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Clinical Endocrinology May 2023To quantify the effect of carnitine on glucose and lipid metabolic profiles and fertility outcomes in women with Polycystic ovary syndrome (PCOS). (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To quantify the effect of carnitine on glucose and lipid metabolic profiles and fertility outcomes in women with Polycystic ovary syndrome (PCOS).
DESIGN
A systematic review and meta-analysis were conducted.
PATIENTS
Women with PCOS diagnosed by Rotterdam or Androgen Excess Society (AES) criteria and taking carnitine supplement were assessment.
MEASUREMENTS
Fertility outcomes (ovulation, clinical pregnancy, live birth, and miscarriage), lipid parameters (BMI, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein), fasting glucose and insulin, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR).
RESULTS
In total, 839 participants were included in this analysis. The dosage of carnitine and treatment duration reported by studies varied from 250 mg to 3000 mg daily and 84 to 90 days, respectively. The publication bias was absent. Compared with placebo, carnitine significantly improved ovulation rates (RR 3.42, 95% CI 2.39 to 4.89, I2 = 0%) and pregnancy rates (RR 11.05, 95% CI 1.21 to 100.58, I2 = 79%). None of included studies reported live birth. After treatment, carnitine resulted in significant reductions relative to baseline in body mass index (BMI, MD -0.93 kg/m2, 95% CI -1.15 to -0.70, I2 = 55.0%), insulin levels (MD -2.47 mIU/L, 95% CI -4.49 to -0.45, I2 = 0%) and the Homeostasis Model Assessment index (MD -0.67, 95% CI -1.20 to -0.14, I2 = 0%) than placebo, but not for lipid profiles including triglyceride, total cholesterol, and low-density lipoprotein.
CONCLUSION
With the available literature, carnitine seems to improve ovulation and clinical pregnancy and insulin resistance, BMI in women with PCOS. These effects are warranted to be further validated, due to insufficient statistical power.
Topics: Pregnancy; Female; Humans; Polycystic Ovary Syndrome; Insulin Resistance; Glucose; Carnitine; Fertility; Insulin; Lipoproteins, LDL; Triglycerides; Cholesterol; Lipids
PubMed: 36746677
DOI: 10.1111/cen.14885 -
European Journal of Preventive... Feb 2024The effect of fibrate treatment on cardiovascular risk is inconsistent. This meta-analysis aimed to assess the effect of fibrates on major adverse cardiovascular outcome... (Meta-Analysis)
Meta-Analysis
AIMS
The effect of fibrate treatment on cardiovascular risk is inconsistent. This meta-analysis aimed to assess the effect of fibrates on major adverse cardiovascular outcome (MACE) reduction.
METHODS AND RESULTS
PubMed, Embase, and Cochrane library databases were searched up to February 2023 for randomized controlled trials comparing fibrate therapy against placebo and reporting cardiovascular outcomes and lipid profile changes. The primary outcome was the clinical outcomes of each trial that most closely corresponding to MACE, a composite of cardiovascular death, acute myocardial infarction, stroke, and coronary revascularization. A pre-specified meta-regression analysis to examine the relationship between the changes in lipid levels after fibrate treatment and the risk of MACE was also performed. Twelve trials were selected for final analysis, with 25 781 patients and 2741 MACEs in the fibrate group and 27 450 patients and 3754 MACEs in the control group. Overall, fibrate therapy was associated with decreased risk of MACE [RR 0.87, 95% confidence interval (CI) 0.81-0.94] with moderate heterogeneity (I2 = 47%). In meta-regression analysis, each 1 mmol/L reduction in low-density lipoprotein cholesterol (LDL-C) after fibrate treatment reduced MACE (RR 0.71, 95% CI 0.49-0.94, P = 0.01), while triglyceride level changes did not show a significant association (RR per 1mmol/L reduction 0.96, 95% CI 0.53-1.40, P = 0.86). A sensitivity analysis with the composite outcome of cardiovascular death or acute myocardial infarction produced similar results.
CONCLUSION
Treatment with fibrates was associated with decreased risk of MACE. The reduction in MACE risk with fibrate therapy appears to be attributable to LDL-C reduction rather than a decrease in triglyceride levels.
Topics: Humans; Cholesterol, LDL; Fibric Acids; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Cardiovascular Diseases; Risk Factors; Myocardial Infarction; Triglycerides; Heart Disease Risk Factors
PubMed: 37855457
DOI: 10.1093/eurjpc/zwad331 -
Expert Review of Cardiovascular Therapy Jul 2020Although several lipid-lowering drugs are available, they are not sufficient for some patients. Bempedoic acid is a small molecule adenosine triphosphate-citrate lyase...
INTRODUCTION
Although several lipid-lowering drugs are available, they are not sufficient for some patients. Bempedoic acid is a small molecule adenosine triphosphate-citrate lyase inhibitor indicated for the treatment of adults with hypercholesterolemia.
AREAS COVERED
We performed a systematic review of the literature using PubMed database, and the following keywords were used: 'bempedoic acid,' 'hypercholesterolemia,' and 'adenosine triphosphate citrate lyase.' The chemical property, mechanism of action, pharmacokinetics, clinical efficacy, and safety of bempedoic acid are introduced in this paper.
EXPERT OPINION
Bempedoic acid can modulate the metabolism of cholesterol. Clinical trials indicated that bempedoic acid could significantly reduce low-density lipoprotein cholesterol levels. Bempedoic acid was well tolerated.
Topics: Cholesterol; Dicarboxylic Acids; Fatty Acids; Humans; Hypercholesterolemia; Hypolipidemic Agents; Treatment Outcome
PubMed: 32532162
DOI: 10.1080/14779072.2020.1782744 -
Cancers Mar 2021To quantify the associations between dietary fats and their major components, as well as serum levels of cholesterol, and liver cancer risk, we performed a systematic... (Review)
Review
To quantify the associations between dietary fats and their major components, as well as serum levels of cholesterol, and liver cancer risk, we performed a systematic review and meta-analysis of prospective studies. We searched PubMed, Embase, and Web of Science up to October 2020 for prospective studies that reported the risk estimates of dietary fats and serum cholesterol for liver cancer risk. We carried out highest versus lowest intake or level and dose-response analyses. Higher intake of dietary saturated fatty acids (SFA) was associated with a higher liver cancer risk in both category analysis (relative risk [RR] = 1.34, 95% confidence interval [CI]: 1.06, 1.69) and dose-response analysis (RR = 1.04, 95%CI: 1.01, 1.07). Higher serum total cholesterol was inversely associated with liver cancer but with large between-studies variability (RR = 0.72, 95%CI: 0.69, 0.75, I = 75.3%). The inverse association was more pronounced for serum high-density lipoprotein (HDL) cholesterol (RR = 0.42, 95%CI: 0.27, 0.64). Higher intake of dietary SFA was associated with higher risk of liver cancer while higher serum levels of cholesterol and HDL were associated with a lower risk of liver cancer with high between-studies variability.
PubMed: 33808094
DOI: 10.3390/cancers13071580 -
BMJ Evidence-based Medicine Dec 2021Drug treatment to reduce cholesterol to new target levels is now recommended in four moderate- to high-risk patient populations: patients who have already sustained a...
Drug treatment to reduce cholesterol to new target levels is now recommended in four moderate- to high-risk patient populations: patients who have already sustained a cardiovascular event, adult diabetic patients, individuals with low density lipoprotein cholesterol levels ≥190 mg/dL and individuals with an estimated 10-year cardiovascular risk ≥7.5%. Achieving these cholesterol target levels did not confer any additional benefit in a systematic review of 35 randomised controlled trials. Recommending cholesterol lowering treatment based on estimated cardiovascular risk fails to identify many high-risk patients and may lead to unnecessary treatment of low-risk individuals. The negative results of numerous cholesterol lowering randomised controlled trials call into question the validity of using low density lipoprotein cholesterol as a surrogate target for the prevention of cardiovascular disease.
Topics: Adult; Anticholesteremic Agents; Cardiovascular Diseases; Cholesterol; Cholesterol, LDL; Humans; Randomized Controlled Trials as Topic
PubMed: 32747335
DOI: 10.1136/bmjebm-2020-111413 -
Journal of Ethnopharmacology Aug 2023Opuntia speciesis used in traditional medicine to treat diabetes mellitus (DM). Polysaccharide is one of the main components of Opuntia. Opuntia polysaccharide (OPS) is... (Meta-Analysis)
Meta-Analysis Review
ETHNOPHARMACOLOGICAL RELEVANCE
Opuntia speciesis used in traditional medicine to treat diabetes mellitus (DM). Polysaccharide is one of the main components of Opuntia. Opuntia polysaccharide (OPS) is a kind of natural active macromolecular substance, numerous animal experiments have been conducted to treat DM, however, its protective effect and mechanism in animal models of DM has not been clarified.
AIM OF THE STUDY
The aim of this study is to evaluate the efficacy of OPS on DM through a stematic review and meta-analysis of animal models, and whether its improves blood glucose (BG) levels, body weight (BW), food intake, water intake, and lipid levels, and to summarize the potential mechanism of OPS in the treatment of DM.
MATERIALS AND METHODS
We searched relevant Chinese and English databases from the date of construction to March 2022, including PubMed (MEDLINE), Embase, Cochrane Library, Scopus and Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedicine Literature Database (CBM), Chinese Science and Technology Periodicals Database (VIP), Wanfang Database. 16 studies were included for meta-analysis.
RESULTS
The results showed that compared with the model group, the OPS significantly improved BG, BW, food intake, water intake, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Meta-regression and subgroup analysis showed that intervention dose, animal species, duration and modeling method may be the source of the heterogeneity. There was no statistical difference between the positive control group and the OPS treatment group in improving BW, food intake, water intake, TC, TG, HDL-C, and LDL-C.
CONCLUSIONS
OPS can effectively improve the symptoms of hyperglycemia, polydipsia, polyphagia, low body weight, and dyslipidemia in DM animals. The possible protective mechanisms of OPS on DM animals are immune regulation, repair of damaged pancreatic β cells, and inhibition of oxidative stress and cell apoptosis.
Topics: Animals; Opuntia; Cholesterol, LDL; Diabetes Mellitus; Triglycerides; Cholesterol, HDL; Models, Animal
PubMed: 37054824
DOI: 10.1016/j.jep.2023.116490 -
Critical Reviews in Food Science and... 2020Several studies have been conducted on the effects of peanut consumption on cardiovascular diseases (CVD) risk factors. However, the findings are conflicting and appear... (Meta-Analysis)
Meta-Analysis
Several studies have been conducted on the effects of peanut consumption on cardiovascular diseases (CVD) risk factors. However, the findings are conflicting and appear inconsistent. The aim of this review is to summarize the findings on the effect of peanut consumption on the risk factors of CVDs. We used relevant keywords and searched through PubMed, Scopus and Web of Science for articles published studies up to November 2018. Randomized controlled trials (RCTs) were included in this meta-analysis. Random or fixed-effects meta-analysis method depending on the results of heterogeneity tests was used to estimate the effect size. Between-study heterogeneity was assessed by Q test and index. Subgroup analysis was conducted to find any excess relationship. Publication bias was checked by Egger's test and funnel plot. Quality of studies was assessed by the Cochrane criteria. According to the results of 13 RCTs, peanuts has no significant effect on weight (WMD: -0.11 kg, P = 0.773), waist circumference (WMD: -1.41 cm, P = 0.139), body mass index (WMD: -0.14 kg/m, P = 0.428), systolic and diastolic blood pressure (WMD: -0.09 mmHg, P = 0.939 and WMD: 0.60 mmHg, P = 0.652, respectively), low-density lipoprotein cholesterol (WMD: -3.31 mg/dl, P = 0.472), triglyceride (WMD: -7.59 mg/dl, P = 0.180), total cholesterol (WMD: 3.15 mg/dl, P = 0.171), fasting blood sugar (WMD: 0.57 mg/dl, P = 0.604) and serum insulin (WMD: -0.40, P = 0.582). Also, this meta-analysis showed that peanut had a positive significant effect on high-density lipoprotein cholesterol (HDL) (WMD: 2.72 mg/dl, P = 0.001). Peanuts consumption has a positive significant effect on HDL especially at the type of peanut oil, high-oleic peanut and peanut sprout and in healthy subjects and for consumption more than 12 weeks, while has no significant effect on other CVD risk factors.
Topics: Arachis; Cardiovascular Diseases; Cholesterol, HDL; Cholesterol, LDL; Healthy Volunteers; Humans; Risk Factors; Triglycerides
PubMed: 30638042
DOI: 10.1080/10408398.2018.1558395 -
Public Health Nov 2021This study aimed to summarise the effect of community-based intervention programmes on the prevention of cardiovascular disease (CVD) by reducing cardiometabolic risk... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This study aimed to summarise the effect of community-based intervention programmes on the prevention of cardiovascular disease (CVD) by reducing cardiometabolic risk factors.
STUDY DESIGN
This was a systematic review and meta-analysis.
METHODS
A systematic search in the PubMed database and screening of reference lists aimed to identify community-based CVD prevention programmes from inception up to April 2020. The mean differences and standard deviations for CVD risk factors, including blood pressure, lipid profile, blood glucose and body weight indices, were extracted and pooled using a random effects model.
RESULTS
Screening of 11,889 titles/abstracts and full texts resulted in 48 studies being included in this review. The meta-analysis showed that community-based programmes have led to considerable decreases in systolic blood pressure (weighted mean difference [WMD] = -2.90 mm Hg, 95% confidence interval [95% CI]: -3.63, -2.16), diastolic blood pressure (WMD = -2.21 mm Hg, 95% CI: -3.12, -1.29), serum levels of low-density lipoprotein cholesterol (LDL-C; WMD = -8.88 mg/dl, 95% CI: -12.84, -4.92), triglycerides (WMD = -8.40 mg/dl, 95% CI: -12.10, -4.70), total cholesterol (WMD = -2.96 mg/dl, 95% CI: -3.10, -2.81) and fasting blood glucose (WMD = -2.06 mg/dl, 95% CI: -3.02, -1.10). A moderate decrease in body weight was also found with community-based CVD prevention programmes. However, community-based CVD prevention programmes were not associated with any significant changes in serum levels of high-density lipoprotein.
CONCLUSIONS
The present study indicates that community-based strategies have successfully led to an improvement in CVD risk factors, particularly by reducing blood pressure, serum levels of LDL-C and triglycerides, obesity indices and blood glucose. The impact of these programmes on CVD is modified by the type of intervention and by different cultural and physical environments.
Topics: Blood Pressure; Cardiovascular Diseases; Cholesterol, LDL; Humans; Lipids; Risk Factors; Triglycerides
PubMed: 34700187
DOI: 10.1016/j.puhe.2021.09.006 -
Clinical Nutrition ESPEN Dec 2023Functional foods, such as onions, have been the center of many recent investigations. In this systematic-review and meta-analysis, we aimed to gather up the existing... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Functional foods, such as onions, have been the center of many recent investigations. In this systematic-review and meta-analysis, we aimed to gather up the existing information with regard to the impact of onion supplementation on anthropometric measurements/indices, lipid profile, indices of glycemic control and hepatic health, systolic and diastolic blood pressures (SBP and DBP), and adiponectin and leptin.
METHODS
All major online datasets (PubMed, Web of Science, Cochrane, and Scopus) were thoroughly searched from inception up to October 2022. Relevant randomized controlled trials (RCTs) were obtained using the eligibility criteria. Weighted mean differences (WMDs) were calculated and reported. Statistical significance was set as p-values <0.05.
RESULTS
Among all the retrieved data, 14 RCTs were eligible to be included. The results of the crude analysis showed that onion supplementation significantly improved body fat percentage (BFP), low-density lipoprotein-cholesterol (LDL-c), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), systolic blood pressure, adiponectin, and aspartate aminotransferase (AST). Subgroup analysis revealed that interventions lasting more than 12 weeks can significantly alter weight, waist circumference (WC), body mass index (BMI), BFP, LDL-c, TC, SBP, and DBP. Moreover, the intake of dosages of >300 mg/day of onion supplementation could significantly improve weight, WC, BMI, BFP, LDL-c, HDL-C, TC, AST, ALT, SBP and DBP.
CONCLUSION
It seems that the intake of onion supplementation can improve health metabolic parameters. We observed that with either longer follow-up periods or higher dosages of onion supplementation, improvements in cardio-metabolic parameters could be expected.
Topics: Humans; Onions; Cholesterol, LDL; Adiponectin; Randomized Controlled Trials as Topic; Dietary Supplements
PubMed: 38056991
DOI: 10.1016/j.clnesp.2023.08.032 -
Critical Reviews in Food Science and... 2022The development of cardiometabolic diseases is related to conditions such as obesity, abdominal fat, insulin resistance, diabetes mellitus, elevated blood pressure and...
The development of cardiometabolic diseases is related to conditions such as obesity, abdominal fat, insulin resistance, diabetes mellitus, elevated blood pressure and changes in lipid profile. The whole of Trans Fatty Acid (TFA) intake is associated with the increase of cardiometabolic risk factors. There are two main sources of TFA, the ruminant TFA (rTFA) which are produced by biohydrogenation in animal's rumen, and the industrial TFA (iTFA), produced by hydrogenation of vegetable oils, the individual effect of each group is still controversial. The aim of this study was to analyze the effect of industrially and ruminants TFA intake on cardiometabolic risk in adults. It was carried out a systematic search of the literature in October 2019 and two independent authors selected and extracted data from articles. After the selection process, nine clinical trials were included, and summary tables were constructed to present data for all outcomes. The results showed that both sources of TFA can increase cardiometabolic risk parameters, especially lipid profile. At levels up to 1.5%-7% of energy, the effect of rTFA seems to be greater than iTFA and it seems to be greater in women. However, rTFA seems to be less harmful than iTFA for High Density Lipoprotein cholesterol, although for total cholesterol and Low density Lipoprotein cholesterol it may be worse. In summary, both sources of TFA can increase cardiometabolic risk parameters, especially lipid profile. However, the dose of TFA and the whole composition of the food must be considered.
Topics: Adult; Animals; Cardiovascular Diseases; Cholesterol, HDL; Cholesterol, LDL; Dietary Fats; Female; Heart Disease Risk Factors; Humans; Male; Risk Factors; Ruminants; Trans Fatty Acids
PubMed: 33081490
DOI: 10.1080/10408398.2020.1836471