Project Summary: Metabolic syndrome (MS) represents one of the leading causes of morbidity and mortality in the adult population worldwide. It has emerged as a leading global public health and clinical challenge. The study of metabolic abnormalities, mainly insulin resistance among the young has gained much importance due to the increased incidence of MS globally. MS has been defined as the presence of at least three of the five criteria viz: abdominal obesity, high blood pressure, hyperglycemia, high serum triglycerides (TG), and low serum high-density lipoprotein (HDL). MS is associated with the risk of developing cardiovascular disease (CVD) and type 2 diabetes (T2DM). Insulin resistance (IR) is believed to be an important underlying factor behind several related clinical and biochemical abnormalities that are predisposed to diabetes, hypertension, and coronary heart disease and hence in the development of MS. Extensive research is under way globally to identify the etiology, relationship between insulin resistance and metabolic syndrome. Evaluation of metabolic abnormalities mainly insulin resistance in apparently healthy young adults could be of great importance as it may serve as a predictor of increased risk for major chronic diseases that take decades to develop, such as obesity, metabolic syndrome, and cardiovascular disease. Therefore, we propose to evaluate insulin resistance by HOMA IR model by estimating fasting blood glucose and fasting plasma insulin in apparently healthy adults and compare with the patient already diagnosed with metabolic syndrome

Project Summary: There is no information about the previously indicated positive effect of oligofructose in the Saudi population on the well-being of patients with diabetes. In this research project, we aim to elucidate the significant effect of using prebiotic oligofructose supplementation on improving the metabolic profile of Saudi adults with diabetes directly and indirectly through its effect on the gut flora. b. Research Significance: This is the first investigation of the effect of prebiotic oligofructose supplementation on the well-being of Saudi patients with diabetes. Moreover, it will produce more information about the structure of microbial gut flora in patients with diabetes and if it can be improved by introducing oligofructose in our food processing as well as a meal plan for patients with diabetes. c. Research Objectives: To assess the effect of prebiotic Oligofructose supplementation on improving body weight, glycemic control, lipid profiles, inflammatory biomarkers, and accompanied changes in main gut floral species in Saudi adults with diabetes compared to healthy control subjects. d. Research Methodology: This is a double-blind, randomized, placebo-controlled study on 50 type 2 diabetes and 50 matched control Saudi adults. Subjects are going to be randomly assigned to receive either prebiotics oligofructose (16g/day) or an equicaloric amount of maltodextrin placebo for 3 months. The recruitment will be conducted at the King Abdullah bin Abdulaziz University Hospital. After verifying that the patients met the inclusion criteria and obtaining consent, a baseline assessment will be obtained including socio-characteristics, anthropometrics measures, dietary assessment, and blood and feces samples analysis. Then, each subject will be randomly assigned to an oligofructose or placebo group. The follow-up assessment will be performed at weeks 4, 8, and 12 and telephone follow-up in between will be performed three times during the study to verify compliance and enquire about possible side effects. The Gut microbiome analysis will be performed using DNA isolated from faeces samples. 16S rRNA genes will be amplified using Ion 16S™ Metagenomics Kit. This kit allows the utilization of novel approach that simultaneously investigates seven out of the 9 hypervariable regions in the bacterial 16S rRNA gene using with PCR primers cocktail designed to target >80% of the sequences found in the Greengenes database found at http://greengenes.lbl.gov/cgi-bin/nph-index.cgi. The Greengenes web application provides access to the 16S rRNA gene sequence alignment for browsing, blasting, probing, and downloading. PCR products will be sequenced using NGS sequencing facility in the Strategic Centre for Diabetes Research. Bioinformatics and statistical analysis will be performed in the Strategic Centre for Diabetes Research, Departments of Biotechnology, Information Technology, and Biostatistics.

Project Summary: Bariatric surgery has become one medical therapy for patients who complained from obesity and co-morbidities associated with obesity. However, numerous reports have shown an increase in body weight post-bariatric surgery. Evidence shows that there is changes in appetite hormones post-bariatric surgery such as Leptin and Ghrelin. However, there are changes in appetite hormones post bariatric surgery such as Leptin and Ghrelin. However, there is not clear understanding if that hormones changes will extend up to one year post bariatric surgery in which responsible for increase food intake and gain body weight post bariatric surgery. The aim of the current study is to assess the association between Appetite test (subjective) and the hormones associated with appetite (Leptin and Ghrelin) in patients one year post bariatric surgery. This study is a pilot study that will assess appetite subjectively using Visual Analog Scale (VAS). Biomarkers to assess appetite will be measured (Leptin and Ghrelin levels).. Additional test will be measured including body composition, Resting Energy Expenditure (REE), food intake Glycemic Index (GI), Glycemic Load (GL) using 24 hr recall and physical activity using a validated tool to assess physical activity. The result of this study will provide a clear answer of the reason of gain body weigh in in patients one year post-bariatric surgery.