENT OPTIONS AND A BETTER UNDERSTANDING OF THE PATHOGENESIS OF EACH CONDITION. 2022 5 1388 32 DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASE: NON-INVASIVE ASSESSMENT OF CARDIOVASCULAR RISK. THE PREVALENCE AND BURDEN OF DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE ON GLOBAL HEALTH AND SOCIOECONOMIC DEVELOPMENT IS ALREADY HEAVY AND STILL RISING. DIABETES MELLITUS BY ITSELF IS LINKED TO ADVERSE CARDIOVASCULAR EVENTS, AND THE PRESENCE OF CONCOMITANT CHRONIC KIDNEY DISEASE FURTHER AMPLIFIES CARDIOVASCULAR RISK. THE CULMINATION OF TRADITIONAL (MALE GENDER, SMOKING, ADVANCED AGE, OBESITY, ARTERIAL HYPERTENSION AND DYSLIPIDEMIA) AND NON-TRADITIONAL RISK FACTORS (ANEMIA, INFLAMMATION, PROTEINURIA, VOLUME OVERLOAD, MINERAL METABOLISM ABNORMALITIES, OXIDATIVE STRESS, ETC.) CONTRIBUTES TO ADVANCED ATHEROSCLEROSIS AND INCREASED CARDIOVASCULAR RISK. TO DECREASE THE MORBIDITY AND MORTALITY OF THESE PATIENTS DUE TO CARDIOVASCULAR CAUSES, TIMELY AND EFFICIENT CARDIOVASCULAR RISK ASSESSMENT IS OF HUGE IMPORTANCE. CARDIOVASCULAR RISK ASSESSMENT CAN BE BASED ON LABORATORY PARAMETERS, IMAGING TECHNIQUES, ARTERIAL STIFFNESS PARAMETERS, ANKLE-BRACHIAL INDEX AND 24 H BLOOD PRESSURE MEASUREMENTS. NEWER METHODS INCLUDE EPIGENETIC MARKERS, SOLUBLE ADHESION MOLECULES, CYTOKINES AND MARKERS OF OXIDATIVE STRESS. IN THIS REVIEW, THE AUTHORS PRESENT SEVERAL NON-INVASIVE METHODS OF CARDIOVASCULAR RISK ASSESSMENT IN PATIENTS WITH DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE. 2021 6 726 37 CAN TYPE 1 DIABETES BE AN UNEXPECTED COMPLICATION OF OBESITY? TYPE 1 DIABETES (T1D) IS ONE OF THE MOST COMMON CHRONIC AUTOIMMUNE DISEASES, CHARACTERIZED BY ABSOLUTE INSULIN DEFICIENCY CAUSED VIA INFLAMMATORY DESTRUCTION OF THE PANCREATIC BETA-CELL. GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS PLAY A ROLE IN THE DEVELOPMENT OF DISEASES. ALMOST (1/5) OF CASES INVOLVE PEOPLE UNDER THE AGE OF 20. IN RECENT YEARS, THE INCIDENCE OF BOTH T1D AND OBESITY HAS BEEN INCREASING, ESPECIALLY AMONG CHILDREN, ADOLESCENTS, AND YOUNG PEOPLE. IN ADDITION, ACCORDING TO THE LATEST STUDY, THE PREVALENCE OF OVERWEIGHT OR OBESITY IN PEOPLE WITH T1D HAS INCREASED SIGNIFICANTLY. THE RISK FACTORS OF WEIGHT GAIN INCLUDED USING EXOGENOUS INSULIN, INTENSIFYING INSULIN THERAPY, FEAR OF HYPOGLYCEMIA AND RELATED DECREASE IN PHYSICAL ACTIVITY, AND PSYCHOLOGICAL FACTORS, SUCH AS EMOTIONAL EATING AND BINGE EATING. IT HAS ALSO BEEN SUGGESTED THAT T1D MAY BE A COMPLICATION OF OBESITY. THE RELATIONSHIP BETWEEN BODY SIZE IN CHILDHOOD, INCREASE IN BODY MASS INDEX VALUES IN LATE ADOLESCENCE AND THE DEVELOPMENT OF T1D IN YOUNG ADULTHOOD IS CONSIDERED. MOREOVER, THE COEXISTENCE OF T1D AND T2D IS INCREASINGLY OBSERVED, THIS SITUATION IS CALLED DOUBLE OR HYBRID DIABETES. THIS IS ASSOCIATED WITH AN INCREASED RISK OF THE EARLIER DEVELOPMENT OF DYSLIPIDEMIA, CARDIOVASCULAR DISEASES, CANCER, AND CONSEQUENTLY A SHORTENING OF LIFE. THUS, THE PURPOSE OF THIS REVIEW WAS TO SUMMARIZE THE RELATIONSHIPS BETWEEN OVERWEIGHT OR OBESITY AND T1D. 2023 7 1045 30 CLINICAL CORRELATION AMONG MALE INFERTILITY AND OVERALL MALE HEALTH: A SYSTEMATIC REVIEW OF THE LITERATURE. PURPOSE: ONGOING EVIDENCE HAS SUGGESTED THE ROLE OF MALE FACTOR INFERTILITY AS A POTENTIAL PREDICTOR OF MORTALITY AND GENERAL HEALTH STATUS. THE AIM OF THE PRESENT REVIEW IS TO UPDATE THE CURRENT KNOWLEDGE BASE REGARDING THE ASSOCIATION BETWEEN MALE FACTOR INFERTILITY AND GENERAL HEALTH THROUGH A CRITICAL REVIEW OF THE LITERATURE. MATERIALS AND METHODS: A SYSTEMATIC REVIEW OF THE LITERATURE WAS CARRIED OUT FROM INCEPTION TO NOVEMBER 2019 IN ORDER TO EVALUATE SIGNIFICANT ASSOCIATIONS BETWEEN MALE INFERTILITY AND ADVERSE HEALTH OUTCOMES SUCH AS CARDIOVASCULAR, ONCOLOGIC, METABOLIC AND AUTOIMMUNE DISEASES AS WELL AS OVERALL MORTALITY. RESULTS: IN ALL, 27 STUDIES MET INCLUSION CRITERIA AND WERE CRITICALLY EXAMINED. FIVE STUDIES EXAMINED MALE INFERTILITY AND CARDIOVASCULAR DISEASE RISK, 11 EXAMINED ONCOLOGIC RISK (E.G., OVERALL CANCER RISK, TESTIS AND PROSTATE CANCER), 8 EXAMINED AGGREGATE CHRONIC MEDICAL DISEASES AND 5 INFERTILITY RELATED TO INCIDENCE OF MORTALITY, FOR A TOTAL OF 599,807 MEN DIAGNOSED WITH ANY MALE FACTOR INFERTILITY COVERING A PERIOD FROM 1916 TO 2016. CONCLUSIONS: A MAN'S FERTILITY AND OVERALL HEALTH APPEAR TO BE INTERCONNECTED. THEREFORE, A DIAGNOSIS OF MALE INFERTILITY MAY ALLOW A WINDOW INTO FUTURE COMORBIDITY AND/OR MORTALITY WHICH MAY HELP GUIDE CLINICAL DECISIONS AND COUNSELING. SEVERAL POSSIBLE ETIOLOGIES SUCH AS GENETIC, EPIGENETIC, DEVELOPMENTAL, AND LIFESTYLE-BASED FACTORS NEED TO BE FURTHER EVALUATED IN ORDER TO ESTABLISH THE UNDERLYING MECHANISMS BETWEEN MALE INFERTILITY AND HEALTH. 2020 8 2213 42 EPIGENETIC MODIFICATIONS AS OUTCOMES OF EXERCISE INTERVENTIONS RELATED TO SPECIFIC METABOLIC ALTERATIONS: A SYSTEMATIC REVIEW. BACKGROUND: CHRONIC DISEASES ARISE AS A CONSEQUENCE OF AN UNHEALTHY LIFESTYLE PRIMARILY CHARACTERIZED BY PHYSICAL INACTIVITY AND UNBALANCED DIETS. REGULAR PHYSICAL ACTIVITY CAN IMPROVE HEALTH, AND THERE IS CONSISTENT EVIDENCE THAT THESE IMPROVEMENTS MAY BE THE RESULT OF EPIGENETIC MODIFICATIONS. OBJECTIVE: TO IDENTIFY EPIGENETIC MODIFICATIONSAS OUTCOMES OF EXERCISE INTERVENTIONS RELATED TO SPECIFIC METABOLIC ALTERATIONS. METHODS: THE PREFERRED REPORTING ITEMS FOR SYSTEMATIC REVIEWS AND META-ANALYSES PROTOCOLS (PRISMA-P) METHODOLOGY FOR MANUSCRIPT RESEARCH AND PREPARATION WAS FOLLOWED USING PUBMED AND EBSCO DATABASES FOR LITERATURE REVIEW. OUT OF 2,638 ARTICLES IDENTIFIED, ONLY 34 ARTICLES MET THE INCLUSION CRITERIA. RESULTS: THE SECTIONS OF THE REVIEW WERE ORGANIZED BY METABOLIC ALTERATIONS IN WHICH STUDIES WERE GROUPED ACCORDING TO HEALTHY, DISEASED, AND TRAINED INDIVIDUALS. RESISTANCE EXERCISE IN HUMANS INDUCED EPIGENETIC CHANGES IN PATHWAYS ASSOCIATED WITH ENERGY METABOLISM AND INSULIN SENSITIVITY, CONTRIBUTING TO HEALTHY SKELETAL MUSCLE. ENDURANCE EXERCISE ALSO CAUSED MODIFICATIONS IN BIOMARKERS ASSOCIATED TO METABOLIC ALTERATIONS THROUGH CHANGES IN DNA METHYLATION AND THE EXPRESSION OF SPECIFIC MIRNAS. HOWEVER, BOTH RESISTANCE AND ENDURANCE EXERCISE ARE NECESSARY TO OBTAIN A BETTER PHYSIOLOGICAL ADAPTATION AND A COMBINATION OF BOTH SEEMS TO BE NEEDED TO PROPERLY TACKLE THE INCREASING PREVALENCE OF NON-COMMUNICABLE PATHOLOGIES. CONCLUSION: GIVEN THE HETEROGENEITY AND COMPLEXITY OF THE EXISTING LITERATURE, IT IS CURRENTLY NOT POSSIBLE TO PROPOSE A SPECIFIC RECOMMENDATION ABOUT THE TYPE, INTENSITY, OR DURATION OF EXERCISE THAT COULD BE BENEFICIAL FOR DIFFERENT SUBSETS OF THE POPULATION (HEALTHY, DISEASED, AND/OR TRAINED). NEVERTHELESS, THIS REVIEW HIGHLIGHTS THE IMPORTANCE OF EXERCISE FOR HEALTH AND SHOWS THE NEED TO PERFORM MORE RESEARCH IN THIS EMERGING AREA TO IDENTIFY EPIGENETIC BIOMARKERS THAT COULD SERVE AS INDICATORS OF EXERCISE ADAPTATIONS. 2019 9 3676 40 INFLAMMATION AND NEUTROPHIL IMMUNOSENESCENCE IN HEALTH AND DISEASE: TARGETED TREATMENTS TO IMPROVE CLINICAL OUTCOMES IN THE ELDERLY. DESPITE INCREASING LONGEVITY, MANY OLD PEOPLE ARE NOT IN GOOD HEALTH. THERE HAS BEEN AN INCREASE IN THE PREVALENCE OF AGE-ASSOCIATED MULTI-MORBIDITY (TWO OR MORE CHRONIC CONDITIONS IN THE SAME PERSON). ALSO, SEVERE INFECTIONS, SUCH AS PNEUMONIA, REMAIN SIGNIFICANT CAUSES OF MORTALITY AND MORBIDITY IN THIS AGING GROUP. MANY CHRONIC HEALTH CONDITIONS SHARE RISK FACTORS SUCH AS INCREASING AGE, SMOKING, A SEDENTARY LIFE STYLE AND BEING PART OF A LOWER SOCIOECONOMIC GROUP. HOWEVER, DESPITE THIS, MULTI-MORBIDITIES OFTEN CO-OCCUR MORE COMMONLY THAN WOULD BE PREDICTED. THIS HAS LED TO THE HYPOTHESIS THAT THEY SHARE COMMON UNDERLYING MECHANISMS. THIS IS AN IMPORTANT CONCEPT, FOR IF IT WERE TRUE, TREATMENTS COULD BE DEVISED WHICH TARGET THESE COMMON PATHWAYS AND IMPROVE A NUMBER OF AGE-ASSOCIATED HEALTH CONDITIONS. MANY CHRONIC ILLNESSES ASSOCIATED WITH MULTI-MORBIDITY AND SEVERE INFECTIONS ARE CHARACTERIZED BY AN ABNORMAL AND SUSTAINED INFLAMMATORY RESPONSE, WITH NEUTROPHILS BEING KEY EFFECTOR CELLS IN THE PATHOLOGICAL PROCESS. STUDIES HAVE DESCRIBED ABERRANT NEUTROPHIL FUNCTIONS ACROSS THESE CONDITIONS, AND SOME HAVE HIGHLIGHTED POTENTIAL MECHANISMS FOR ALTERED CELL BEHAVIOURS WHICH APPEAR SHARED ACROSS DISEASE STATES. IT HAS BEEN SUGGESTED THAT ALTERED FUNCTIONS MAY REPRESENT NEUTROPHIL "SENESCENCE". THIS REVIEW CONSIDERS HOW AND WHY NEUTROPHIL FUNCTIONS CHANGE AS THE CELL AGES, AND HOW AND WHY NEUTROPHIL FUNCTIONS CHANGE AS THE HOST AGES IN HEALTH AND DISEASE AND DISCUSSES WHETHER NEUTROPHIL FUNCTIONS COULD BE TARGETED TO IMPROVE HEALTH OUTCOMES IN OLDER ADULTS. 2018 10 1385 48 DIABETES IN CHILDHOOD CANCER SURVIVORS: EMERGING CONCEPTS IN PATHOPHYSIOLOGY AND FUTURE DIRECTIONS. WITH ADVANCEMENTS IN CANCER TREATMENT AND SUPPORTIVE CARE, THERE IS A GROWING POPULATION OF CHILDHOOD CANCER SURVIVORS WHO EXPERIENCE A SUBSTANTIAL BURDEN OF COMORBIDITIES RELATED TO HAVING RECEIVED CANCER TREATMENT AT A YOUNG AGE. DESPITE AN OVERALL REDUCTION IN THE INCIDENCE OF MOST CHRONIC HEALTH CONDITIONS IN CHILDHOOD CANCER SURVIVORS OVER THE PAST SEVERAL DECADES, THE CUMULATIVE INCIDENCE OF CERTAIN LATE EFFECTS, IN PARTICULAR DIABETES MELLITUS (DM), HAS INCREASED. THE IMPLICATIONS ARE SIGNIFICANT, BECAUSE DM IS A KEY RISK FACTOR FOR CARDIOVASCULAR DISEASE, A LEADING CAUSE OF PREMATURE DEATH IN CHILDHOOD CANCER SURVIVORS. THE UNDERLYING PATHOPHYSIOLOGY OF DM IN CANCER SURVIVORS IS MULTIFACTORIAL. DM DEVELOPS AT YOUNGER AGES IN SURVIVORS COMPARED TO CONTROLS, WHICH MAY REFLECT AN "ACCELERATED AGING" PHENOTYPE IN THESE INDIVIDUALS. THE TREATMENT-RELATED EXPOSURES (I.E., CHEMOTHERAPY, RADIATION) THAT INCREASE RISK FOR DM IN CHILDHOOD CANCER SURVIVORS MAY BE MORE THAN ADDITIVE WITH ESTABLISHED DM RISK FACTORS (E.G., OLDER AGE, OBESITY, RACE, AND ETHNICITY). EMERGING RESEARCH ALSO POINTS TO PARALLELS IN CELLULAR PROCESSES IMPLICATED IN AGING- AND CANCER TREATMENT-RELATED DM. STILL, THERE REMAINS MARKED INTER-INDIVIDUAL VARIABILITY REGARDING RISK OF DM THAT IS NOT EXPLAINED BY DEMOGRAPHIC AND THERAPEUTIC RISK FACTORS ALONE. RECENT STUDIES HAVE HIGHLIGHTED THE ROLE OF GERMLINE GENETIC RISK FACTORS AND EPIGENETIC MODIFICATIONS THAT ARE ASSOCIATED WITH RISK OF DM IN BOTH THE GENERAL AND ONCOLOGY POPULATIONS. THIS REVIEW SUMMARIZES OUR CURRENT UNDERSTANDING OF RECOGNIZED RISK FACTORS FOR DM IN CHILDHOOD CANCER SURVIVORS TO HELP INFORM TARGETED APPROACHES FOR DISEASE SCREENING, PREVENTION, AND TREATMENT. FURTHERMORE, IT HIGHLIGHTS THE EXISTING SCIENTIFIC GAPS IN UNDERSTANDING THE RELATIVE CONTRIBUTIONS OF INDIVIDUAL THERAPEUTIC EXPOSURES AND THE MECHANISMS BY WHICH THEY EXERT THEIR EFFECTS THAT UNIQUELY PREDISPOSE THIS POPULATION TO DM FOLLOWING CANCER TREATMENT. 2023 11 6469 45 TISSUE-SPECIFIC METHYLATION PROFILE IN OBESE PATIENTS WITH TYPE 2 DIABETES BEFORE AND AFTER ROUX-EN-Y GASTRIC BYPASS. EATING HABITS, LIFESTYLES, AND EXPOSURE TO SPECIFIC ENVIRONMENTAL FACTORS CAN GREATLY IMPACT THE RISK OF DEVELOPING TYPE 2 DIABETES (T2D), INFLUENCE THE GENOME EPIGENETICALLY, AND AFFECT THE EXPRESSION OF GENES, INCLUDING GENES RELATED TO GLYCEMIC CONTROL, AT ANY STAGE OF LIFE. THE EPIGENETIC MECHANISM UNDERLYING OBESITY AND T2D PATHOGENESIS REMAINS POORLY UNDERSTOOD. CONVENTIONAL STRATEGIES FOR THE TREATMENT OF OBESITY AND ITS COMORBIDITIES OFTEN HAVE POOR LONG-TERM ADHERENCE, AND PHARMACOLOGICAL INTERVENTIONS ARE LIMITED. BARIATRIC SURGERY IS THE MOST EFFECTIVE CURRENT OPTION TO TREAT SEVERE OBESITY, AND ROUX-EN-Y GASTRIC BYPASS (RYGB) IS THE MOST APPLIED TECHNIQUE WORLDWIDE. EPIGENETIC CHANGES DIFFER DEPENDING ON THE APPROACH USED TO TREAT OBESITY AND ITS ASSOCIATED COMORBIDITIES (CLINICAL OR SURGICAL). COMPARED TO PRIMARY CLINICAL CARE, BARIATRIC SURGERY LEADS TO MUCH GREATER LOSS OF BODY WEIGHT AND HIGHER REMISSION RATES OF T2D AND METABOLIC SYNDROME, WITH METHYLATION PROFILES IN PROMOTER REGIONS OF GENES IN OBESE INDIVIDUALS BECOMING SIMILAR TO THOSE OF NORMAL-WEIGHT INDIVIDUALS. BARIATRIC SURGERY CAN INFLUENCE DNA METHYLATION IN PARALLEL WITH CHANGES IN GENE EXPRESSION PATTERN. CHANGES IN CLINICAL BIOMARKERS THAT REFLECT IMPROVEMENTS IN GLUCOSE AND LIPID METABOLISM AFTER RYGB OFTEN OCCUR BEFORE MAJOR WEIGHT LOSS AND ARE COORDINATED BY SURGERY-INDUCED CHANGES IN INTESTINAL HORMONES. THEREFORE, THE INTESTINE METHYLATION PROFILE WOULD ASSIST IN UNDERSTANDING THE MECHANISMS INVOLVED IN IMPROVED GLYCEMIC CONTROL AFTER BARIATRIC SURGERY. THE MAIN OBJECTIVES IN THIS AREA FOR THE FUTURE ARE TO IDENTIFY EPIGENETIC MARKS THAT COULD BE USED AS EARLY INDICATORS OF METABOLIC RISK, AND TO DEVELOP TREATMENTS ABLE TO DELAY OR EVEN REVERSE THESE EPIGENETIC CHANGES. STUDIES THAT PROVIDE THE "HUMAN EPIGENETIC PROFILE" WILL BE OF CONSIDERABLE VALUE TO IDENTIFY TISSUE-SPECIFIC EPIGENETIC SIGNATURES AND THEIR ROLE IN THE DEVELOPMENT OF CHRONIC DISEASES. FURTHER STUDIES SHOULD APPLY METHODS BASED ON GLOBAL ANALYSIS OF THE GENOME TO IDENTIFY METHYLATED SITES ASSOCIATED WITH DISEASE AND EPIGENETIC MARKS ASSOCIATED WITH THE REMODELING RESPONSE TO BARIATRIC SURGERY. THIS REVIEW DESCRIBES THE MAIN EPIGENETIC ALTERATIONS ASSOCIATED WITH OBESITY AND T2D AND THE POTENTIAL ROLE OF RYGB IN REMODELING THESE CHANGES. 2017 12 2699 41 EXCESS BODY WEIGHT: NOVEL INSIGHTS INTO ITS ROLES IN OBESITY COMORBIDITIES. EXCESS BODY WEIGHT IS A GLOBAL HEALTH PROBLEM DUE TO SEDENTARY LIFESTYLE AND UNHEALTHY DIET, AFFECTING 2 BILLION POPULATION WORLDWIDE. OBESITY IS A MAJOR RISK FACTOR FOR METABOLIC DISEASES. NOTABLY, THE METABOLIC RISK OF OBESITY LARGELY DEPENDS ON BODY WEIGHT DISTRIBUTION, OF WHICH VISCERAL ADIPOSE TISSUES BUT NOT SUBCUTANEOUS FATS ARE CLOSELY ASSOCIATED WITH OBESITY COMORBIDITIES, INCLUDING TYPE 2 DIABETES, NON-ALCOHOLIC FATTY LIVER DISEASE, CARDIOVASCULAR DISEASE AND CERTAIN TYPES OF CANCER. LATEST MULTI-OMICS AND MECHANISTICAL STUDIES REPORTED THE CRUCIAL INVOLVEMENT OF GENETIC AND EPIGENETIC ALTERATIONS, ADIPOKINES DYSREGULATION, IMMUNITY CHANGES, IMBALANCE OF WHITE AND BROWN ADIPOSE TISSUES, AND GUT MICROBIAL DYSBIOSIS IN MEDIATING THE PATHOGENIC ASSOCIATION BETWEEN VISCERAL ADIPOSE TISSUES AND COMORBIDITIES. IN THIS REVIEW, WE EXPLORE THE EPIDEMIOLOGY OF EXCESS BODY WEIGHT AND THE UP-TO-DATE MECHANISM OF HOW EXCESS BODY WEIGHT AND OBESITY LEAD TO CHRONIC COMPLICATIONS. WE ALSO EXAMINE THE UTILIZATION OF VISCERAL FAT MEASUREMENT AS AN ACCURATE CLINICAL PARAMETER FOR RISK ASSESSMENT IN HEALTHY INDIVIDUALS AND CLINICAL OUTCOME PREDICTION IN OBESE SUBJECTS. IN ADDITION, CURRENT APPROACHES FOR THE PREVENTION AND TREATMENT OF EXCESS BODY WEIGHT AND ITS RELATED METABOLIC COMORBIDITIES ARE FURTHER DISCUSSED. 2023 13 2715 35 EXERCISE-INDUCED BIOCHEMICAL CHANGES AND THEIR POTENTIAL INFLUENCE ON CANCER: A SCIENTIFIC REVIEW. AIM: TO REVIEW AND DISCUSS THE AVAILABLE INTERNATIONAL LITERATURE REGARDING THE INDIRECT AND DIRECT BIOCHEMICAL MECHANISMS THAT OCCUR AFTER EXERCISE, WHICH COULD POSITIVELY, OR NEGATIVELY, INFLUENCE ONCOGENIC PATHWAYS. METHODS: THE PUBMED, MEDLINE, EMBASE AND COCHRANE LIBRARIES WERE SEARCHED FOR PAPERS UP TO JULY 2016 ADDRESSING BIOCHEMICAL CHANGES AFTER EXERCISE WITH A PARTICULAR REFERENCE TO CANCER. THE THREE AUTHORS INDEPENDENTLY ASSESSED THEIR APPROPRIATENESS FOR INCLUSION IN THIS REVIEW BASED ON THEIR SCIENTIFIC QUALITY AND RELEVANCE. RESULTS: 168 PAPERS WERE SELECTED AND CATEGORISED INTO INDIRECT AND DIRECT BIOCHEMICAL PATHWAYS. THE INDIRECT EFFECTS INCLUDED CHANGES IN VITAMIN D, WEIGHT REDUCTION, SUNLIGHT EXPOSURE AND IMPROVED MOOD. THE DIRECT EFFECTS INCLUDED INSULIN-LIKE GROWTH FACTOR, EPIGENETIC EFFECTS ON GENE EXPRESSION AND DNA REPAIR, VASOACTIVE INTESTINAL PEPTIDE, OXIDATIVE STRESS AND ANTIOXIDANT PATHWAYS, HEAT SHOCK PROTEINS, TESTOSTERONE, IRISIN, IMMUNITY, CHRONIC INFLAMMATION AND PROSTAGLANDINS, ENERGY METABOLISM AND INSULIN RESISTANCE. SUMMARY: EXERCISE IS ONE OF SEVERAL LIFESTYLE FACTORS KNOWN TO LOWER THE RISK OF DEVELOPING CANCER AND IS ASSOCIATED WITH LOWER RELAPSE RATES AND BETTER SURVIVAL. THIS REVIEW HIGHLIGHTS THE NUMEROUS BIOCHEMICAL PROCESSES, WHICH EXPLAIN THESE POTENTIAL ANTICANCER BENEFITS. 2017 14 456 48 APPLYING A LIFE COURSE BIOLOGICAL AGE FRAMEWORK TO IMPROVING THE CARE OF INDIVIDUALS WITH ADULT CANCERS: REVIEW AND RESEARCH RECOMMENDATIONS. IMPORTANCE: THE PRACTICE OF ONCOLOGY WILL INCREASINGLY INVOLVE THE CARE OF A GROWING POPULATION OF INDIVIDUALS WITH MIDLIFE AND LATE-LIFE CANCERS. MANAGING CANCER IN THESE INDIVIDUALS IS COMPLEX, BASED ON DIFFERENCES IN BIOLOGICAL AGE AT DIAGNOSIS. BIOLOGICAL AGE IS A MEASURE OF ACCUMULATED LIFE COURSE DAMAGE TO BIOLOGICAL SYSTEMS, LOSS OF RESERVE, AND VULNERABILITY TO FUNCTIONAL DETERIORATION AND DEATH. BIOLOGICAL AGE IS IMPORTANT BECAUSE IT AFFECTS THE ABILITY TO MANAGE THE RIGORS OF CANCER THERAPY, SURVIVORS' FUNCTION, AND CANCER PROGRESSION. HOWEVER, BIOLOGICAL AGE IS NOT ALWAYS CLINICALLY APPARENT. THIS REVIEW PRESENTS A CONCEPTUAL FRAMEWORK OF LIFE COURSE BIOLOGICAL AGING, SUMMARIZES CANDIDATE MEASURES, AND DESCRIBES A RESEARCH AGENDA TO FACILITATE CLINICAL TRANSLATION TO ONCOLOGY PRACTICE. OBSERVATIONS: MIDLIFE AND LATE-LIFE CANCERS ARE CHRONIC DISEASES THAT MAY ARISE FROM CUMULATIVE PATTERNS OF BIOLOGICAL AGING OCCURRING OVER THE LIFE COURSE. BEFORE DIAGNOSIS, EACH NEW PATIENT WAS ON A DISTINCT COURSE OF BIOLOGICAL AGING RELATED TO PAST EXPOSURES, LIFE EXPERIENCES, GENETICS, AND NONCANCER CHRONIC DISEASE. CANCER AND ITS TREATMENTS MAY ALSO BE ASSOCIATED WITH BIOLOGICAL AGING. SEVERAL MEASURES OF BIOLOGICAL AGE, INCLUDING P16INK4A, EPIGENETIC AGE, TELOMERE LENGTH, AND INFLAMMATORY AND BODY COMPOSITION MARKERS, HAVE BEEN USED IN ONCOLOGY RESEARCH. ONE OR MORE OF THESE MEASURES MAY BE USEFUL IN CANCER CARE, EITHER ALONE OR IN COMBINATION WITH CLINICAL HISTORY AND GERIATRIC ASSESSMENTS. HOWEVER, FURTHER RESEARCH WILL BE NEEDED BEFORE BIOLOGICAL AGE ASSESSMENT CAN BE RECOMMENDED IN ROUTINE PRACTICE, INCLUDING DETERMINATION OF SITUATIONS IN WHICH KNOWLEDGE ABOUT BIOLOGICAL AGE WOULD CHANGE TREATMENT, ASCERTAINING WHETHER TREATMENT EFFECTS ON BIOLOGICAL AGING ARE SHORT-LIVED OR PERSISTENT, AND TESTING INTERVENTIONS TO MODIFY BIOLOGICAL AGE, DECREASE TREATMENT TOXIC EFFECTS, AND MAINTAIN FUNCTIONAL ABILITIES. CONCLUSIONS AND RELEVANCE: UNDERSTANDING DIFFERENCES IN BIOLOGICAL AGING COULD ULTIMATELY ALLOW CLINICIANS TO BETTER PERSONALIZE TREATMENT AND SUPPORTIVE CARE, DEVELOP TAILORED SURVIVORSHIP CARE PLANS, AND PRESCRIBE PREVENTIVE OR AMELIORATIVE THERAPIES AND BEHAVIORS INFORMED BY AGING MECHANISMS. 2021 15 6822 42 [GENDER MEDICINE. SEX- AND GENDER-SPECIFIC ASPECTS OF CLINICAL MEDICINE]. GENDER MEDICINE STUDIES SEX- AND GENDER-BASED DIFFERENCES IN THE DEVELOPMENT AND PREVENTION OF DISEASES, THE AWARENESS AND PRESENTATION OF SYMPTOMS, AND THE EFFECTIVENESS OF THERAPY. GENDER MEDICINE IS PART OF PERSONALIZED MEDICINE, CONSIDERING DIFFERENCES IN BIOLOGICAL AND PSYCHOSOCIAL FACTORS INDIVIDUALLY. THERE ARE DIFFERENCES IN GENES, CHROMOSOMES, HORMONES, AND METABOLISM AS WELL AS DIFFERENCES IN CULTURE, ENVIRONMENT, AND SOCIETY. LIFELONG INTERACTIONS BETWEEN PHYSICAL AND PSYCHOSOCIAL FACTORS WILL INFLUENCE THE HEALTH AND ILL-HEALTH OF MEN AND WOMEN IN DIFFERENT WAYS. EPIGENETIC MODIFICATIONS PROVIDE EVIDENCE OF THE IMPACT OF ENVIRONMENT AND LIFESTYLE DURING VULNERABLE PHASES ON BIOLOGICAL PROCESSES, EFFECTING FUTURE GENERATIONS. MATERNAL LIFESTYLE AND ENVIRONMENTAL FACTORS DURING PREGNANCY CAN IMPACT THE HEALTH OF OFFSPRING IN LATER LIFE ALREADY IN UTERO IN A SEX-SPECIFIC WAY. PAIN, STRESS, AND COPING STYLES DIFFER BETWEEN MEN AND WOMEN. WOMEN EXPERIENCE MORE DRAMATIC PHYSICAL CHANGES DURING THEIR LIFETIME, WHICH ARE ASSOCIATED WITH SPECIFIC BURDENS AND PSYCHOSOCIAL ALTERATIONS. WOMEN WITH MULTIPLE ROLES AND RESPONSIBILITIES SUFFERING FROM STRESS DEVELOP DEPRESSION MORE FREQUENTLY. HOWEVER, MEN ARE OFTEN NOT DIAGNOSED AND TREATED APPROPRIATELY IN CASES OF DEPRESSION OR OSTEOPOROSIS, DISEASES THAT ARE TYPICALLY CONSIDERED "FEMALE." THERE ARE PROMINENT DIFFERENCES BETWEEN MEN AND WOMEN IN MEDICINE REGARDING THE IMMUNE SYSTEM, INFLAMMATION, AND NONCOMMUNICABLE DISEASES SUCH AS OBESITY, TYPE 2 DIABETES, HYPERTENSION, AND CARDIOVASCULAR DISEASE. WOMEN EXPERIENCE MORE OFTEN AUTOIMMUNE DISEASES AND SUFFER MORE FREQUENTLY FROM (CHRONIC) PAIN, NEURODEGENERATIVE CHANGES, AND FUNCTIONAL DISABILITIES. MEN HAVE SHORTER LIFE EXPECTANCY BUT RELATIVELY MORE HEALTHY YEARS OF LIFE, WHICH IS IN GREATER PART ASCRIBED TO PSYCHOSOCIAL DETERMINANTS. STATE-OF-THE-ART CLINICAL MEDICINE COMPRISES INDIVIDUAL RISK FACTORS BASED ON SEX- AND GENDER-SENSITIVE HEALTH PROGRAMS IN ORDER TO IMPROVE THE HEALTH-RELATED QUALITY OF LIFE FOR MEN AND WOMEN. 2014 16 4803 30 OBESITY AND MALE INFERTILITY. THE WORLDWIDE PREVALENCE OF OBESITY IS INCREASING AMONG BOTH SEXES, WITH ASSOCIATED IMPACTS ON CHRONIC HEALTH AND MEDICAL COMORBIDITIES. SIMILARLY, THE EFFECTS OF OBESITY ON REPRODUCTIVE HEALTH ARE INCREASINGLY BEING RECOGNIZED. ADIPOSITY IS ASSOCIATED WITH REDUCED FERTILITY IN MEN, WITH A COMPLEX AND MULTIFACTORIAL ETIOLOGY. THE REPORTED EFFECTS OF OBESITY ON SEMEN PARAMETERS AND IMPAIRED FERTILITY ARE CONTRASTING, WITH SOME STUDIES SHOWING A CLEAR REDUCTION IN REPRODUCTIVE OUTCOMES ASSOCIATED WITH INCREASED BODY MASS INDEX, WHILE OTHERS DO NOT SHOW SUCH IMPACTS. THESE CONTROVERSIES MAY BE DUE TO THE COMPLEX PATHOPHYSIOLOGY AND INTERPLAY BETWEEN GONADOTROPINS AND END ORGANS, AS WELL AS GENETIC AND EPIGENETIC CHANGES AND OXIDATIVE STRESS ON MALE FERTILITY AND FUNCTION. THESE DIFFERENT ASPECTS HAVE LED TO HETEROGENEOUS PARTICIPANTS IN STUDIES AND VARYING IMPLICATIONS FOR ASSISTED REPRODUCTIVE OUTCOMES AS WELL AS OFFSPRING HEALTH. TREATMENT MODALITIES TO MANAGE OBESITY INCLUDE LIFESTYLE, MEDICAL, AND SURGICAL OPTIONS, WITH EMERGING AND EFFECTIVE MEDICAL TREATMENTS SHOWING PROMISE IN REPRODUCTIVE OUTCOMES. 2023 17 3915 32 LINE-1 IN OBESITY AND CARDIOMETABOLIC DISEASES: A SYSTEMATIC REVIEW. EPIGENETIC MECHANISMS MAY PLAY AN IMPORTANT ROLE IN THE ETIOLOGY OF OBESITY AND CARDIOMETABOLIC DISEASES, BY ACTIVATING OR SILENCING THE RELATED-GENES. SCIENTIFIC EVIDENCE HAS SUGGESTED THAT LINE-1 METHYLATION IS ASSOCIATED WITH BODY COMPOSITION AND OBESITY-RELATED DISEASES, INCLUDING INSULIN RESISTANCE, TYPE 2 DIABETES MELLITUS, AND CARDIOVASCULAR DISEASE (CVD). IT ALSO HAS BEEN EVALUATED AS PREDICTOR OF WEIGHT LOSS. THE STUDIES' RESULTS ARE STILL CONFLICTING, AND POSITIVE AND NEGATIVE ASSOCIATIONS HAVE BEEN FOUND TO LINE-1 METHYLATION REGARDING ADIPOSITY AND CARDIOMETABOLIC MARKERS. OVERALL, THIS REVIEW PRESENTS OBSERVATIONAL (CROSS-SECTIONAL AND LONGITUDINAL) STUDIES AND INTERVENTIONS (DIET, EXERCISES, AND BARIATRIC SURGERY) THAT EVALUATED THE RELATIONSHIP OF THE LINE-1 METHYLATION WITH OBESITY, WEIGHT LOSS, DYSLIPIDEMIAS, HYPERTENSION, INSULIN RESISTANCE, CVD, AND METABOLIC SYNDROME. TEACHING POINTS EPIGENETIC MECHANISMS MAY PLAY AN IMPORTANT ROLE IN THE ETIOLOGY OF OBESITY AND CARDIOMETABOLIC DISEASES. MANY STUDIES HAVE RELATED METHYLATION OF LINE-1 WITH CARDIOMETABOLIC DISEASES; HOWEVER, THE RESULTS ARE STILL CONTROVERSIAL. THE RELATIONSHIP BETWEEN THE ETIOLOGY OF CHRONIC DISEASES AND THE METHYLATION OF LINE-1 IS NOT FULLY ELUCIDATED. WITH ADVANCES IN EPIGENETIC STUDIES, RELATED MECHANISMS MAY BE EARLY BIOMARKERS IN WEIGHT CHANGE AND CARDIOMETABOLIC RISK. 2019 18 6029 43 THE BURDEN OF DIABETES: EMERGING DATA. IN RECENT TIMES, THE GLOBAL PREVALENCE OF DIABETES HAS INCREASED SUBSTANTIALLY, REACHING 8.3% IN 2014, WHICH CORRESPONDS TO 387 MILLION PATIENTS. STUDIES IN EUROPE AND USA HAVE SHOWN INCREASED INCIDENCE OF TYPE 1 DIABETES (T1D) OVER TIME AT A RATE OF 3-5% PER YEAR. ANOTHER MOST WORRYING FEATURE OF THE RAPID INCREASE OF DIABETES IS THE EMERGENCE OF TYPE 2 DIABETES (T2D) IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS. THE WELL-KNOWN BEHAVIORAL RISKS FACTORS AND EPIGENETIC MECHANISMS RECENTLY OBSERVED REQUIRE AN INTEGRATED APPROACH TO PREVENT T2D. DIABETES SIGNIFICANTLY INFLUENCES THE PATIENT' SURVIVAL, QUALITY OF LIFE, AND DEVELOPMENT OF ORGAN SYSTEM DEGENERATION. EPIDEMIOLOGICAL STUDIES HAVE SHOWN INCREASED MORTALITY IN DIABETIC PATIENTS, ESPECIALLY WOMEN, WHICH INCREASED APPROXIMATELY FIVEFOLD, WHEREAS CARDIOVASCULAR MORTALITY INCREASED 20- TO 30-FOLD WHEN COMPARED TO THE NORMAL POPULATION. DIABETES IS THE LEADING CAUSE OF END-STAGE RENAL DISEASE AND VISION LOSS IN DEVELOPED COUNTRIES. AROUND 40% OF T1D AND T2D START ON RENAL REPLACEMENT THERAPY. WHILE AFTER 40 YEARS OF DIABETES, THE CUMULATIVE PROPORTION OF PATIENTS WITH ANY RETINOPATHY AND ADVANCED RETINOPATHY WAS 84.1 AND 50.2%, RESPECTIVELY. HOWEVER, THE MOST PREVALENT CHRONIC COMPLICATION OF DIABETES IS NEUROPATHY. DISTAL SYMMETRIC POLYNEUROPATHY OCCURS IN AT LEAST 20% OF PEOPLE WITH T1D AFTER 20 YEARS AND IN 10-15% OF NEWLY DIAGNOSED T2D, INCREASING TO 50% AFTER 10 YEARS. CARDIOVASCULAR AUTONOMIC NEUROPATHY MAY BE PRESENT IN UP TO 60% OF PATIENTS AFTER 15 YEARS AND IS AN INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR MORTALITY. 2017 19 637 32 BIOLOGY OF PREMATURE AGEING IN SURVIVORS OF CANCER. OVER 30 MILLION CANCER SURVIVORS EXIST WORLDWIDE. SURVIVORS HAVE AN EARLIER ONSET AND HIGHER INCIDENCE OF CHRONIC COMORBIDITIES, INCLUDING ENDOCRINOPATHIES, CARDIAC DYSFUNCTION, OSTEOPOROSIS, PULMONARY FIBROSIS, SECONDARY CANCERS AND FRAILTY THAN THE GENERAL POPULATION; HOWEVER, THE FUNDAMENTAL BASIS OF THESE CHANGES AT THE CELLULAR LEVEL IS UNKNOWN. AN ELECTRONIC SEARCH WAS PERFORMED ON EMBASE, MEDLINE IN-PROCESS & OTHER NON-INDEXED CITATIONS, AND THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS. ORIGINAL ARTICLES ADDRESSING THE CELLULAR BIOLOGY OF AGEING AND/OR THE MECHANISMS OF CANCER THERAPIES SIMILAR TO AGEING MECHANISMS WERE INCLUDED, AND REFERENCES OF THESE ARTICLES WERE REVIEWED FOR FURTHER SEARCH. WE FOUND MULTIPLE BIOLOGICAL PROCESS OF AGEING AT THE CELLULAR LEVEL AND THEIR ASSOCIATION WITH CANCER THERAPIES, AS WELL AS WITH CLINICAL EFFECTS. THE DIRECT EFFECTS OF VARIOUS CHEMOTHERAPIES AND RADIATION ON TELOMERE LENGTH, SENESCENT CELLS, EPIGENETIC MODIFICATIONS AND MICRORNA WERE FOUND. WE REVIEW THE EFFECTS OF CANCER THERAPIES ON RECOGNISED HALLMARKS OF AGEING. LONG-TERM COMORBIDITIES SEEN IN CANCER SURVIVORS MIMIC THE PHENOTYPES OF AGEING AND LIKELY RESULT FROM THE INTERACTION BETWEEN THERAPEUTIC EXPOSURES AND THE UNDERLYING BIOLOGY OF AGEING. LONG-TERM FOLLOW-UP OF CANCER SURVIVORS AND RESEARCH ON PREVENTION STRATEGIES SHOULD BE PURSUED TO INCREASE THE LENGTH AND QUALITY OF LIFE AMONG THE GROWING POPULATION OF CANCER SURVIVORS. 2017 20 6165 36 THE GLOBAL DIABETES EPIDEMIC AS A CONSEQUENCE OF LIFESTYLE-INDUCED LOW-GRADE INFLAMMATION. THE RECENT MAJOR INCREASE IN THE GLOBAL INCIDENCE OF TYPE 2 DIABETES SUGGESTS THAT MOST CASES OF THIS DISEASE ARE CAUSED BY CHANGES IN ENVIRONMENT AND LIFESTYLE. ALL MAJOR RISK FACTORS FOR TYPE 2 DIABETES (OVERNUTRITION, LOW DIETARY FIBRE, SEDENTARY LIFESTYLE, SLEEP DEPRIVATION AND DEPRESSION) HAVE BEEN FOUND TO INDUCE LOCAL OR SYSTEMIC LOW-GRADE INFLAMMATION THAT IS USUALLY TRANSIENT OR MILDER IN INDIVIDUALS NOT AT RISK FOR TYPE 2 DIABETES. BY CONTRAST, INFLAMMATORY RESPONSES TO LIFESTYLE FACTORS ARE MORE PRONOUNCED AND PROLONGED IN INDIVIDUALS AT RISK OF TYPE 2 DIABETES AND APPEAR TO OCCUR ALSO IN THE PANCREATIC ISLETS. CHRONIC LOW-GRADE INFLAMMATION WILL EVENTUALLY LEAD TO OVERT DIABETES IF COUNTER-REGULATORY CIRCUITS TO INFLAMMATION AND METABOLIC STRESS ARE COMPROMISED BECAUSE OF A GENETIC AND/OR EPIGENETIC PREDISPOSITION. HENCE, IT IS NOT THE LIFESTYLE CHANGE PER SE BUT A DEFICIENT COUNTER-REGULATORY RESPONSE IN PREDISPOSED INDIVIDUALS WHICH IS CRUCIAL TO DISEASE PATHOGENESIS. NOVEL APPROACHES OF INTERVENTION MAY TARGET THESE DEFICIENT DEFENCE MECHANISMS. 2010