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Changes in bone mineral density in Down syndrome individuals: a systematic review and meta-analysis.Osteoporosis International : a Journal... Jan 2022Data evaluating changes in bone mineral density (BMD) in Down syndrome (DS) individuals remains controversial. Therefore, we conducted a systematic review and... (Meta-Analysis)
Meta-Analysis Review
Data evaluating changes in bone mineral density (BMD) in Down syndrome (DS) individuals remains controversial. Therefore, we conducted a systematic review and meta-analysis to better understand associations between BMD and DS. A systematic literature search of PubMed, EMBASE, Web of Science, and the Cochrane Library up until 1st January 2021 was conducted. We used the keywords "bone mineral density" and "Down Syndrome." Fifteen studies were included. Overall, our results showed a significant decrease in BMD of total body (TB BMD) [MD = - 0.18; 95% CI (- 0.23 and - 0.12), P < 0.00001, I = 89%], total hip (TH BMD) [MD = - 0.12; 95% CI (- 0.15 and - 0.10), P < 0.00001, I = 0%], lumbar spine (LS BMD) [MD = - 0.12; 95% CI (- 0.14 and - 0.09), P < 0.00001, I = 18%], and femoral neck (FN BMD) [MD = - 0.08; 95% CI (- 0.10 and - 0.06), P < 0.00001, I = 0%] in DS individuals when compared with controls. Moreover, the volumetric BMD of lumbar spine (LS vBMD) [MD = - 0.01; 95% CI (- 0.02 and - 0.01), P = 0.0004, I = 19%] also showed a decreasing tendency while the volumetric BMD of the femoral neck (FN vBMD) [MD = 0.01; 95% CI (0.00 and 0.02), P = 0.02, I = 0%] was elevated in DS individuals versus controls. These findings demonstrated that individuals with DS had a decreased total and regional (TH, LS, and FN) BMD when compared with the general population. Additionally, when BMD was adjusted for skeletal volume, LS vBMD was also lower, while FN vBMD was elevated in DS individuals versus controls.
Topics: Absorptiometry, Photon; Bone Density; Down Syndrome; Femur Neck; Humans; Lumbar Vertebrae
PubMed: 34383099
DOI: 10.1007/s00198-021-06070-7 -
The International Journal of Social... Feb 2018The notion that environment affects mental health has a long history; in this systematic review, we aimed to study whether the living environment is related to... (Review)
Review
BACKGROUND AND AIMS
The notion that environment affects mental health has a long history; in this systematic review, we aimed to study whether the living environment is related to depressive mood.
METHODS
We searched databases of PubMed, Scopus and Web of Science for population-based original studies prior to October 2016. We included studies that measured depressive symptoms or depression and had measures of urbanization, population density, aesthetics of living environment, house/built environment, green areas, walkability, noise, air pollution or services.
RESULTS
Out of 1,578 articles found, 44 studies met our inclusion criteria. Manual searches of the references yielded 13 articles, resulting in 57 articles being included in the systematic review. Most of the studies showed statistically significant associations with at least one of the characteristics of living environment and depressive mood. House and built environment with, for example, poor housing quality and non-functioning, lack of green areas, noise and air pollution were more clearly related to depressive mood even after adjustment for different individual characteristics. On the contrary, the results in relation to population density, aesthetics and walkability of living environment, and availability of services and depressive mood were more inconsistent.
CONCLUSION
Adverse house/built environment, including poor housing quality and non-functioning, lack of green spaces, noise and air pollution are related to depressive mood and should be taken into account during planning in order to prevent depressive mood.
Topics: Depression; Environment; Housing; Humans; Mental Health; Residence Characteristics
PubMed: 29212385
DOI: 10.1177/0020764017744582 -
European Heart Journal. Cardiovascular... Dec 2022Considering the inconsistencies in the literature on the atorvastatin effect on blood pressure (BP), we performed these meta-analyses. (Meta-Analysis)
Meta-Analysis
AIMS
Considering the inconsistencies in the literature on the atorvastatin effect on blood pressure (BP), we performed these meta-analyses.
METHODS AND RESULTS
Through a search of the Excerpta Medica Database (EMBASE), PubMed, and Web of Science databases, 1412 articles were identified, from which 33 randomized clinical trials (RCT) and 44 pre-clinical were selected. Populations from RCT were stratified according to baseline BP and lipid levels. We performed meta-analyses of the effect of atorvastatin on systolic (SBP), diastolic and mean BP; heart rate (HR); HR variability, and baroreflex. Atorvastatin reduced SBP in the overall population (P = 0.05 vs. placebo; P = 0.03 vs. baseline), in normotensive and hyperlipidaemic (P = 0.04 vs. placebo; P = 0.0001 vs. baseline) and in hypertensive and hyperlipidaemic (P = 0.02 vs. placebo; P = 0.008 vs. baseline) individuals in parallel RCT, but it did not affect SBP in normotensive and normolipidaemic individuals (P = 0.51 vs. placebo; P = 0.4 vs. baseline). Although an effect of atorvastatin was detected in hyperlipidaemic individuals, the meta-regression coefficient for the association of low density lipoprotein (LDL)-cholesterol reduction with SBP reduction in the overall population demonstrated that SBP reduction is not dependent on the changes in LDL-cholesterol. A meta-analysis of preclinical reports demonstrated that SBP was reduced in atorvastatin-treated hypertensive and normolipidaemic rats (spontaneously hypertensive rats: P < 0.00001), but not in normotensive and normolipidaemic rats (control rats: P = 0.97). Atorvastatin also reduced the HR in spontaneously hypertensive rat.
CONCLUSION
Atorvastatin lowers BP independent of LDL-cholesterol levels. Additional studies are needed to estimate the involvement of the autonomic nervous system in the BP-lowering effect of atorvastatin.
Topics: Humans; Rats; Animals; Atorvastatin; Blood Pressure; Heart Rate; Hypertension; Cholesterol
PubMed: 36138492
DOI: 10.1093/ehjcvp/pvac053 -
Clinica Chimica Acta; International... Apr 2015The association between leptin and bone mineral density (BMD) is controversial because of conflicting findings from previous studies. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The association between leptin and bone mineral density (BMD) is controversial because of conflicting findings from previous studies.
METHODS
This meta-analysis aimed to provide an overview of the serum leptin levels and BMD in a healthy population. We reviewed the PubMed, Embase, and Cochrane Library databases until July 2014 for research on the association between leptin levels and BMD in healthy people.
RESULTS
We included and analyzed 45 studies in this systematic review and meta-analysis. The pooled correlations between leptin and BMD were analyzed by using the method of the inverse of the variance. Leptin was positively associated with BMD and the bone mineral content (BMC), especially in postmenopausal women (pooled r: 0.13-0.49). Overall, high serum leptin levels were associated with higher BMD levels.
CONCLUSIONS
This meta-analysis suggests that serum leptin levels are positively associated with BMD and BMC, especially in postmenopausal women.
Topics: Bone Density; Female; Humans; Leptin; Male
PubMed: 25748037
DOI: 10.1016/j.cca.2015.02.040 -
Endocrine Practice : Official Journal... Sep 2023Age-related declines in muscle and bone, alongside a shift toward greater adiposity, contribute to falls and fracture risk. Testosterone is osteogenic, myogenic, and... (Meta-Analysis)
Meta-Analysis Review
Safety and Efficacy of Testosterone Therapy on Musculoskeletal Health and Clinical Outcomes in Men: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.
OBJECTIVE
Age-related declines in muscle and bone, alongside a shift toward greater adiposity, contribute to falls and fracture risk. Testosterone is osteogenic, myogenic, and catabolic to fat. As such, we examined the effects of testosterone therapy on musculoskeletal health and clinical outcomes in men.
METHODS
Electronic databases (Medline, Embase, Web of Science, Central) were systematically searched for randomized controlled trials (RCTs) reporting on the effects of testosterone therapy versus placebo on any primary outcome (bone density, muscle mass, fat mass, muscle strength/physical performance) or secondary outcome (falls, fractures, disability, adverse events) in men (≥18 years). A random effects meta-regression examined the effects of testosterone on prespecified outcomes.
RESULTS
One thousand seven hundred twenty-eight men across 16 RCTs were included (mean age: 77.1 ± 7.6 years). Baseline mean serum testosterone ranged from 7.5 ± 0.3 to 18.9 ± 1.2 nmol/L. Compared to placebo, 6 months of testosterone therapy increased hip bone density and total lean mass, but effects for handgrip and total fat mass did not reach statistical significance. No significant effects of testosterone therapy on musculoskeletal outcomes were evident at 12 months. The limited number of RCTs reporting on adverse events/clinical outcomes, and the low incidence of these events across RCTs, prohibited statistical comparisons.
CONCLUSION
After 6 months, testosterone effectively increases hip bone density and total lean mass in men, but its effects are unclear for lumbar spine bone density and handgrip strength. Further, RCTs are needed to clarify the safety and efficacy of testosterone on musculoskeletal health and clinical outcomes.
Topics: Male; Humans; Aged; Aged, 80 and over; Testosterone; Bone Density; Fractures, Bone; Bone and Bones; Muscle Strength; Randomized Controlled Trials as Topic
PubMed: 37164187
DOI: 10.1016/j.eprac.2023.04.013 -
International Journal of Environmental... Dec 2022In the United States, a significant amount of the population is affected by hyperlipidemia, which is associated with increased levels of serum low-density lipoprotein... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
In the United States, a significant amount of the population is affected by hyperlipidemia, which is associated with increased levels of serum low-density lipoprotein (LDL-C) and risk of cardiovascular disease. As of 2019, the guidelines set by the American College of Cardiology/American Heart Association advocate for the use of statins as the major contributor to lowering serum LDL-C. While proven to be effective, side effects, including muscle-related symptoms and new-onset diabetes mellitus, can make patients unable to tolerate statin therapy. Additionally, there is a subset of the population which does not approach a recommended LDL-C goal on statin treatment. Due to these findings, it was deemed necessary to review the literature of current statin-alternative lipid-lowering therapies.
METHODS
A systematic review of preclinical and clinical papers, and a current meta-analysis, was performed using PubMed and Google Scholar. Following the literature review, a meta-analysis was conducted using ProMeta 3.
RESULTS
Through systematic review and meta-analysis of the current literature, it is suggested that newer lipid-lowering therapies such as proprotein convertase subtilsin-kixen type 9 (PCSK9) inhibitors are a safe and effective statin alternative for the population with statin intolerance. PCSK9 inhibitors were shown to have no significant effect in causing myalgia in patients and showed no increase in adverse cardiovascular outcomes compared to a control of a current antilipemic medication regimen.
DISCUSSION
There are many statin-alternative therapies that should be investigated further as a potential replacement for patients with statin intolerance or as an addition for patients with statin resistance.
Topics: Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Proprotein Convertase 9; PCSK9 Inhibitors; Cholesterol, LDL; Cardiovascular Diseases; Anticholesteremic Agents
PubMed: 36554779
DOI: 10.3390/ijerph192416899 -
Autoimmunity Reviews Nov 2017Despite the improvement in the quality of life of patients with SLE due to scientific and technological advances, SLE remains a disease that over the years may produce... (Review)
Review
Despite the improvement in the quality of life of patients with SLE due to scientific and technological advances, SLE remains a disease that over the years may produce irreversible damage to patients. Osteoporosis and secondary bone fractures are two of the major causes of irreparable injury in patients with SLE. Vitamin D insufficiency may play a vital role both in reduced bone mineral density (BMD) and in the appearance of fractures, although its mechanisms of action are still unclear. We performed a systematic review of the literature in order to determine the prevalence and predictors of reduced vitamin D plasma levels, bone loss and the presence of fractures in SLE patients. Our review encompassed all English-language publications using Medline and EMBase electronic databases from their inception (1966 and 1980, respectively) to December 2016. We included all intervention studies and observational studies in which vitamin D plasma levels, BMD and bone loss were measured and applied to patients with SLE. Previous studies suggested an increase in bone loss and fracture in patients with SLE compared with general population and although there is a high prevalence of vitamin D insufficiency in the general population, previous studies had demonstrated lower vitamin D levels in patients with SLE compared to age-matched controls. The etiology of reduced bone mass and reduced vitamin D plasma levels in SLE is multifactorial and includes a variety of intrinsic factors related to the disease itself and treatment side effects. SLE patients are at risk for developing these two comorbidities (reduced vitamin D plasma levels and low BMD) and it is therefore essential to study, monitor, prevent and treat bone metabolism disorders in SLE patients.
Topics: Bone Density; Humans; Lupus Erythematosus, Systemic; Osteoporosis; Prognosis; Quality of Life; Vitamin D; Vitamin D Deficiency
PubMed: 28899800
DOI: 10.1016/j.autrev.2017.09.011 -
Frontiers in Endocrinology 2022(1) To establish the prevalence of sleep disorders in women with PCOS. (2) To establish the association between sleep disturbance and cardiovascular risk factors in... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
(1) To establish the prevalence of sleep disorders in women with PCOS. (2) To establish the association between sleep disturbance and cardiovascular risk factors in women with PCOS.
METHODS
The electronic databases PubMed and EMBASE were searched for observational studies of individuals with PCOS published in English from inception to 21 October 2021. The dichotomous outcome measure was presented as odds ratio (OR) and 95% confidence interval (CI). The mean difference (MD) in continuous variables was expressed for each study.
RESULTS
A total of 18 articles were included in this meta-analysis, with a total of 16,152 participants from nine different countries. Women with PCOS had a high prevalence of sleep disturbance (OR = 6.22; 95% CI: 2.77, 13.97; < 0.001), higher PSQI scores (MD = 2.10; 95% CI: 0.29, 3.90; = 0.02), and shorter duration of sleep (MD = -15.65 min; 95% CI: -27.18, -4.13; = 0.008). We found that body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-c), fasting glucose, 2-h glucose, and waist circumference (WC) levels were significantly higher and high-density lipoprotein cholesterol (HDL-c) was significantly lower in PCOS with sleep disturbance than in PCOS without sleep disturbance.
CONCLUSIONS
The current study shows a high prevalence of sleep disturbance in women with PCOS and provides evidence of an association between cardiovascular risk factors and sleep disturbance among this population. Increased attention should be paid to sleep management in clinical guidelines for PCOS.
UNLABELLED
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022298040.
Topics: Cardiovascular Diseases; Cholesterol, HDL; Cholesterol, LDL; Female; Glucose; Heart Disease Risk Factors; Humans; Polycystic Ovary Syndrome; Risk Factors; Sleep Quality; Sleep Wake Disorders
PubMed: 36176474
DOI: 10.3389/fendo.2022.971604 -
Current Diabetes Reviews 2016Canagliflozin is a competitive, reversible, highly selective SGLT2 inhibitor and available in 100mg and 300mg as oral tablet form. Owing to this, it induced glucosuria... (Review)
Review
Canagliflozin is a competitive, reversible, highly selective SGLT2 inhibitor and available in 100mg and 300mg as oral tablet form. Owing to this, it induced glucosuria and cause changes in glucose homeostasis without affecting insulin. This review addressed the efficacy and safety of canagliflozin in a specialized patients such as chronic kidney disease (stage III CKD), high risk cardiovascular patient and elderly population. Canagliflozin has reduced HbA1c in all the specialized population, albeit reduction is less as compared to the normal cohort. Additionally, canagliflozin causes reduction in body weight as well as in blood pressure. It was very well tolerated and did not produce significant adverse events compared to standard care (placebo) except genital mycotic infection due to glucosuria. In cardio vascular safety analysis, canagliflozin might be associated with increased incidence of major adverse cardiovascular plus (MACE plus) events in the initial period, which is of concern in a high- risk cardiovascular cohort. In patients with type 2 diabetes mellitus (T2 DM) and stage III CKD cohort, canagliflozin was well tolerated without much affecting eGFR and should be initiated with 100mg. Canagliflozin showed good safety profile in elderly population with T2DM without significantly affecting overall bone mineral density and bone resorption.
Topics: Aged; Aged, 80 and over; Canagliflozin; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Diabetic Nephropathies; Humans; Hypoglycemic Agents; Renal Insufficiency, Chronic; Risk Factors
PubMed: 26084476
DOI: 10.2174/1573399811666150618143948 -
Journal of Diabetes and Metabolic... Jun 2024The prevalence of osteoporosis increases as the population ages. The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of... (Review)
Review
PURPOSE
The prevalence of osteoporosis increases as the population ages. The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of osteoporosis among the general population ≥ 50 years old in Iran.
METHODS
Multiple databases including Scopus, WOS, Medline, Embase, and Persian databases (SID and Magiran) were systematically searched to identify relevant research papers. All population-based studies estimating the prevalence of osteoporosis in the Iranian population were included and imported into Endnote software. Two authors independently reviewed the articles. The Newcastle-Ottawa Scale was used to assess the risk of bias. Statistical analysis was performed using Stata software, and a significance level of 0.05 was applied to the analyses.
RESULTS
Totally 2117 documents were retrieved from the databases up until October 11, 2022. After reading the full texts, 10 documents were included in the study. Our results indicated that the pooled prevalence of osteoporosis in the femoral neck region was 0.19 (95%CI: 0.12-0.26) and 0.19 (95%CI: 0.13-0.25) for women and men, respectively. Pooled prevalence of spinal osteoporosis was 0.29 (95%CI: 0.21-0.38) among women and 0.16 (95%CI: 0.12-0.19) among men. The total pooled prevalence of osteoporosis was 0.38 (95%CI: 0.29-0.48) for women and 0.25 (95%CI: 0.22-0.29) for men.
CONCLUSION
Our study highlights the elevated prevalence of osteoporosis among individuals aged 50 years and older, with females exhibiting higher rates. Notably, osteoporosis in the femoral neck region demonstrated the lowest prevalence in both sexes. The implementation of comprehensive strategies is imperative to address osteoporosis problems effectively.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-023-01352-9.
PubMed: 38932872
DOI: 10.1007/s40200-023-01352-9