-
International Urology and Nephrology Apr 2016The goal of this systematic review is to evaluate the efficacy and safety of paricalcitol versus active non-selective vitamin D receptor activators (VDRAs) for secondary... (Meta-Analysis)
Meta-Analysis Review
Comparison between paricalcitol and active non-selective vitamin D receptor activator for secondary hyperparathyroidism in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials.
PURPOSE
The goal of this systematic review is to evaluate the efficacy and safety of paricalcitol versus active non-selective vitamin D receptor activators (VDRAs) for secondary hyperparathyroidism (SHPT) management in chronic kidney disease (CKD) patients.
METHODS
PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), clinicaltrials.gov (inception to September 2015), and ASN Web site were searched for relevant studies. A meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs that assessed the effects and adverse events of paricalcitol and active non-selective VDRA in adult CKD patients with SHPT was performed using Review Manager 5.2.
RESULTS
A total of 10 trials involving 734 patients were identified for this review. The quality of included trials was limited, and very few trials reported all-cause mortality or cardiovascular calcification without any differences between two groups. Compared with active non-selective VDRAs, paricalcitol showed no significant difference in both PTH reduction (MD -7.78, 95% CI -28.59-13.03, P = 0.46) and the proportion of patients who achieved the target reduction of PTH (OR 1.27, 95% CI 0.87-1.85, P = 0.22). In addition, no statistical differences were found in terms of serum calcium, episodes of hypercalcemia, serum phosphorus, calcium × phosphorus products, and bone metabolism index.
CONCLUSIONS
Current evidence is insufficient, showing paricalcitol is superior to active non-selective VDRAs in lowering PTH or reducing the burden of mineral loading. Further trials are required to prove the tissue-selective effect of paricalcitol and to overcome the limitation of current research.
Topics: Ergocalciferols; Humans; Hyperparathyroidism, Secondary; Parathyroid Hormone; Randomized Controlled Trials as Topic; Receptors, Calcitriol; Renal Insufficiency, Chronic
PubMed: 26748501
DOI: 10.1007/s11255-015-1195-6 -
Nutrition Reviews Dec 2023There is growing evidence that insufficient dietary intake is associated with sarcopenia.
Energy and nutrient intake by people with and without sarcopenia diagnosed by the European Working Group on Sarcopenia in Older People: a systematic review and meta-analysis.
CONTEXT
There is growing evidence that insufficient dietary intake is associated with sarcopenia.
OBJECTIVE
In this systematic review and meta-analysis, the energy and nutrient intakes by people with and without sarcopenia were compared using only the European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) consensus diagnostic criteria.
DATA SOURCES
Only observational studies that compared energy and nutrient intake from food alone by individuals with and without sarcopenia were included. Studies were searched in the following databases: Embase, PubMed, Scopus, Web of Science, Lilacs, Ovid, and Scopus. The review followed the PRISMA checklist and submitted the protocol to PROSPERO.
DATA EXTRACTION
Data were extracted by 2 authors independently. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale.
DATA ANALYSIS
A total of 8648 articles were identified and 12 were selected. Among individuals with sarcopenia, lower intakes of energy and some nutrients, mainly with antioxidant properties, were observed compared with those without sarcopenia. Meta-analyses showed that individuals with sarcopenia consume fewer calories/day than individuals without sarcopenia (n = 10 studies; standardized mean difference (SMD) -0.15; 95% confidence interval: -0.29, -0.01) diagnosed by EWGSOP1 and EWGSOP2. Individuals with sarcopenia consume less omega-3, folate, magnesium, phosphorus, selenium, zinc, and vitamins C, D, and E when compared with those without sarcopenia.
CONCLUSION
The results of the present study suggest that insufficient intake of energy and nutrients with antioxidant potential may be associated with sarcopenia.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD 42020195698.
PubMed: 38114090
DOI: 10.1093/nutrit/nuad154 -
Journal of Diabetes Research 2022Chronic kidney disease (CKD) is a main health problem associated with increased risk of cardiovascular disease, morbidity, and mortality. Recent studies shown that the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic kidney disease (CKD) is a main health problem associated with increased risk of cardiovascular disease, morbidity, and mortality. Recent studies shown that the progression of CKD may be related to the change of intestinal flora. Resistant starch (RS) is a type of dietary fiber that can act as a substrate for microbial fermentation. Some studies have found that the supplementation of RS can improve the intestinal flora disorder in CKD patients. However, the specific effect of RS on CKD patients remains controversial.
OBJECTIVE
We designed this meta-analysis to identify and assess the effects of RS on patients with CKD.
METHODS
A comprehensive search of MEDLINE, Embase, Web of Science, and Cochrane systematic review databases was conducted in January 2020, and all new trials were updated in August 2021. Randomized trials were collected to assess the effects of RS on patients with CKD. The weighted average effect size of the net change was calculated by using the random-effects model.
RESULTS
The meta-analysis included 8 studies involving 301 participants. RS intake significantly reduced serum indolephenol sulfate (IS), blood phosphorus, IL-6, and uric acid levels in dialysis patients. The mean difference (MD) of serum IS ( = 0.0002) in the dialysis subgroup was -12.57 mol/L (95% CI: -19.28, -5.86 mol/L). The MD of blood phosphorus ( = 0.03) was -0.39 mg/dl (95% CI: -0.78, -0.01 mg/dl). The MD of serum uric acid ( = 0.004) between the dialysis subgroup and the nondialysis subgroup was -31.58 mmol/L (95% CI: -52.99, -10.17 mmol/L). The mean difference (MD) of IL-6 ( = 0.02) in the dialysis subgroup was -1.16 mol/L (95% CI: -2.16, -0.16 mol/L). However, there was no significant change of RS on hs-CRP, serum creatinine, blood urea nitrogen (BUN), blood paracresol sulfate, and blood lipid.
CONCLUSIONS
The intake of RS reduced the serum IS, serum phosphorus, IL-6, and uric acid levels significantly in dialysis patients, while hs-CRP, serum creatinine, BUN, serum paracresol sulfate, and blood lipid showed no significant changes.
Topics: C-Reactive Protein; Creatinine; Humans; Interleukin-6; Phosphorus; Renal Insufficiency, Chronic; Resistant Starch; Sulfates; Uric Acid
PubMed: 35899018
DOI: 10.1155/2022/1861009 -
Frontiers in Medicine 2022Baduanjin (BDJ) exercise is a traditional exercise that combines breathing, body movement, meditation and awareness to help delay the onset and progression of senile...
PURPOSE
Baduanjin (BDJ) exercise is a traditional exercise that combines breathing, body movement, meditation and awareness to help delay the onset and progression of senile degenerative musculoskeletal diseases, such as osteoporosis (OP). The aim of this meta-analysis is to evaluate the efficacy of BDJ exercise, and preliminarily infer its effective mechanism in the treatment of OP.
METHODS
We identified relevant randomized controlled trials (RCTs) through eight databases, and compared BDJ exercise with the control groups (including blank control and conventional treatment intervention). The main outcome measure was bone mineral density (BMD), the additional outcome measures were visual analogue scale (VAS), Berg balance scale (BBS), serum Calcium (Ca), serum Phosphorus (P), serum Alkaline phosphatase (ALP), and serum bone gla protein (BGP). Meta-analysis and trial sequence analysis (TSA) were performed using RevMan 5.4, Stata 16.0, and TSA 0.9.
RESULTS
In total, 13 RCTs involving 919 patients were included in the analysis. For postmenopausal osteoporosis, BDJ exercise alone and BDJ exercise combined with conventional treatment can improve the BMD of lumbar spine. BDJ exercise alone can influence serum Ca and ALP. BDJ exercise combined with conventional treatment can improve balance (BBS) and influence serum BGP. For senile osteoporosis, BDJ exercise alone and BDJ exercise combined with conventional treatment can improve balance (BBS). BDJ exercise combined with conventional treatment can improve the BMD of hip and pain relieve (VAS). For primary osteoporosis, BDJ exercise combined with conventional treatment can improve the BMD of lumbar spine and femoral neck.
CONCLUSION
Baduanjin exercise may be beneficial to improve BMD, relieve pain, improve balance ability, influence serum BGP and serum ALP in patients with OP, but differences occur due to various types of OP. Due to the low quality of research on the efficacy and mechanism of BDJ exercise in the treatment of OP, high-quality evidence-based research is still needed to provide reliable supporting evidence.
SYSTEMATIC REVIEW REGISTRATION
[http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022329022].
PubMed: 35991646
DOI: 10.3389/fmed.2022.935961 -
Ecology May 2023Mycorrhizal response is the most common metric for characterizing how much benefit a plant derives from mycorrhizal symbiosis. Traditionally, ecologists have used these...
Mycorrhizal response is the most common metric for characterizing how much benefit a plant derives from mycorrhizal symbiosis. Traditionally, ecologists have used these metrics to generalize benefit from mycorrhizal symbiosis in plant species, ignoring the potential for plant intraspecific trait variation to alter the outcome of the mutualism. In order for mean trait values to be useful as a functional trait to describe a species, as has been attempted for mycorrhizal response traits, interspecific variation must be much larger than intraspecific variation. While the variation among species has been extensively studied with respect to mycorrhizal response traits, variation within species has rarely been examined. We conducted a systematic review and analyzed how much variation for mycorrhizal growth and nutrient response typically exists within a plant species. We assessed 28 publications that included 60 individual studies testing mycorrhizal response in at least five genotypes of a plant species, and we found that intraspecific trait variation for mycorrhizal response was generally very large and highly variable depending on study design. The difference between the highest and lowest growth response in a study ranged from 10% to 350% across studies, and 36 of the studies included species for which both positive and negative growth responses to mycorrhizae were observed across different genotypes. The intraspecific variation for mycorrhizal growth response in some of these studies was larger than the variation documented among species across the plant kingdom. Phosphorus concentration and content was measured in 17 studies and variation in phosphorus response was similar to variation in growth responses. We also found that plant genotype was just as important for predicting mycorrhizal response as the effects of fungal inoculant identity. Our analysis highlights not only the potential importance of intraspecific trait variation for mycorrhizal response, but also the lack of research that has been done on the scale of this variation in plant species. Including intraspecific variation into research on the interactions between plants and their symbionts can increase our understanding of plant coexistence and ecological stability.
Topics: Mycorrhizae; Symbiosis; Genotype; Phenotype; Phosphorus; Plant Roots
PubMed: 36882945
DOI: 10.1002/ecy.4015 -
Journal of Environmental Management May 2019Water quality is declining worldwide and an increasing number of waterbodies lose their ecological function due to human population growth and climate change.... (Review)
Review
Water quality is declining worldwide and an increasing number of waterbodies lose their ecological function due to human population growth and climate change. Constructed floating wetlands (CFWs) are a promising ecological engineering tool for restoring waterbodies. The functionality of CFWs has been studied in-situ, in mesocosms and in the laboratory, but a systematic review of the success of in situ applications to improve ecosystem health is missing to date. This review summarises the pollutant dynamics in the presence of CFWs and quantifies removal efficiencies for major pollutants with a focus on in situ applications, including studies that have only been published in the Chinese scientific literature. We find that well designed CFWs successfully decrease pollutant concentrations and improve the health of the ecosystem, shown by lower algae biomass and more diverse fish, algae and invertebrate communities. However, simply extrapolating pollutant removal efficiencies from small-scale experiments will lead to overestimating the removal capacity of nitrogen, phosphorus and organic matter of in situ applications. We show that predicted climate change and eutrophication scenarios will likely increase the efficiency rate of CFWs, mainly due to increased growth and pollutant uptake rates at higher temperatures. However, an increase in rainfall intensity could lead to a lower efficiency of CFWs due to shorter hydraulic retention times and more pollutants being present in the particulate, not the dissolved form. Finally, we develop a framework that will assist water resource managers to design CFWs for specific management purposes. Our review clearly highlights the need of more detailed in situ studies, particularly in terms of understanding the short- and long-term ecosystem response to CFWs under different climate change scenarios.
Topics: Animals; Ecosystem; Eutrophication; Humans; Nitrogen; Phosphorus; Wetlands
PubMed: 30877941
DOI: 10.1016/j.jenvman.2019.02.064 -
Journal of Nanobiotechnology Dec 2022Critical-sized bone defects are always difficult to treat, and they are associated with a significant burden of disease in clinical practice. In recent decades, due to... (Meta-Analysis)
Meta-Analysis Review
Critical-sized bone defects are always difficult to treat, and they are associated with a significant burden of disease in clinical practice. In recent decades, due to the fast development of biomaterials and tissue engineering, many bioinspired materials have been developed to treat large bone defects. Due to the excellent osteoblastic ability of black phosphorous (BP), many BP-based biomaterials have been developed to treat bone defects. Therefore, there are abundant studies as well as a tremendous amount of research data. It is urgent to conduct evidence-based research to translate these research data and results into validated scientific evidence. Therefore, in our present study, a qualitative systematic review and a quantitative meta-analysis were performed. Eighteen studies were included in a systematic review, while twelve studies were included in the meta-analysis. Our results showed that the overall quality of experimental methods and reports of biomaterials studies was still low, which needs to be improved in future studies. Besides, we also proved the excellent osteoblastic ability of BP-based biomaterials. But we did not find a significant effect of near-infrared (NIR) laser in BP-based biomaterials for treating bone defects. However, the quality of the evidence presented by included studies was very low. Therefore, to accelerate the clinical translation of BP-based biomaterials, it is urgent to improve the quality of the study method and reporting in future animal studies. More evidence-based studies should be conducted to enhance the quality and clinical translation of BP-based biomaterials.
Topics: Animals; Biocompatible Materials; Phosphorus; Bone Regeneration; Tissue Engineering
PubMed: 36496422
DOI: 10.1186/s12951-022-01735-9 -
American Journal of Kidney Diseases :... Dec 2015Serum parathyroid hormone (PTH), phosphorus, and calcium levels are surrogate outcomes that are central to the evaluation of drug treatments in chronic kidney disease... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Serum parathyroid hormone (PTH), phosphorus, and calcium levels are surrogate outcomes that are central to the evaluation of drug treatments in chronic kidney disease (CKD). This systematic review evaluates the evidence for the correlation between drug effects on biochemical (PTH, phosphorus, and calcium) and all-cause and cardiovascular mortality end points in adults with CKD.
STUDY DESIGN
Systematic review and meta-analysis.
SETTING & POPULATION
Adults with CKD.
SELECTION CRITERIA FOR STUDIES
Randomized trials reporting drug effects on biochemical and mortality end points.
INTERVENTION
Drug interventions with effects on serum PTH, phosphorus, and calcium levels, including vitamin D compounds, phosphate binders, cinacalcet, bisphosphonates, and calcitonin.
OUTCOMES
Correlation between drug effects on biochemical and all-cause and cardiovascular mortality.
RESULTS
28 studies (6,999 participants) reported both biochemical and mortality outcomes and were eligible for analysis. Associations between drug effects on surrogate biochemical end points and corresponding effects on mortality were weak and imprecise. All correlation coefficients were less than 0.70, and 95% credible intervals were generally wide and overlapped with zero, consistent with the possibility of no association. The exception was an inverse correlation between drug effects on serum PTH levels and all-cause mortality, which was nominally significant (-0.64; 95% credible interval, -0.85 to -0.15), but the strength of this association was very imprecise. Risk of bias within available trials was generally high, further reducing confidence in the summary correlations. Findings were robust to adjustment for age, baseline serum PTH level, allocation concealment, CKD stage, and drug class.
LIMITATIONS
Low power in analyses and combining evidence from many different drug comparisons with incomplete data across studies.
CONCLUSIONS
Drug effects on serum PTH, phosphorus, and calcium levels are weakly and imprecisely correlated with all-cause and cardiovascular death in the setting of CKD. Risks of mortality (patient-level outcome) cannot be inferred from treatment-induced changes in biochemical outcomes in people with CKD. Similarly, existing data do not exclude a mortality benefit with treatment. Trials need to address patient-centered outcomes to evaluate drug effectiveness in this setting.
Topics: Biomarkers; Calcium; Humans; Mortality; Parathyroid Hormone; Phosphorus; Renal Agents; Renal Insufficiency, Chronic; Treatment Outcome
PubMed: 26003472
DOI: 10.1053/j.ajkd.2015.03.036 -
Clinical Nephrology Jan 2022This paper was written to systematically review and meta-analyze the evidence on the efficacy of lanthanum carbonate (LC) and calcium carbonate (CC) and the risk of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This paper was written to systematically review and meta-analyze the evidence on the efficacy of lanthanum carbonate (LC) and calcium carbonate (CC) and the risk of cardiovascular calcification on hemodialysis (HD) patients.
MATERIALS AND METHODS
The Cochrane library, PubMed, Web of Science, Chinese journal full-text database (CNKI), WANGFANG DATA, and Sino Med were searched between January 1946 and December 2020. The literature with respect to the randomized controlled clinical trial comparing LC and CC in HD patients was selected. The main outcomes include coronary artery calcification score (CACS), cardiovascular events, and serum phosphorus (mmol/L). The statistical program used for meta-analysis was Stata V14.0.
RESULTS
Of 388 original titles screened, data was extracted from 9 studies (625 participants). LC can significantly reduce the progression of coronary artery calcification compared to CC (standardized mean deviation (SMD) = -0.59, 95% CI: -0.94 to -0.25, p < 0.01). The LC group had lower serum phosphorus levels (SMD = -1.35, 95% CI: -2.33 to -0.36, p < 0.01), lower serum calcium levels (SMD = -1.03, 95% CI: -1.83 to -0.23, p = 0.012), and lower fibroblast growth factor 23 (FGF-23) level (SMD = -4.80, 95% CI: -7.96 to -1.64, p = 0.003) than the CC group. The Egger regression test of CACS showed no potential publication bias (p = 0.72).
CONCLUSION
Compared with CC, LC can significantly delay the process of coronary artery calcification, and at the same time reduce patients' serum phosphate, serum calcium, and FGF-23. Therefore, we recommend LC as a phosphorus-lowering drug for HD patients.
Topics: Calcium; Calcium Carbonate; Chelating Agents; Fibroblast Growth Factor-23; Humans; Lanthanum; Phosphorus; Randomized Controlled Trials as Topic; Renal Dialysis
PubMed: 34448696
DOI: 10.5414/CN110522 -
International Journal of Hyperthermia :... 2021Microwave ablation (MWA) is used for the treatment of severe secondary hyperparathyroidism (SHPT), but its efficacy and safety still remained unclear. This study aimed... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Microwave ablation (MWA) is used for the treatment of severe secondary hyperparathyroidism (SHPT), but its efficacy and safety still remained unclear. This study aimed to investigate the efficacy and safety of ultrasound (US)-guided MWA in patients with SHPT.
METHODS
The PubMed, Cochrane library, Embase, China national knowledge infrastructure (CNKI) and Wanfang databases were searched to identify published studies that evaluated the efficacy and safety of US-guided MWA in patients with SHPT. The primary outcomes were parathyroid hormone (PTH), serum calcium and phosphorus levels.
RESULTS
A total of 26 studies with 932 patients were identified. The PTH levels showed significant reduction at 1 month [weighted mean difference (WMD) = 945.33, 95% CI: 797.15∼1093.52] and 6 months (WMD = 1,151.91, 95% CI: 990.93∼1312.89) after MWA of SHPT patients. The serum calcium (WMD = 0.39, 95% CI: 0.30 ∼ 0.48) and phosphorus levels (WMD = 0.64, 95% CI: 0.43 ∼ 0.85) showed significant reduction at 6 months after MWA of SHPT patients. The most common complications observed were hypocalcemia (35.2%) and transient hoarseness (9.2%). No other major complications or death occurred in our study patients.
CONCLUSION
These findings suggest MWA as a safe and effective minimally invasive technique for the management of SHPT. PTH, calcium, and phosphorus levels were significantly reduced at 1 and 6 months after MWA.
Topics: Ablation Techniques; Humans; Hyperparathyroidism, Secondary; Microwaves; Parathyroid Hormone; Ultrasonography, Interventional
PubMed: 34428994
DOI: 10.1080/02656736.2021.1965664