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Journal of Minimally Invasive Gynecology Feb 2020To conduct a systematic review of the literature on patients with extrapelvic deep endometriosis.
OBJECTIVE
To conduct a systematic review of the literature on patients with extrapelvic deep endometriosis.
DATA SOURCES
A thorough search of the PubMed/Medline, Embase, and Cochrane databases was performed.
METHODS OF STUDY SELECTION
Studies in the last 20 years that reported on primary extrapelvic endometriosis were included (PROSPERO registration number CRD42019125370).
TABULATION, INTEGRATION, AND RESULTS
The initial search identified 5465 articles, and 179 articles, mostly case reports and series, were included. A total of 230 parietal (PE), 43 visceral (VE), 628 thoracic (TE), 6 central nerve system, 12 extrapelvic muscle or nerve, and 1 nasal endometriosis articles were identified. Abdominal endometriosis was divided into PE and VE. PE lesions involved primary lesions of the abdominal wall, groin, and perineum. When present, symptoms included a palpable mass (99%), cyclic pain (71%) and cyclic bleeding (48%). Preoperative clinical suspicion was low, the use of tissue diagnosis was indeterminate (25%), and a few (8%) malignancies were suspected. Surgical treatment for PE included wide local excision (97%), with 5% recurrence and no complications. Patients with VE involving abdominal organs - kidneys, liver, pancreas, and biliary tract - were treated surgically (86%) with both conservative (51%) and radical resection (49%), with 15% recurrence and 2 major complications reported. In patients with TE involving the diaphragm, pleura, and lung, isolated and concomitant lesions occurred and favored the right side (80%). Patients with TE presented with the triad of catamenial pain, pneumothorax, and hemoptysis. Thoracoscopy with resection followed by pleurodesis was the most common procedure performed, with 29% recurrence. Adjuvant medical therapy with gonadotropin-releasing hormone was administered in 15% of cases. Preoperative magnetic resonance imaging was performed in all cases of nonthoracic and nonabdominal endometriosis. Common symptoms were paresthesia and cyclic pain with radiation. Surgical resection was reported in 84%, with improvement of symptoms.
CONCLUSION
Extrapelvic endometriosis, traditionally thought to be rare, has been reported in a considerable number of cases. Heightened awareness and clinical suspicion of the disease and a multidisciplinary approach are recommended to achieve a prompt diagnosis and optimize patient outcomes. Currently, there are no comparative studies to provide recommendations regarding optimal diagnostic methods, treatment options, and outcomes for endometriosis involving extrapelvic sites.
Topics: Adult; Diaphragm; Endometriosis; Female; Gastrointestinal Diseases; Humans; Magnetic Resonance Imaging; Muscular Diseases; Nervous System Diseases; Pneumothorax; Recurrence; Thoracic Diseases; Thoracoscopy
PubMed: 31618674
DOI: 10.1016/j.jmig.2019.10.004 -
The Cochrane Database of Systematic... Jan 2019Laparoscopy is a common procedure in many surgical specialties. Complications arising from laparoscopy are often related to initial entry into the abdomen.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Laparoscopy is a common procedure in many surgical specialties. Complications arising from laparoscopy are often related to initial entry into the abdomen. Life-threatening complications include injury to viscera (e.g. bowel, bladder) or to vasculature (e.g. major abdominal and anterior abdominal wall vessels). No clear consensus has been reached as to the optimal method of laparoscopic entry into the peritoneal cavity.
OBJECTIVES
To evaluate the benefits and risks of different laparoscopic entry techniques in gynaecological and non-gynaecological surgery.
SEARCH METHODS
We searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, PsycINFO, and trials registers in January 2018. We also checked the references of articles retrieved.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) that compared one laparoscopic entry technique versus another. Primary outcomes were major complications including mortality, vascular injury of major vessels and abdominal wall vessels, visceral injury of bladder or bowel, gas embolism, solid organ injury, and failed entry (inability to access the peritoneal cavity). Secondary outcomes were extraperitoneal insufflation, trocar site bleeding, trocar site infection, incisional hernia, omentum injury, and uterine bleeding.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected studies, assessed risk of bias, and extracted data. We expressed findings as Peto odds ratios (Peto ORs) with 95% confidence intervals (CIs). We assessed statistical heterogeneity using the I² statistic. We assessed the overall quality of evidence for the main comparisons using GRADE methods.
MAIN RESULTS
The review included 57 RCTs including four multi-arm trials, with a total of 9865 participants, and evaluated 25 different laparoscopic entry techniques. Most studies selected low-risk patients, and many studies excluded patients with high body mass index (BMI) and previous abdominal surgery. Researchers did not find evidence of differences in major vascular or visceral complications, as would be anticipated given that event rates were very low and sample sizes were far too small to identify plausible differences in rare but serious adverse events.Open-entry versus closed-entryTen RCTs investigating Veress needle entry reported vascular injury as an outcome. There was a total of 1086 participants and 10 events of vascular injury were reported. Four RCTs looking at open entry technique reported vascular injury as an outcome. There was a total of 376 participants and 0 events of vascular injury were reported. This was not a direct comparison. In the direct comparison of Veress needle and Open-entry technique, there was insufficient evidence to determine whether there was a difference in rates of vascular injury (Peto OR 0.14, 95% CI 0.00 to 6.82; 4 RCTs; n = 915; I² = N/A, very low-quality evidence). Evidence was insufficient to show whether there were differences between groups for visceral injury (Peto OR 0.61, 95% CI 0.06 to 6.08; 4 RCTs; n = 915: I² = 0%; very low-quality evidence), or failed entry (Peto OR 0.45, 95% CI 0.14 to 1.42; 3 RCTs; n = 865; I² = 63%; very low-quality evidence). Two studies reported mortality with no events in either group. No studies reported gas embolism or solid organ injury.Direct trocar versus Veress needle entryTrial results show a reduction in failed entry into the abdomen with the use of a direct trocar in comparison with Veress needle entry (OR 0.24, 95% CI 0.17 to 0.34; 8 RCTs; N = 3185; I² = 45%; moderate-quality evidence). Evidence was insufficient to show whether there were differences between groups in rates of vascular injury (Peto OR 0.59, 95% CI 0.18 to 1.96; 6 RCTs; n = 1603; I² = 75%; very low-quality evidence), visceral injury (Peto OR 2.02, 95% CI 0.21 to 19.42; 5 RCTs; n = 1519; I² = 25%; very low-quality evidence), or solid organ injury (Peto OR 0.58, 95% Cl 0.06 to 5.65; 3 RCTs; n = 1079; I² = 61%; very low-quality evidence). Four studies reported mortality with no events in either group. Two studies reported gas embolism, with no events in either group.Direct vision entry versus Veress needle entryEvidence was insufficient to show whether there were differences between groups in rates of vascular injury (Peto OR 0.39, 95% CI 0.05 to 2.85; 1 RCT; n = 186; very low-quality evidence) or visceral injury (Peto OR 0.15, 95% CI 0.01 to 2.34; 2 RCTs; n = 380; I² = N/A; very low-quality evidence). Trials did not report our other primary outcomes.Direct vision entry versus open entryEvidence was insufficient to show whether there were differences between groups in rates of visceral injury (Peto OR 0.13, 95% CI 0.00 to 6.50; 2 RCTs; n = 392; I² = N/A; very low-quality evidence), solid organ injury (Peto OR 6.16, 95% CI 0.12 to 316.67; 1 RCT; n = 60; very low-quality evidence), or failed entry (Peto OR 0.40, 95% CI 0.04 to 4.09; 1 RCT; n = 60; very low-quality evidence). Two studies reported vascular injury with no events in either arm. Trials did not report our other primary outcomes.Radially expanding (STEP) trocars versus non-expanding trocarsEvidence was insufficient to show whether there were differences between groups in rates of vascular injury (Peto OR 0.24, 95% Cl 0.05 to 1.21; 2 RCTs; n = 331; I² = 0%; very low-quality evidence), visceral injury (Peto OR 0.13, 95% CI 0.00 to 6.37; 2 RCTs; n = 331; very low-quality evidence), or solid organ injury (Peto OR 1.05, 95% CI 0.07 to 16.91; 1 RCT; n = 244; very low-quality evidence). Trials did not report our other primary outcomes.Other studies compared a wide variety of other laparoscopic entry techniques, but all evidence was of very low quality and evidence was insufficient to support the use of one technique over another.
AUTHORS' CONCLUSIONS
Overall, evidence was insufficient to support the use of one laparoscopic entry technique over another. Researchers noted an advantage of direct trocar entry over Veress needle entry for failed entry. Most evidence was of very low quality; the main limitations were imprecision (due to small sample sizes and very low event rates) and risk of bias associated with poor reporting of study methods.
Topics: Abdominal Wall; Blood Vessels; Female; Gynecologic Surgical Procedures; Humans; Intestines; Intraoperative Complications; Laparoscopy; Male; Peritoneal Cavity; Randomized Controlled Trials as Topic; Urinary Bladder
PubMed: 30657163
DOI: 10.1002/14651858.CD006583.pub5 -
Minerva Urologica E Nefrologica = the... Aug 2018Currently, abdominal obesity has reached an epidemic stage and obesity represents an important challenge for worldwide health authorities. Epidemiologic studies have... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Currently, abdominal obesity has reached an epidemic stage and obesity represents an important challenge for worldwide health authorities. Epidemiologic studies have demonstrated that the stone risk incidence increases with Body Mass Index, through multiple pathways. Metabolic syndrome and diabetes are associated with an increased renal stones disease incidence. The aim of this systematic review was to investigate the prevalence, morbidity, risk factors involved in the association between obesity and urolithiasis.
EVIDENCE ACQUISITION
The search involved finding relevant studies from MEDLINE, EMBASE, Ovid, the Cochrane Central Register of Controlled Trials, CINAHL, Google Scholar, and individual urological journals between January 2001 and May 2017. The inclusion criteria were for studies written in the English language, reporting on the association between obesity and urinary stones.
EVIDENCE SYNTHESIS
The underlying pathophysiology of stone formation in obese patients is thought to be related to insulin resistance, dietary factors, and a lithogenic urinary profile. Uric acid stones and calcium oxalate stones are observed frequently in these patients. Insulin resistance is thought to alter the renal acid-base metabolism, resulting in a lower urine pH, and increasing the risk of uric acid stone disease. Obesity is also associated with excess nutritional intake of lithogenic substances and with an increase in urinary tract infection incidence. Recent studies highlighted that renal stone disease increases the risk of myocardial infarction, progression of chronic kidney disease, and diabetes. Contemporary, bariatric surgery has been shown to be associated with hyperoxaluria and oxalate nephropathy. Certainly, the many health risks of obesity, including nephrolithiasis, will add more burden on urologists and nephrologists.
CONCLUSIONS
Obesity related nephrolithiasis seems to necessitate weight loss as primary treatment, but the recognition of the associated complications is necessary to prevent induction of new and equally severe medical problems. The optimal approach to obesity control that minimizes stone risk needs to be determined in order to manage obesity-induced renal stones disease.
Topics: Body Mass Index; Humans; Kidney Calculi; Obesity; Prevalence; Risk Factors; Urolithiasis
PubMed: 29856171
DOI: 10.23736/S0393-2249.18.03113-2 -
The Cochrane Database of Systematic... Mar 2019Polycystic ovary syndrome (PCOS) affects 8% to 13% of reproductive-aged women and is associated with reproductive and metabolic dysfunction. Obesity worsens the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Polycystic ovary syndrome (PCOS) affects 8% to 13% of reproductive-aged women and is associated with reproductive and metabolic dysfunction. Obesity worsens the presentation of PCOS and weight management (weight loss, maintenance or prevention of excess weight gain) is proposed as an initial treatment strategy, best achieved through lifestyle changes incorporating diet, exercise and behavioural interventions.
OBJECTIVES
To assess the effectiveness of lifestyle treatment in improving reproductive, anthropometric (weight and body composition), metabolic and quality of life factors in PCOS.
SEARCH METHODS
We searched the Cochrane Gynaecology and Fertility Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL and AMED (date of last search March 2018). We also searched controlled trials registries, conference abstracts, relevant journals, reference lists of relevant papers and reviews, and grey literature databases, with no language restrictions applied.
SELECTION CRITERIA
Randomised controlled trials (RCTs) comparing lifestyle treatment (diet, exercise, behavioural or combined treatments) to minimal or no treatment in women with PCOS.
DATA COLLECTION AND ANALYSIS
Two authors independently selected trials, assessed evidence quality and risk of bias, and extracted data. Our primary outcomes were live birth, miscarriage and pregnancy. We used inverse variance and fixed-effect models in the meta-analyses. We reported dichotomous outcomes as an odds ratio and continuous outcomes as a mean difference (MD) or standardised mean difference (SMD).
MAIN RESULTS
We included 15 studies with 498 participants. Ten studies compared physical activity to minimal dietary and behavioural intervention or no intervention. Five studies compared combined dietary, exercise and behavioural intervention to minimal intervention. One study compared behavioural intervention to minimal intervention. Risk of bias varied: eight studies had adequate sequence generation, seven had adequate clinician or outcome assessor blinding, seven had adequate allocation concealment, six had complete outcome data and six were free of selective reporting. No studies assessed the fertility primary outcomes of live birth or miscarriage. No studies reported the secondary reproductive outcome of menstrual regularity, as defined in this review.Lifestyle intervention may improve a secondary (endocrine) reproductive outcome, the free androgen index (FAI) (MD -1.11, 95% confidence interval (CI) -1.96 to -0.26, 6 RCTs, N = 204, I = 71%, low-quality evidence). Lifestyle intervention may reduce weight (kg) (MD -1.68 kg, 95% CI -2.66 to -0.70, 9 RCTs, N = 353, I = 47%, low-quality evidence). Lifestyle intervention may reduce body mass index (BMI) (kg/m) (-0.34 kg/m, 95% CI -0.68 to -0.01, 12 RCTs, N = 434, I= 0%, low-quality evidence). We are uncertain of the effect of lifestyle intervention on glucose tolerance (glucose outcomes in oral glucose tolerance test) (mmol/L/minute) (SMD -0.02, 95% CI -0.38 to 0.33, 3 RCTs, N = 121, I = 0%, low-quality evidence).
AUTHORS' CONCLUSIONS
Lifestyle intervention may improve the free androgen index (FAI), weight and BMI in women with PCOS. We are uncertain of the effect of lifestyle intervention on glucose tolerance. There were no studies that looked at the effect of lifestyle intervention on live birth, miscarriage or menstrual regularity. Most studies in this review were of low quality mainly due to high or unclear risk of bias across most domains and high heterogeneity for the FAI outcome.
Topics: Abdominal Fat; Exercise; Female; Humans; Insulin Resistance; Life Style; Obesity; Polycystic Ovary Syndrome; Randomized Controlled Trials as Topic; Virilism; Waist Circumference; Weight Loss
PubMed: 30921477
DOI: 10.1002/14651858.CD007506.pub4 -
Diabetes & Metabolic Syndrome 2019Recent studies have reported that globally, more than 1.9 billion adults are overweight and 650 million are obese. Approximately 2.8 million deaths are reported as a...
Recent studies have reported that globally, more than 1.9 billion adults are overweight and 650 million are obese. Approximately 2.8 million deaths are reported as a result of being overweight or obese. Due to the consumption of energy dense food (i.e. unhealthy food habits), sedentary life style, lack of health care services and financial support, the developing countries are facing high risk of obesity and their adverse consequences (i.e. diabetes, ischemic heart disease, etc). In India, more than 135 million individuals were affected by obesity. The prevalence of obesity in India varies due to age, gender, geographical environment, socio-economic status, etc. According to ICMR-INDIAB study 2015, prevalence rate of obesity and central obesity are varies from 11.8% to 31.3% and 16.9%-36.3% respectively. In India, abdominal obesity is one of the major risk factors for cardiovascular disease (CVDs). Various studies have shown that the prevalence of obesity among women were significantly higher as compared to men. Obesity is one of the main medical and financial burdens for the government. This problem of obesity can be preventable by spreading public awareness about obesity and its health consequences. Governmental agencies should promote the benefits of healthy life style, food habits and physical activity. The aim of this article is to report the prevalence of obesity in different regions of India and highlight the problem areas.
Topics: Humans; India; Obesity; Prevalence
PubMed: 30641719
DOI: 10.1016/j.dsx.2018.08.032 -
The Journals of Gerontology. Series A,... Sep 2019There is increasing use of computed tomography (CT) in sarcopenia research using a wide variety of techniques. We performed a systematic review of the CT literature to...
BACKGROUND/OBJECTIVE
There is increasing use of computed tomography (CT) in sarcopenia research using a wide variety of techniques. We performed a systematic review of the CT literature to identify the differences between approaches used.
METHODS
A comprehensive search of PubMed from 1983 to 2017 was performed to identify studies that used CT muscle measurements to assess muscle mass and myosteatosis. The CT protocols were evaluated based on anatomic landmark(s), thresholding, muscle(s) segmented, key measurement (ie, muscle attenuation, cross-sectional area, volume), derived variables, and analysis software. From the described search, 657 articles were identified and 388 studies met inclusion criteria for this systematic review.
RESULTS
Muscle mass was more commonly assessed than myosteatosis (330 vs. 125). The most commonly assessed muscle or muscle groups were total abdominal wall musculature (142/330 and 49/125 for muscle mass and myosteatosis, respectively) and total thigh musculature (90/330 and 48/125). The most commonly used landmark in the abdomen was the L3 vertebra (123/142 and 45/49 for muscle mass and myosteatosis, respectively). Skeletal muscle index and intermuscular adipose tissue were the most commonly used measures of abdominal wall muscle mass (114/142) and myosteatosis (27/49), respectively. Cut points varied across studies. A significant majority of studies failed to report important CT technical parameters, such as use of intravenous contrast and slice thickness (94% and 63%, respectively).
CONCLUSIONS
There is considerable variation in the CT approaches used for the assessment of muscle mass and myosteatosis. There is a need to develop consensus for CT-based evaluation of sarcopenia and myosteatosis.
Topics: Adipose Tissue; Body Composition; Humans; Muscle, Skeletal; Sarcopenia; Tomography, X-Ray Computed
PubMed: 30726878
DOI: 10.1093/gerona/glz034 -
Age and Ageing Jun 2021Obese older people are more likely to be frail than those with a normal body mass index (BMI), but the results of individual studies have been inconsistent. We conducted... (Meta-Analysis)
Meta-Analysis
Obese older people are more likely to be frail than those with a normal body mass index (BMI), but the results of individual studies have been inconsistent. We conducted a systematic review and meta-analysis to clarify the association between obesity and the risk of frailty, and whether there was a relationship between BMI and frailty, in community-dwelling older adults aged ≥60 years. Eight databases (PubMed/MEDLINE, EMBASE, EBSCO, CINAHL, Scopus, Cochrane Library and Web of Science) were systematically searched from inception to August 2020. Relative risks for incident frailty were pooled using a random-effects model. We found a positive association between abdominal obesity and frailty [relative risk (RR) = 1.57, 95% confidence interval (CI) 1.29-1.91, I2 = 48.1%, P = 0.086, six observational studies, 18,764 subjects]. People in the higher category of waist circumference had a pooled 57% higher risk of frailty than those with a normal waist circumference. In addition, a total of 12 observational studies comprising 37,985 older people were included in the meta-analysis on the relationship between BMI and the risk for frailty. Taking the normal BMI as the reference group, the pooled RR of frailty risk ranged from 1.45 (95% CI 1.10-1.90, I2 = 83.3%; P < 0.01) for the underweight group, to 0.93 (95% CI 0.85-1.02, I2 = 34.6%; P = 0.114) for the overweight group and to 1.40 (95% CI 1.17-1.67, I2 = 86.1%; P < 0.01) for the obese group. We have shown that obesity or underweight is associated with an increased risk of frailty in community-dwelling older adults.
Topics: Aged; Body Mass Index; Frail Elderly; Frailty; Humans; Independent Living; Obesity; Obesity, Abdominal; Risk Factors
PubMed: 33693472
DOI: 10.1093/ageing/afab039 -
Disability and Rehabilitation Apr 2018This study systematically review and meta-analyse the effectiveness of inspiratory muscle training (IMT) to reduce postoperative pulmonary complications (PPC) and length... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This study systematically review and meta-analyse the effectiveness of inspiratory muscle training (IMT) to reduce postoperative pulmonary complications (PPC) and length of hospital stay (LOS), both in the preoperative and/or postoperative periods of cardiac, pulmonary, and abdominal surgical patients. Sensitive analysis was performed to examine which patients benefit more from IMT according to methodological features (quality of studies and sample size), patient's characteristics (pulmonary risk stratification, age, and body mass index), type of surgery, period of training, and training protocols (training doses and level of supervision).
METHODS
The literature search was made in the electronic databases PubMed®, EBSCO, Web of Science, PEDro and Scopus. Only randomized controlled trials were included. Data extraction, quality assessment and meta-analysis were performed.
RESULTS
We included 17 randomized controlled trials in the systematic review, of which, 12 were included for the PPC meta-analysis and 11 for the LOS meta-analysis. IMT significantly reduced the risk of PPC (Risk Ratio (RR) = 0.50, 95%CI: 0.39, 0.64, I=0.0%), and a decrease in LOS (Mean Difference = -1.41, 95%CI: -2.07, -0.75, I = 0.0%).
CONCLUSION
IMT is effective to reduce PPC and LOS in patients undergoing surgery. Implications for Rehabilitation Physiotherapy interventions with inspiratory muscle training (IMT) are effective to reduce postoperative pulmonary complications (PPC) and length of hospital stay (LOS) after major surgery, and should start preoperatively. Rehabilitation with IMT is beneficial at all ages and risk levels, but older and high-risk patients benefit more, as well as pulmonary surgery patients. IMT is more effective if it is supervised, and prescription target at least two-week period, sessions with more than 15 minutes, with imposed load increment, and adding other exercise modes.
Topics: Abdomen; Breathing Exercises; Humans; Length of Stay; Muscle Strength; Postoperative Care; Postoperative Complications; Preoperative Care; Respiratory Muscles; Thoracic Surgical Procedures
PubMed: 28093920
DOI: 10.1080/09638288.2016.1277396 -
Advances in Nutrition (Bethesda, Md.) Jul 2023To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in... (Meta-Analysis)
Meta-Analysis Review
Mediterranean Diet-Based Interventions to Improve Anthropometric and Obesity Indicators in Children and Adolescents: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.
To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean diet-based interventions on anthropometric variables could facilitate their implementation in efforts to prevent obesity in the young population. The aim of the present meta-analysis was to evaluate the effects of Mediterranean diet-based interventions on anthropometric and obesity indicators among children and adolescents. Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews), including all studies up until 15 March, 2023. Eligible articles were randomized controlled trials measuring the effect of an intervention based on the promotion of the Mediterranean diet and obesity-associated parameters. The effect size of each study was estimated by Cohen's d for continuous variables or risk difference for categorical variables. Compared to the control group, the Mediterranean diet-based interventions showed small and significant reductions in body mass index (d = -0.14; 95% CI: -0.26, -0.01; I = 77.52%). Participants in the Mediterranean diet-based interventions had a significant reduction in the percentage of obesity (risk difference = 0.12; 95% CI: 0.01, 0.23; I = 84.56%) in comparison with the control group. Interventions had greater effects when aiming at participants with excess weight (that is, overweight or obesity), both for body mass index, waist circumference, waist-to-height ratio, percentage of obesity, and percentage of abdominal obesity. Mediterranean diet-based interventions have a significant effect on reducing the body mass index as well as reducing obesity in children and adolescents (aged 3-18 y). This trial was registered at PROSPERO as CRD42023386789.
Topics: Child; Humans; Adolescent; Pediatric Obesity; Diet, Mediterranean; Exercise; Randomized Controlled Trials as Topic; Overweight; Body Mass Index
PubMed: 37127186
DOI: 10.1016/j.advnut.2023.04.011 -
Beneficial Microbes Feb 2021Obesity and overweight are two of the most health challenges with an increasing prevalence in recent years, in which several complications have been identified to have a... (Meta-Analysis)
Meta-Analysis
Obesity and overweight are two of the most health challenges with an increasing prevalence in recent years, in which several complications have been identified to have a high impact in patients' health conditions. In this vein, an increasing interest in the gut microbiota has emerged as a target for therapeutic strategies in obesity and overweight due to its direct relation with the aforementioned health conditions and complications. Thus, the aim of this study was to evaluate the efficacy of probiotics as a therapeutic strategy in the management of obesity and overweight. A systematic review of randomised controlled trials was carried out in 6 databases until May 2019 to assess the use of probiotics in obesity and overweight patients. The Jadad Scale was used to assess the quality of the clinical trials. Twenty-three clinical trials published between 2000 and 2019 met the inclusion criteria. The role of probiotics in reducing body mass index and weight as well as changing the visceral abdominal fat area, waist and hip circumference were shown in 14 of 23 trials (60.87%); 14 trials (60.87%) showed changes on patients' fatty acids and biomarkers; and 4 trials (17.39%) studied the role of the gut microbiota in obese and overweight patients. Some probiotics strains are shown to be effective in reducing body mass index and hip circumference. This review provides evidence of successful results in weight loss using probiotic groups.
Topics: Adolescent; Adult; Aged; Body Weight; Fatty Acids; Female; Gastrointestinal Microbiome; Humans; Male; Middle Aged; Obesity; Overweight; Probiotics; Randomized Controlled Trials as Topic; Weight Loss; Young Adult
PubMed: 33459204
DOI: 10.3920/BM2020.0111