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Frontiers in Medicine 2024Obstructive sleep apnea (OSA) and metabolic syndrome (MetS) often coexist, and the causal relationship between them is not yet clear; treatments for OSA include...
BACKGROUND
Obstructive sleep apnea (OSA) and metabolic syndrome (MetS) often coexist, and the causal relationship between them is not yet clear; treatments for OSA include continuous positive airway pressure (CPAP), mandibular advancement device (MAD), surgery, and lifestyle intervention and so on. However, the effects of different treatments on metabolic syndrome in OSA patients are still under debate.
OBJECTIVES
Review the effects of different treatments on metabolic syndrome in OSA patients by meta-analysis.
METHODS
we searched articles in PubMed, Embase, Cochrane Library, CNKI, CBM, and Wanfang data from database construction to Feb. 2024.RevMan5.4 and Stata software were used to conduct a meta-analysis of 22 articles.
RESULTS
A total of 22 articles were finally included. The results showed that CPAP treatment could reduce the prevalence of metabolic syndrome in OSA patients in randomized controlled trials (RCTs) (RR = 0.82 [95% CI, 0.75 to 0.90]; < 0.01) and single-arm studies (RR = 0.73 [95% CI, 0.63 to 0.84]; < 0.01). As for metabolic syndrome components, CPAP treatment reduces blood pressure, fasting glucose (FG), triglycerides (TG), and waist circumference (WC) but can't affect high-density lipoprotein cholesterol (HDL-C) levels. Lifestyle intervention could significantly reduce the prevalence of metabolic syndrome in OSA patients (RR = 0.60 [95% CI, 0.48 to 0.74]; < 0.01) and can lower blood pressure, fasting glucose, and waist circumference but can't affect the lipid metabolism of OSA patients. Upper airway surgery can only reduce TG levels in OSA patients (MD = -0.74 [95% CI, -1.35 to -0.13]; = 0.02) and does not affect other components of metabolic syndrome. There is currently no report on the impact of upper airway surgery on the prevalence of metabolic syndrome. No study has reported the effect of MAD on metabolic syndrome in OSA patients.
CONCLUSION
We confirmed that both CPAP and lifestyle intervention can reduce the prevalence of MetS in OSA patients. CPAP treatment can lower blood pressure, fasting glucose, waist circumference, and triglyceride levels in OSA patients. Lifestyle intervention can lower blood pressure, fasting glucose, and waist circumference in OSA patients. Upper airway surgery can only reduce TG levels in OSA patients.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022326857.
PubMed: 38515989
DOI: 10.3389/fmed.2024.1354489 -
Frontiers in Endocrinology 2024Over 1.9 billion adult people have overweight or obesity. Considered as a chronic disease itself, obesity is associated with several comorbidities. Chronic pain affects... (Meta-Analysis)
Meta-Analysis
CONTEXT
Over 1.9 billion adult people have overweight or obesity. Considered as a chronic disease itself, obesity is associated with several comorbidities. Chronic pain affects approximately 60 million people and its connection with obesity has been displayed in several studies. However, controversial results showing both lower and higher pain thresholds in subjects with obesity compared to individuals with normal weight and the different parameters used to define such association (e.g., pain severity, frequency or duration) make it hard to draw straight forward conclusions in the matter. The objective of this article is to examine the relationship between overweight and obesity (classified with BMI as recommended by WHO) and self-perceived pain intensity in adults.
METHODS
A literature search was conducted following PRISMA guidelines using the databases CINAHL, Cochrane Library, EMBASE, PEDro, PubMed, Scopus and Web of Science to identify original studies that provide BMI values and their associated pain intensity assessed by self-report scales. Self-report pain scores were normalized and pooled within meta-analyses. The Cochrane's Q test and I index were used to clarify the amount of heterogeneity; meta-regression was performed to explore the relationship between each outcome and the risk of bias.
RESULTS
Of 2194 studies, 31 eligible studies were identified and appraised, 22 of which provided data for a quantitative analysis. The results herein suggested that adults with excess weight (BMI ≥ 25.0) or obesity (BMI ≥ 30.0) but not with overweight (pre-obesity) alone (BMI 25.0-29.9), are more likely to report greater intensities of pain than individuals of normal weight (BMI 18.5-24.9). Subgroup analyses regarding the pathology of the patients showed no statistically significant differences between groups. Also, influence of age in the effect size, evaluated by meta-regression, was only observed in one of the four analyses. Furthermore, the robustness of the findings was supported by two different sensitivity analyses.
CONCLUSION
Subjects with obesity and excess weight, but not overweight, reported greater pain intensities than individuals with normal weight. This finding encourages treatment of obesity as a component of pain management. More research is required to better understand the mechanisms of these differences and the clinical utility of the findings.
SYSTEMATIC REVIEW REGISTRATION
https://doi.org/10.17605/OSF.IO/RF2G3, identifier OSF.IO/RF2G3.
Topics: Adult; Humans; Overweight; Pain Measurement; Obesity; Weight Gain; Pain
PubMed: 38510698
DOI: 10.3389/fendo.2024.1340465 -
Probiotics ameliorate endocrine disorders via modulating inflammatory pathways: a systematic review.Genes & Nutrition Mar 2024Probiotics has offered a new prospect to treat and manage a variety of endocrine disorders such as obesity, diabetes, non- alcoholic fatty liver disease and metabolic... (Review)
Review
Probiotics has offered a new prospect to treat and manage a variety of endocrine disorders such as obesity, diabetes, non- alcoholic fatty liver disease and metabolic syndrome. The precise mechanisms by which probiotics exert their beneficial effects on endocrine disorders and its associated problems are still indecisive. It seems that regulating the immune system and suppressing pro-inflammatory pathways like tumor necrosis factor-α and interleukin-6 or triggering anti-inflammatory pathways like interleukin-4 and 10 may be one of the potential mechanisms in the managing of endocrine disorders. In this systematic review, we hypothesized that various probiotic strains (Lactobacillus, Biofidiobacteria, Streptococcus, Entrococcus, Clostridium, and Bacillus) alone or in combination with each other could manage endocrine disorders via modulating inflammatory pathways such as suppressing pro-inflammatory cytokines (IL-6, IL-12, TNF-α, TNF-β, NFκB, and MCP-1), stimulating anti-inflammatory cytokines (IL-4,IL-6, IL-22, IL-23, IL-33, and TGF-β) and maintaining other factors like C-reactive protein, Toll like receptors, LPS, and NK cells. Data source this search was performed in PubMed and Scopus. Both human and animal studies were included. Among more than 15,000 papers, 25 studies were identified as eligible for more assessments. Quality assessment of the studies was cheeked by two researchers independently by title and abstract screening, then article which have inclusion criteria were included, and data retrieved from the included full text studies as the authors had originally reported. Results specified that Lactobacillus has been the most widely used probiotic as well as which one exhibiting the extend of the therapeutic effects on endocrine disorders, especially obesity by modulating immune responses. Also, most studies have revealed that probiotics through suppressing pro-inflammatory pathways specially via reducing levels TNF-α cytokine exhibited protective or beneficial effects on endocrine diseases particularly obesity as well as through decreasing level of IL-6 induced therapeutic effects in diabetes. This systematic review suggests that probiotics could ameliorate endocrine disorders via their immunomodulatory effects.
PubMed: 38504163
DOI: 10.1186/s12263-024-00743-8 -
Heliyon Mar 2024Self-confidence is a key element in successfully promoting achievement strivings among the healthcare workforce. Targeted interventions can strengthen this... (Review)
Review
BACKGROUND
Self-confidence is a key element in successfully promoting achievement strivings among the healthcare workforce. Targeted interventions can strengthen this characteristic in nursing students, thus improving the quality of hospital services.
OBJECTIVES
We evaluated the effect of educational interventions on boosting self-confidence in nursing students using systematic review and meta-analysis.
METHODS
A comprehensive search was used to screen the related studies in Scopus, PubMed, Embase, Web of Science, and PsycINFO. Peer-reviewed literature in English until June 2023 was reviewed. Inclusion criteria were controlled trials, either non-randomized studies of intervention (NRSI) or randomized (RCTs). Studies were assessed for methodological quality by the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) and the Cochrane "Risk of Bias" tool for RCTs (RoB 2.0) and quality assessment tool for before-after (pre-post) studies with no control group. The main outcome was the self-confidence score of nursing students because of educational methods or intervention/s. Using the inverse variance weights method, a pooled standardized mean difference (SMD) estimate with a corresponding 95% confidence interval (CI) was determined. Random-effects meta-analysis was used to assess conceptual heterogeneity using Stata.
RESULTS
Twenty-two studies were selected involving 1758 participants and 940 cases of nursing students in the intervention group on boosting self-confidence (Fourteen Randomized controlled trials, Five Quasi-experimental, and three Before-After studies). The post-intervention self-confidence results in the nursing student's intervention group were significantly greater (SMD) (SMD for Controlled experimental design = 0.51; 95% CI = 0.14-0.89), (SMD for Quasi-experimental = 0.04; 95% CI = -0.33-0.41), (SMD for Before-After (Pre-Post) = 2.74; 95% CI = 1.85-3.63). The random-effect meta-analysis of 22 interventional studies determined that educational interventions are significantly associated with the improving self-confidence of nursing students. The intervention showed a moderate impact on the research units, according to Cohen's d results. Also, the results of simulation learning intervention (SMD = 0.42; 95% CI = 0.03-0.81) showed a significant relationship between intervention and outcome in studies.
CONCLUSIONS
Analysis of our findings revealed the successful impact of most interventional approaches in boosting self-confidence, especially in the long term. It can be concluded that self-confidence is a multifactorial concept that can be improved by using targeted combination intervention strategies.
PubMed: 38501010
DOI: 10.1016/j.heliyon.2024.e27347 -
International Journal of Endocrinology 2024Metformin is commonly prescribed to treat polycystic ovary syndrome (PCOS) patients, but in some cases, it may not be effective even at high doses or may cause... (Review)
Review
Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches.
BACKGROUND
Metformin is commonly prescribed to treat polycystic ovary syndrome (PCOS) patients, but in some cases, it may not be effective even at high doses or may cause intolerable side effects. Therefore, recent studies have examined the impact of combining metformin with other antidiabetic medications.
METHODS
A systematic search was performed in Scopus, PubMed, Web of Science, and Embase up to 30 June 2023. All interventional studies that assessed the efficacy of different antidiabetic agents were included.
RESULTS
Among the 3488 records found in the primary search, 16 papers were included. Our study showed that dipeptidyl peptidase-4 inhibitors (DPP4i) had the most significant impact on glycemic profile, while thiazolidinediones (TZDs) had the most influence on lipid levels. However, it was observed that patients taking only metformin experienced a greater increase in high-density lipoprotein cholesterol (HDL-C) levels. Glucagon-like peptide-1 receptor agonists (GLP1RAs) effectively modified various anthropometric measurements, such as weight, body mass index, waist circumference, and waist-to-hip ratio. The effects of different antidiabetic drugs on hormone levels were inconclusive, although testosterone levels were more affected by GLP1RA, sodium-glucose cotransporter-2 inhibitors (SGLT2i), and TZDs. None of the combined therapies showed a significant change in blood pressure.
CONCLUSION
Since PCOS is a metabolic disorder, choosing the best combination of antidiabetic drugs in the clinical course of PCOS patients will be very important. Today, it seems that we need a new metabolic approach for better treatment of the metabolic aspects of these patients.
PubMed: 38500709
DOI: 10.1155/2024/9900213 -
Nutrients Feb 2024The food insulin index (FII) is a novel algorithm used to determine insulin responses of carbohydrates, proteins, and fats. This scoping review aimed to provide an... (Review)
Review
The food insulin index (FII) is a novel algorithm used to determine insulin responses of carbohydrates, proteins, and fats. This scoping review aimed to provide an overview of all scientifically relevant information presented on the application of the FII in the prevention and management of insulin resistance and diabetes. The Arksey and O'Malley framework and the PRISMA Extension for Scoping Reviews 22-item checklist were used to ensure that all areas were covered in the scoping review. Our search identified 394 articles, of which 25 articles were included. Three main themes emerged from the included articles: 1. the association of FII with the development of metabolic syndrome, insulin resistance, and diabetes, 2. the comparison of FII with carbohydrate counting (CC) for the prediction of postprandial insulin response, and 3. the effect of metabolic status on the FII. Studies indicated that the FII can predict postprandial insulin response more accurately than CC, and that a high DII and DIL diet is associated with the development of metabolic syndrome, insulin resistance, and diabetes. The FII could be a valuable tool to use in the prevention and management of T1DM, insulin resistance, and T2DM, but more research is needed in this field.
Topics: Humans; Insulin; Insulin Resistance; Metabolic Syndrome; Food; Diabetes Mellitus
PubMed: 38474713
DOI: 10.3390/nu16050584 -
Diabetology & Metabolic Syndrome Mar 2024A growing body of evidence points to the association between insulin resistance (IR), metabolic syndrome (MetS) and its components and lung cancer incidence, but remains... (Review)
Review
BACKGROUND
A growing body of evidence points to the association between insulin resistance (IR), metabolic syndrome (MetS) and its components and lung cancer incidence, but remains controversial and unknown.
METHODS
A systematic search was conducted through PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI) and Wanfang databases for the corresponding studies. Each study reported the risk estimate and 95% confidence intervals (CI) for lung cancer, and a fixed effects model or random effects model was used for outcome.
RESULTS
We included 31 publications involving 6,589,383 people with 62,246 cases of lung cancer. Diabetes mellitus (DM) (RR = 1.11, 95% CI 1.06-1.16, P = 0.000) and IR (RR = 2.35, 95% CI 1.55-3.58, P = 0.000) showed a positive association with lung cancer risk. BMI (RR = 0.66, 95% CI 0.54-0.81, P = 0.000) and HDL-C (RR = 0.88, 95% CI 0.79-0.97, P = 0.010) were negatively correlated with lung cancer. MetS(RR = 0.99, 95% CI 0.90-1.09, P = 0.801), TC (RR = 0.93, 95% CI 0.81-1.06, P = 0.274), TG (RR = 0.99, 95% CI 0.88-1.12,P = 0.884), LDL-C (RR = 1.01, 95% CI 0.87-1.16, P = 0.928), hypertension (RR = 1.01, 95% CI 0.88-1.15, P = 0.928), FBG (RR = 1.02, 95% CI 0.92-1.13, P = 0.677) and obesity (RR = 1.11, 95% CI 0.92-1.35, P = 0.280) were not associated with lung cancer.
CONCLUSION
Our study showed that the risk of lung cancer is correlated with DM, IR, BMI, and HDL-C. Timely control of these metabolic disorders may have a positive effect on preventing lung cancer. Trial registration Our study has been registered in the Prospective Register of Systematic Reviews (PROSPERO), ID: CRD42023390710.
PubMed: 38468310
DOI: 10.1186/s13098-024-01308-w -
Frontiers in Nutrition 2024Studies have shown that sphingomyelin (SM) and its metabolites play signaling roles in the regulation of human health. Endogenous SM is involved in metabolic syndrome...
BACKGROUND
Studies have shown that sphingomyelin (SM) and its metabolites play signaling roles in the regulation of human health. Endogenous SM is involved in metabolic syndrome (MetS), while dietary SM supplementation may maintain lipid metabolism and prevent or alleviate MetS. Therefore, we hypothesized that dietary SM supplementation is beneficial for human health.
AIMS
In order to examine the impacts of dietary SM on metabolic indexes in adults without MetS, we performed a meta-analysis to test our hypothesis.
METHODS
A comprehensive search was performed to retrieve randomized controlled trials that were conducted between 2003 and 2023 to examine the effects of dietary SM supplementation on metabolic parameters in the Cochrane Library, PubMed, Web of Science, Embase, and ClinicalTrials.gov databases. RevMan 5.4 and Stata 14.0 software were used for meta-analysis, a sensitivity analysis, the risk of bias, and the overall quality of the resulted evidence.
RESULTS
Eventually, 10 articles were included in this meta-analysis. Dietary SM supplementation did not affect the endline blood SM level. When compared to the control, SM supplementation reduced the blood total cholesterol level [MD: -12.97, 95% CI: (-14.57, -11.38), < 0.00001], low-density lipoprotein cholesterol level [MD: -6.62, 95% CI: (-10.74, -2.49), = 0.002], and diastolic blood pressure [MD: -3.31; 95% CI (-4.03, -2.58), < 0.00001] in adults without MetS. The supplementation also increased high-density lipoprotein level [MD:1.41, 95% CI: (0.94, 1.88), < 0.00001] and muscle fiber conduction velocity [MD: 95% 1.21 CI (0.53, 1.88), = 0.0005]. The intake of SM had no effect on the blood phospholipids and lyso-phosphatidylcholine, but slightly decreased phosphatidylcholine, phosphatidylethanolamine, and phosphatidylinositol concentrations. Dietary SM supplementation reduced insulin level [MD: -0.63; 95% CI (-0.96, -0.31), = 0.0001] and HOMA-IR [MD: -0.23; 95% CI (-0.31, -0.16), < 0.00001] without affecting blood levels of glucose and inflammatory cytokines.
CONCLUSION
Overall, dietary SM supplementation had a protective effect on blood lipid profiles and insulin level, but had limited impacts on other metabolic parameters in adults without MetS. More clinical trials and basic research are required.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, identifier CRD42023438460.
PubMed: 38463938
DOI: 10.3389/fnut.2024.1363077 -
Medicine Mar 2024Leukocyte parameters are predicted to be affected in patients with metabolic syndrome (MetS). We conducted a systematic review and meta-analysis to study the association... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Leukocyte parameters are predicted to be affected in patients with metabolic syndrome (MetS). We conducted a systematic review and meta-analysis to study the association between white blood cell parameters (WBC) in people with and without MetS.
METHODS
PubMed, EMBASE, Scopus and Cochrane Library databases were searched according to the study protocol. The standardized mean difference (SMD) and 95% confidence intervals (CI) of leukocyte markers between individuals with and without MetS were pooled using an inverse variance model. Additionally, a subgroup analysis by sex was performed where possible. Methodological quality assessment was conducted using the Newcastle-Ottawa scale (NOS) for observational studies and the Cochrane Risk of Bias tool 2.0 for Randomized Controlled Trials (RCTs).
RESULTS
Of 6068 articles identified, 63 were eligible for the study. Compared to controls, individuals with MetS showed significantly higher concentrations of total leukocyte count (SMD [95% CI]: 0.60 [0.55-0.65]; P < .00001; I2 = 100%), neutrophil counts (0.32 [0.28-0.37]; P < .00001; I2 = 99%), lymphocyte counts (0.15 [0.07-0.23]; P = .0004; I2 = 100%), basophil counts (0.01 [0.00-0.02]; P = .02; I2 = 98%), monocyte counts (0.05 [0.02-0.09]; P = .003; I2 = 99%), and neutrophil-to-lymphocyte ratio (0.24 [0.15-0.33]; P < .00001; I2 = 98%). There were no significant differences in the eosinophil count (0.02 [-0.01 to 0.05]; P = .19; I2 = 96%) and monocyte-to-lymphocyte ratio (0.06 [-0.05 to 0.17]; P = .27; I2 = 100%) between patients with and without MetS, however, the lymphocyte-to-monocyte ratio (0.52 [-0.81 to -0.23]; P = .0005; I2 = 52%) tended to be significantly lower in patients with MetS.
CONCLUSION
Biomarkers such as total leukocyte count, neutrophil count, lymphocyte count, basophil count, monocyte count and neutrophil-to-lymphocyte ratio are associated with higher levels in patients in MetS and thus can potentially be used for early detection of MetS.
Topics: Humans; Metabolic Syndrome; Leukocytes; Leukocyte Count; Neutrophils; Lymphocytes
PubMed: 38457562
DOI: 10.1097/MD.0000000000037331 -
BMJ Open Mar 2024Patients with inflammatory bowel disease (IBD) may experience comorbidities involving metabolic syndrome (MetS). However, this association remains controversial. Our... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Patients with inflammatory bowel disease (IBD) may experience comorbidities involving metabolic syndrome (MetS). However, this association remains controversial. Our objective was to estimate the prevalence of MetS in patients with IBD and assess whether MetS is more strongly associated with ulcerative colitis (UC) or Crohn's disease (CD).
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed, Cochrane Library, Web of Science, EMBASE and MEDLINE were searched from their inception to July 2022.
ELIGIBILITY CRITERIA
Observational studies reporting data regarding the rate of comorbid MetS among patients with IBD and published in English.
DATA EXTRACTION AND SYNTHESIS
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology reporting guidelines were followed. Pooled prevalence, ORs and 95% CIs were calculated using random-effects models. The Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist were used. Heterogeneity, sensitivity and stratified analyses were performed using R (V.4.2.1).
RESULTS
11 eligible studies involving 2501 patients were included. Of these studies, four reported MetS prevalence separately by IBD phenotype, and only one contained a non-IBD comparison group. Overall, the methodological quality of the included studies was moderate. The pooled prevalence of MetS in IBD was 19.4% (95% CI 15.1% to 23.8%), with a moderate heterogeneity (I=51.8%, Cochrane Q statistic=12.4, p=0.053). Stratified analyses demonstrated that the aggregate estimate of comorbid MetS was significantly higher in UC than in CD (38.2% vs 13.6%, χ=4.88, p=0.03). We found a positive association between MetS and UC compared with CD (OR=2.11, 95% CI 1.19 to 3.74, p=0.01). Additionally, four studies identified that higher age was a risk factor associated with the development of MetS.
CONCLUSIONS
MetS is not rare in IBD, especially in UC. However, longitudinal studies are needed to further clarify the relationship between IBD and MetS.
PROSPERO REGISTRATION NUMBER
CRD42022346340.
Topics: Humans; Metabolic Syndrome; Prevalence; Inflammatory Bowel Diseases; Crohn Disease; Colitis, Ulcerative
PubMed: 38453206
DOI: 10.1136/bmjopen-2023-074659