Two Endoscopic Surgical Approaches to Facial Rejuvenation: A Longitudinal Study on Safety and Patient Satisfaction.

Glucose and lipid metabolism involve coordinated actions of insulin, glucagon, and several other hormones to maintain overall energy homeostasis. Insulin’s main role is to facilitate glucose uptake in muscle and adipose tissue, suppress hepatic glucose production, stimulate lipogenesis, and inhibit lipolysis, whereas glucagon acts in an opposing manner, particularly during fasting or physical activity. It enhances hepatic glucose output and promotes lipid mobilization []. The effects of insulin and glucose on hepatic and lipogenic gene expression are mediated by transcriptional regulators such as sterol regulatory element-binding protein 1c and carbohydrate regulatory element-binding protein (ChREBP), which further integrate the control of carbohydrate and lipid metabolism []. Puberty is a period characterized by dynamic hormonal changes, and is associated with notable physiological differences in metabolism and insulin sensitivity in adolescents and young adults. Sexual maturation is also associated with transient insulin resistance and elevated growth hormone and sex steroid levels, which lead to increased β-cell insulin secretion. However, adolescents with obesity may experience more pronounced insulin resistance and β-cell dysfunction than young adults, due to reduced peripheral insulin sensitivity and altered insulin clearance []. Sex hormones such as estrogens and testosterone, whose concentrations increase during puberty, modulate insulin action and metabolic regulation, with estrogen generally improving insulin sensitivity and testosterone exerting variable effects []. The rising popularity of sports supplements, including creatine, carnitine, citrulline, taurine, branched-chain amino acids (BCAAs), caffeine, arginine, β-alanine, and protein formulations, among adolescents and young adults highlights the need for careful scientific evaluation. Since these supplements are commonly used for performance enhancement, the assessment of their efficacy, safety, and regulatory standards is particularly important. This is because many supplements lack strong evidence of efficacy and may carry risks of contamination or adverse effects [], and sports supplements are often consumed by young people without adequate guidance or understanding of potential metabolic consequences. Moreover, certain sports supplements interact with metabolic pathways relevant to glucose regulation, insulin sensitivity, and lipid metabolism. The effects of these interactions in pediatric populations may be beneficial, neutral, or harmful, especially in individuals with impaired glucose tolerance, at risk for diabetes or with diabetes.