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Frontiers in Public Health 2023Existing evidence indicates that exposure to per- and polyfluoroalkyl substances (PFASs) may increase the risk of hypertension, but the findings are inconsistent.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Existing evidence indicates that exposure to per- and polyfluoroalkyl substances (PFASs) may increase the risk of hypertension, but the findings are inconsistent. Therefore, we aimed to explore the relationship between PFASs and hypertension through this systematic review and meta-analysis.
METHODS
We searched PubMed, Embase, and the Web of Science databases for articles published in English that examined the relationship between PFASs and hypertension before 13 August 2022. The random effects model was used to aggregate the evaluation using Stata 15.0 for Windows. We also conducted subgroup analyses by region and hypertension definition. In addition, a sensitivity analysis was carried out to determine the robustness of the findings.
RESULTS
The meta-analysis comprised 15 studies in total with 69,949 individuals. The risk of hypertension was substantially and positively correlated with exposure to perfluorooctane sulfonate (PFOS) (OR = 1.31, 95% CI: 1.14, 1.51), perfluorooctanoic acid (PFOA) (OR = 1.16, 95% CI: 1.07, 1.26), and perfluorohexane sulfonate (PFHxS) (OR = 1.04, 95% CI: 1.00, 1.09). However, perfluorononanoic acid (PFNA) exposure and hypertension were not significantly associated (OR = 1.08, 95% CI: 0.99, 1.17).
CONCLUSION
We evaluated the link between PFASs exposure and hypertension and discovered that higher levels of PFOS, PFOA, and PFHxS were correlated with an increased risk of hypertension. However, further high-quality population-based and pathophysiological investigations are required to shed light on the possible mechanism and demonstrate causation because of the considerable variability.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/ PROSPERO, registration number: CRD 42022358142.
Topics: Humans; Alkanesulfonates; Fluorocarbons; Hypertension
PubMed: 37655293
DOI: 10.3389/fpubh.2023.1173101 -
Complementary Therapies in Medicine Mar 2024Curcumin has antioxidant properties and has been proposed as a potential treatment for NAFLD. The aim of current systematic review and meta-analysis was to evaluate... (Meta-Analysis)
Meta-Analysis
Curcumin effects on glycaemic indices, lipid profile, blood pressure, inflammatory markers and anthropometric measurements of non-alcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials.
OBJECTIVES
Curcumin has antioxidant properties and has been proposed as a potential treatment for NAFLD. The aim of current systematic review and meta-analysis was to evaluate previous findings for the effect of curcumin supplementation on glycaemic indices, lipid profile, blood pressure, inflammatory markers, and anthropometric measurements of NAFLD patients.
METHODS
Relevant studies published up to January 2024 were searched systematically using the following databases: PubMed, SCOPUS, WOS, Science Direct, Ovid and Cochrane. The systematic review and meta-analysis were conducted according to the 2020 PRISMA guidelines. The quality of the papers was assessed the using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Pooled effect sizes were calculated using a random-effects model and reported as the WMD and 95% CI. Also, subgroup analyses were done to find probable sources of heterogeneity among studies.
RESULTS
Out of 21010 records initially identified, 21 eligible RCTs were selected for inclusion in a meta-analysis. Overall, 1191 participants of both genders, 600 in the intervention and 591 in the control group with NAFLD were included. There are several limitations in the studies that were included, for instance, the results are weakened substantially by potential bias or failure to account for potential adulteration (with pharmaceuticals) or contamination (with other herbs) of the curcumin supplements that were tested. However, previous studies have reported curcumin to be a safe complementary therapy for several conditions. Our study indicated that curcumin supplementation in doses of 50-3000 mg/day was associated with significant change in FBG [WMD: -2.83; 95% CI: -4.61, -1.06), I = 51.3%], HOMA-IR [WMD: -0.52; 95% CI: -0.84, -0.20), I= 82.8%], TG [WMD: -10.31; 95% CI: -20.00, -0.61), I = 84.5%], TC [WMD: -11.81; 95% CI: -19.65, -3.96), I = 94.6%], LDL [WMD: -8.01; 95% CI: -15.79, -0.24), I = 96.1%], weight [WMD: -0.81; 95% CI: -1.28, -0.35), I= 0.0%] and BMI [WMD: -0.35; 95% CI: -0.57, -0.13), I= 0.0%] in adults with NAFLD. There was no significant change in HbA1C, plasma insulin, QUICKI, HDL, SBP, DBP, CRP, TNF-α and WC after curcumin therapy. Subgroup analysis suggested a significant changes in serum FBG, TG, SBP, WC in RCTs for intervention durations of ≥ 8 weeks, and SBP, TG, LDL, HDL, BMI, WC in RCTs with sample size > 55 participants.
CONCLUSION
Curcumin supplementation in doses of 50-3000 mg/day over 8-12 weeks was associated with significant reductions in levels of FBG, HOMA-IR, TG, TC, LDL, weight and BMI in patients with NAFLD. Previous studies have reported curcumin as a safe complementary therapy for several diseases. We would suggest that should curcumin supplements be used clinically in specific conditions, it should be used with caution. Also, difference in grades of NAFLD may effect the evaluated outcomes, so it is suggested that future studies be conducted with an analyses on subgroups according to their NAFLD grade. Furthermore, because of the failure to conduct independent biochemical assessment of the turmeric/curcumin product used in most studies as well as potential sources of bias, results should be interpreted with caution.
Topics: Adult; Female; Humans; Male; Blood Pressure; Curcumin; Dietary Supplements; Glycemic Index; Lipids; Non-alcoholic Fatty Liver Disease; Randomized Controlled Trials as Topic
PubMed: 38232906
DOI: 10.1016/j.ctim.2024.103025 -
Environmental Science and Pollution... Aug 20232,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and per- and polyfluoroalkyl substances (PFAS) are endocrine disrupting chemicals that may cause breast cancer. However, there... (Meta-Analysis)
Meta-Analysis Review
2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and per- and polyfluoroalkyl substances (PFAS) are endocrine disrupting chemicals that may cause breast cancer. However, there lacks consistent research on the association between TCDD, PFAS exposure, and breast cancer. To this end, a meta-analysis was carried out in this review to explore the relationship between these two endocrine disruptors and breast cancer. Relevant literature was searched from 5 databases: Medline, Scopus, Embase, PubMed, and Web of Science. Odds ratios (OR) with 95% confidence intervals (CIs) were pooled by fixed-effects and random-effects meta-analysis models. A total of 17 publications were finally included for quantitative evaluation. Meta-analysis showed that TCDD (OR = 1.00, 95% CI = 0.89-1.12, I = 39.3%, P = 0.144), PFOA (OR = 1.07, 95% CI = 0.84-1.38, I = 85.9%, P < 0.001), PFOS (OR = 1.01, 95% CI = 0.95-1.08, I = 65.7%, P < 0.001), PFNA (OR = 0.89, 95% CI = 0.67-1.19, I = 74.4%, P < 0.001), and PFHxS (OR = 0.90, 95% CI = 0.72-1.13, I = 74%, P < 0.001) were not significantly correlated with breast cancer. Internal exposure, however, showed a significant positive correlation between TCDD and BC (OR = 2.85, 95% CI = 1.23-6.59, I = 0.0%, P = 0.882). No statistically significant association between TCDD, PFAS exposure, and breast cancer was observed in this meta-analysis.
Topics: Humans; Female; Breast Neoplasms; Polychlorinated Dibenzodioxins; Fluorocarbons; Endocrine Disruptors; Odds Ratio; Environmental Pollutants; Alkanesulfonic Acids
PubMed: 37420152
DOI: 10.1007/s11356-023-28592-9 -
Phytotherapy Research : PTR Jun 2024Osteoarthritis (OA) is one of the most prevalent degenerative joint diseases. Several meta-analyses have shown that curcumin could improve the function of the knee and... (Meta-Analysis)
Meta-Analysis Review
Osteoarthritis (OA) is one of the most prevalent degenerative joint diseases. Several meta-analyses have shown that curcumin could improve the function of the knee and alleviate pain in OA, while some meta-analyses demonstrate controversial results. Hence, we assessed curcumin's effects on knee OA in an umbrella meta-analysis. PubMed, Scopus, Embase, and Web of Science databases were employed to find English-language meta-analyses of randomized controlled trials investigating the effect of curcumin supplementation on OA outcomes up to September 2023. The visual analog scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, function, and stiffness scales were analyzed. Effect sizes and 95% confidence intervals were utilized to obtain the overall effect size. A random-effects model was applied to perform the meta-analysis. Heterogeneity was determined by I statistics and the Cochrane Q-test. The pooled effect of the 11 included meta-analyses showed that curcumin could significantly decrease the VAS score (weighted mean difference [WMD] and standardized mean difference [SMD]), WOMAC-total (SMD and WMD), WOMAC-Function (SMD and WMD), WOMAC-Pain (SMD), and WOMAC-Stiffness scores (SMD) (p ≤ 0.001, ≤0.001, ≤0.001, 0.007, ≤0.001, 0.002, ≤0.001, ≤0.001, respectively). The results strongly support curcuminoid supplementation in relieving pain, improving joint mobility and stiffness, and shortening medication usage of OA patients.
Topics: Curcumin; Humans; Osteoarthritis, Knee; Randomized Controlled Trials as Topic; Pain Measurement; Osteoarthritis
PubMed: 38576215
DOI: 10.1002/ptr.8153 -
Toxicological Sciences : An Official... Jul 2023Per- and polyfluoroalkyl substances (PFAS) are a class of man-made chemicals that are persistent in the environment. They can be transferred across the placenta to...
Per- and polyfluoroalkyl substances (PFAS) are a class of man-made chemicals that are persistent in the environment. They can be transferred across the placenta to fetuses and through human milk to infants. The American Academy of Pediatrics advises that the benefits of breastfeeding infants almost always outweigh the potential risks of harm from environmental chemicals. However, there are few chemical-specific summaries of the potential harms of exposure to PFAS during the neonatal period through breastfeeding. This systematic review explores whether exposure to PFAS through breastfeeding is associated with adverse health outcomes among infants and children using evidence from human and animal studies. Systematic searches identified 4297 unique records from 7 databases. The review included 37 total articles, including 9 animal studies and 1 human study measuring the direct contribution of exposure of the infant or pup through milk for any health outcome. Animal studies provided evidence of associations between exposure to PFOA through breastfeeding and reduced early life body weight gain, mammary gland development, and thyroid hormone levels. They also provided limited evidence of associations between PFOS exposure through breastfeeding with reduced early life body weight gain and cellular changes in the hippocampus. The direct relevance of any of these outcomes to human health is uncertain, and it is possible that many adverse health effects of exposure through breastfeeding have not yet been studied. This review documents the current state of science and highlights the need for future research to guide clinicians making recommendations on infant feeding.
Topics: Infant; Infant, Newborn; Pregnancy; Female; Animals; Humans; Child; Breast Feeding; Public Health; Milk, Human; Weight Gain; Fluorocarbons; Alkanesulfonic Acids; Environmental Pollutants
PubMed: 37228093
DOI: 10.1093/toxsci/kfad053 -
International Heart Journal Nov 2023Perfluoroalkyl and polyfluoroalkyl substance (PFAS) is a large group of fluorinated synthetic chemicals, e.g., perfluorooctanoic acid (PFOA), perfluorooctanesulfonic... (Meta-Analysis)
Meta-Analysis
Perfluoroalkyl and polyfluoroalkyl substance (PFAS) is a large group of fluorinated synthetic chemicals, e.g., perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorodecanoic acid (PFDA), and perfluorononanoic acid (PFNA). Many epidemiological studies have found that PFAS exposure is associated with hypertension risk, but others possess a different opinion. Overall, the relationship between PFASs and hypertension risk remains controversial. We sought to conduct a systematic review and meta-analysis to clarify the association between PFAS exposure and human risk of hypertension.We conducted a meta-analysis based on population-involving studies published from 1975 to 2023, which we collected from Web of Science, PubMed, and Embase databases. The odds ratio (OR) and standardized mean difference (SMD), with their 95% confidence interval (CI), were used to assess the risk of hypertension with PFAS exposure. The statistical heterogeneity among studies was assessed with the Q-test and I statistics. Research publications related to our meta-analysis topic were systematically reviewed.Fourteen studies involving 71,663 participants, in which 26,281 suffered hypertension, met the inclusion criteria. Our analyses suggest that exposure to general PFAS (OR = 1.09, 95% CI = 1.04-1.14) or PFOS (OR = 1.17, 95% CI = 1.05-1.30) is associated with hypertension risk. Specifically, elevated levels of general PFAS (SMD = 0.25, 95% CI = 0.08-0.42), PFHxS (SMD = 0.17, 95% CI = 0.07-0.27), and PFDA (SMD = 0.08, 95% CI = 0.02-0.13) are associated with a high risk of hypertension.Our meta-analysis indicates that PFAS exposure is a risk factor for hypertension, and increased hypertension risk is associated with higher PFAS levels. Further study may eventually provide a better and more comprehensive elucidation of the potential mechanism of this association.
Topics: Humans; Environmental Pollutants; Alkanesulfonic Acids; Fluorocarbons
PubMed: 37967990
DOI: 10.1536/ihj.23-036 -
Nutrition and Health Mar 2024Curcumin is a polyphenol derived from the L (turmeric) plant and has gained attention through its perceived anti-inflammatory characteristics. The potential... (Meta-Analysis)
Meta-Analysis Review
Curcumin is a polyphenol derived from the L (turmeric) plant and has gained attention through its perceived anti-inflammatory characteristics. The potential interaction with exercise-induced muscle damage (EIMD) and delayed onset muscle soreness (DOMS) has led to investigation of curcumin as a post-exercise strategy that may have the potential to lessen acute reductions in functional strength (FS) following physical activity. The purpose of this review is to assess the evidence examining curcumin in relation to four outcome measures: FS, EIMD, DOMS and inflammation. A Medline, SPORTDiscus and CINAHL database search was undertaken with no publication date limit. Sixteen papers met the inclusion criteria and were included in this review. Three meta-analyses were completed for EIMD, DOMS and inflammation, respectively, with FS being excluded due to limited research. Effect sizes were as follows: EIMD (0.15, -0.12, -0.04, -0.2 and -0.61 corresponding to 0, 24, 48, 72 and 96 h post-exercise, respectively), DOMS (-0.64, -0.33, 0.06, -0.53 and -1.16 corresponding to 0, 24, 48, 72 and 96 h post-exercise, respectively) and inflammation (-0.10, 0.26, 0.15 and 0.26 corresponding to 0, 24, 48 and 72 h post-exercise, respectively). A 96 h post-exercise inflammation meta-analysis was not conducted due to limited data. No effect sizes were statistically significant for EIMD ( = 0.644, 0.739, 0.893, 0.601 and 0.134), DOMS ( = 0.054, 0.092, 0.908, 0.119 and 0.074) and inflammation ( = 0.729, 0.603, 0.611 and 0.396). Further research is needed to thoroughly examine whether an effect exists.
Topics: Humans; Curcumin; Dietary Supplements; Myalgia; Inflammation; Muscles; Muscle, Skeletal
PubMed: 37408367
DOI: 10.1177/02601060231186439 -
Hepatology (Baltimore, Md.) Feb 2024The role of medications for alcohol use disorder (MAUD) in patients with cirrhosis is not well established. Evidence on the efficacy and safety of these drugs in these... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIMS
The role of medications for alcohol use disorder (MAUD) in patients with cirrhosis is not well established. Evidence on the efficacy and safety of these drugs in these patients is scarce.
APPROACH AND RESULTS
We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines on the efficacy of MAUD in patients with cirrhosis. A search was conducted in PubMed, Embase, and Scopus, including all studies until May 2022. The population was defined as patients with AUD and cirrhosis. The primary outcome was alcohol abstinence. Safety was a secondary outcome. We performed a random-effect analysis and expressed the results as relative risk of alcohol consumption. Heterogeneity was measured by I2 . Out of 4095 unique references, 8 studies on 4 different AUD treatments [baclofen (n = 6), metadoxine (n = 1), acamprosate (n = 1), and fecal microbiota transplant (n = 1)] in a total of 794 patients were included. Four were cohort studies, and 4 were RCTs. Only RCTs were included in the meta-analysis. MAUD was associated with a reduced rate of alcohol consumption [relative risk = 0.68 (CI: 0.48-0.97), P = 0.03], increasing alcohol abstinence by 32% compared to placebo or standard treatment, despite high heterogeneity ( I2 = 67%). Regarding safety, out of 165 serious adverse events in patients treated with MAUD, only 5 (3%) were possibly or probably related to study medications.
CONCLUSION
MAUD in patients with cirrhosis is effective in promoting alcohol abstinence and has a good safety profile. Larger studies on the effects of MAUD are needed, especially in patients with advanced liver disease.
Topics: Humans; Alcoholism; Alcohol Drinking; Acamprosate; Liver Cirrhosis, Alcoholic; Liver Cirrhosis
PubMed: 37625154
DOI: 10.1097/HEP.0000000000000570 -
Urologia Feb 2024The major barriers to phytonutrients in prostate cancer therapy are non-specific mechanisms and bioavailability issues. Studies have pointed to a synergistic combination... (Review)
Review
The major barriers to phytonutrients in prostate cancer therapy are non-specific mechanisms and bioavailability issues. Studies have pointed to a synergistic combination of curcumin (CURC) and ursolic acid (UA). We investigate this combination using a systematic review process to assess the most likely mechanistic pathway and human testing in prostate cancer. We used the PRISMA statement to screen titles, abstracts, and the full texts of relevant articles and performed a descriptive analysis of the literature reviewed for study inclusion and consensus of the manuscript. The most common molecular and cellular pathway from articles reporting on the pathways and effects of CURC ( = 173) in prostate cancer was NF-κB ( = 25, 14.5%). The most common molecular and cellular pathway from articles reporting on the pathways and effects of UA ( = 24) in prostate cancer was caspase 3/caspase 9 ( = 10, 41.6%). The three most common molecular and cellular pathway from articles reporting on the pathways and effects of both CURC and UA ( = 193) in prostate cancer was NF-κB ( = 28, 14.2%), Akt ( = 22, 11.2%), and androgen ( = 19, 9.6%). Therefore, we have identified the potential synergistic target pathways of curcumin and ursolic acid to involve NF-κB, Akt, androgen receptors, and apoptosis pathways. Our review highlights the limited human studies and specific effects in prostate cancer.
Topics: Male; Humans; Ursolic Acid; Curcumin; NF-kappa B; Signal Transduction; Proto-Oncogene Proteins c-akt; Apoptosis; Triterpenes; Prostatic Neoplasms
PubMed: 37776274
DOI: 10.1177/03915603231202304 -
International Journal of Environmental... Dec 2023Language development starts during the fetal period when the brain is sensitive to endocrine disruptions from environmental contaminants. This systematic review aims to... (Review)
Review
Language development starts during the fetal period when the brain is sensitive to endocrine disruptions from environmental contaminants. This systematic review aims to systematically summarize the existing literature on early-life exposure to PFAS and children's language and communication development, which is an indicator of neurocognitive development. A structured literature search was conducted using three databases, PubMed, Scopus, and CINAHL, last updated in April 2023. The population was defined as children and young adults. PFAS exposure was assessed pre- or postnatally. The outcome was defined as a language and communication ability assessed with validated instruments, parental self-reports, or clinical language disorder diagnoses. In total, 15 studies were identified for subsequent analyses. Thirteen were performed in background-exposed populations and two in highly exposed populations. There were some indications of potential adverse effects; however, these were not consistent across child sex, age of assessment, or PFAS exposure levels. No systematic effect of early-life PFAS exposure on language and communication development was found. These inconclusive findings may partly be explained by the use of general test instruments with limited validity as to children's language and communication development. Further studies over a wider exposure range using specific language test instruments are needed.
Topics: Child; Female; Young Adult; Humans; Child Language; Prenatal Exposure Delayed Effects; Fluorocarbons; Language Development; Communication; Environmental Pollutants; Alkanesulfonic Acids
PubMed: 38131721
DOI: 10.3390/ijerph20247170