-
Frontiers in Endocrinology 2024This systematic review and meta-analysis was conducted to compare the benefits of adrenalectomy and conservative treatment for comorbidities associated with mild... (Meta-Analysis)
Meta-Analysis Comparative Study
OBJECTIVE
This systematic review and meta-analysis was conducted to compare the benefits of adrenalectomy and conservative treatment for comorbidities associated with mild autonomous cortisol secretion (MACS) in patients diagnosed with MACS.
BACKGROUND
MACS is the most common benign hormone-secreting functional adrenal incidentaloma. Overproduction of cortisol is observed in MACS patients, resulting in a variety of long-term health issues, including arterial hypertension (HTN), diabetes mellitus (DM), dyslipidemia, obesity, and osteoporosis; however, the classic clinical manifestations of Cushing's syndrome (CS) are not present.
METHODS
A systematic search was conducted using MEDLINE, Embase, Web of Sciences, and Scopus databases on December, 2023. Two reviewers independently extracted data and assessed the quality of the included articles. A meta-analysis was performed to compare the beneficial effects of adrenalectomy versus conservative management for MACS-related comorbidities.
RESULTS
Fifteen articles were included in this study, which evaluated 933 MACS patients (384 Adrenalectomy and 501 Conservative treatment, and 48 excluded due to incomplete follow-up duration). MACS diagnosis criteria were different among the included articles. All studies, however, stated that there must be no overt CS symptoms. Meta-analysis demonstrates the overall advantage of adrenalectomy over conservative treatment for MACS-related comorbidities (Cohen's d = -0.49, 95% CI [-0.64, -0.34], p = 0.00). Subgroup analysis indicated that the systolic blood pressure (pooled effect size = -0.81, 95% CI [-1.19, -0.42], p = 0.03), diastolic blood pressure (pooled effect size = -0.63, 95% CI [-1.05, -0.21], p = 0.01), and BMD (pooled effect size = -0.40, 95% CI [-0.73, -0.07], p = 0.02) were significantly in favor of adrenalectomy group rather than conservative treatment but no significant differences between the two treatment groups in other MACS-related comorbidities were reported.
CONCLUSION
Despite the limited and diverse data, this study demonstrates the advantage of adrenalectomy over conservative treatment for MACS-related comorbidities.
Topics: Humans; Adrenalectomy; Hydrocortisone; Adrenal Gland Neoplasms; Conservative Treatment; Cushing Syndrome; Hypertension
PubMed: 38808111
DOI: 10.3389/fendo.2024.1374711 -
Frontiers in Public Health 2024Poor sleep quality can exacerbate many other physiological functions, such as obesity, cardiovascular disease, and high blood pressure. Although primary studies were...
BACKGROUND
Poor sleep quality can exacerbate many other physiological functions, such as obesity, cardiovascular disease, and high blood pressure. Although primary studies were conducted in Ethiopia, no studies concluded the pooled prevalence of poor sleep quality in Ethiopia. Therefore, this study was conducted to determine the pooled prevalence and its determinants of sleep quality among diabetes in Ethiopia.
OBJECTIVE
Assess the pooled prevalence and its determinants of sleep quality among diabetes in Ethiopia.
METHODS
The studies were searched systematically using international databases from PubMed, Google Scholar, Cochrane Library, Embase, and CINAHL. The quality of the articles searched was assessed using the New Castle Ottawa scale for a cross-sectional study design. Statistical analysis was performed using STATA version 14 and a systematic review was performed using a random effect model method. The Preferred Reporting Item for Systematic Review and Meta-analyses (PRISMA) guideline was followed for reporting results.
RESULTS
From the total of 728 records screened, 8 studies with 2,471 participants who met the inclusion criteria were included in this systematic review. The estimated pooled prevalence of poor sleep quality in Ethiopia was 48.54%.
CONCLUSION
Almost half of diabetes patients had poor sleep quality. The preparation of brochures on diabetic information and the organization of health education about the negative impact of poor sleep quality on patients are among the best modalities to improve the problem of poor sleep quality.
Topics: Humans; Ethiopia; Prevalence; Diabetes Mellitus; Sleep Quality; Cross-Sectional Studies; Sleep Wake Disorders; Female; Male
PubMed: 38807992
DOI: 10.3389/fpubh.2024.1363408 -
Scientific Reports May 2024The aim of this study is to investigate the impact of exercise on intermediate disease markers in populations with overweight and obesity, providing evidence-based... (Meta-Analysis)
Meta-Analysis
The aim of this study is to investigate the impact of exercise on intermediate disease markers in populations with overweight and obesity, providing evidence-based recommendations for clinicians to utilize these markers in developing exercise prescriptions for this group. The study was conducted by retrieving data from PubMed, Embase, Cochrane Library, Web of Science, and CNKI and only including Randomized Controlled Trials (RCTs) to examine the effect of different exercise interventions on intermediate disease markers in overweight and obese people. The quality of the included studies was evaluated using the Cochrane Bias Risk Assessment tool and the data was analyzed using Stata 15.1 data analysis software. The RCTs were collected from January 2017 to March 2024. A total of 56 RCTs were included and the results of 10 outcomes were analyzed using random effects meta-analysis. The total sample size used in the study was 3193 The results showed that resistance training significantly reduced total cholesterol (SUCRA: 99.9%), triglycerides (SUCRA: 100.0%), low-density lipoprotein (SUCRA: 100.0%), systolic pressure (SUCRA: 92.5%), and increased high-density lipoprotein (SUCRA: 100.0%). Aerobic exercise significantly reduced insulin (SUCRA: 89.1%) and HbA1c (SUCRA: 95.3%). Concurrent training significantly reduced HOMA-IR (SUCRA: 93.8%), diastolic blood pressure (SUCRA: 71.2%) and Glucose (SUCRA: 87.6%). Exercise has a significant impact on intermediate disease markers in populations with overweight and obese. Compared with no exercise, exercise lowers total cholesterol, triglycerides, LDL, systolic blood pressure, diastolic blood pressure, HOMA-IR, insulin, and HbA1c, and increases HDL in people with overweight and obese. These findings provide evidence-based recommendations for exercise interventions aimed at weight reduction and the prevention of chronic diseases in individuals with overweight and obese.
Topics: Humans; Obesity; Randomized Controlled Trials as Topic; Biomarkers; Exercise; Overweight; Network Meta-Analysis; Male; Exercise Therapy; Glycated Hemoglobin; Triglycerides; Female; Resistance Training
PubMed: 38802439
DOI: 10.1038/s41598-024-62677-w -
Cureus May 2024[This corrects the article DOI: 10.7759/cureus.43153.].
[This corrects the article DOI: 10.7759/cureus.43153.].
PubMed: 38800779
DOI: 10.7759/cureus.c179 -
Diabetes, Metabolic Syndrome and... 2024In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and... (Review)
Review
In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother's occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.
PubMed: 38799280
DOI: 10.2147/DMSO.S458003 -
International Journal of Environmental... May 2024In recent years, weight gain and reduced physical activity in the general population have contributed to the development of obesity and other health problems; on the... (Review)
Review
The Influence of Behavioral Sciences on Adherence to Physical Activity and Weight Loss in Overweight and Obese Patients: A Systematic Review of Randomized Controlled Trials.
In recent years, weight gain and reduced physical activity in the general population have contributed to the development of obesity and other health problems; on the other hand, studies in behavioral sciences have been used to modify behaviors for a healthier life, so the objective of this study was to identify the evidence of interventions in behavioral sciences on adherence to physical activity and weight loss in obese patients. This systematic review study is based on a search of the electronic databases PubMed, Web of Science, Scopus, and Cochrane. Studies assessed the evidence from intervention studies that assessed the influence of intervention studies of behavioral sciences on public health. The articles were published between 2013 and 2023. The systematic search of the databases identified 2951 articles. The review analyzed 10 studies. Behavioral science interventions presented evidence through strategies such as multicomponent interventions, lottery and financial incentives, message framing, message framing with financial incentive and physical activity, and psychological satisfaction, demonstrating results in weight loss and maintenance and increased physical activity. This study presents scientific evidence through healthy behavior change methodologies, and future studies can explore these strategies in conjunction with public health technologies in the search for public-private partnerships to promote physical activity in adults.
Topics: Humans; Exercise; Obesity; Weight Loss; Overweight; Randomized Controlled Trials as Topic; Behavioral Sciences
PubMed: 38791844
DOI: 10.3390/ijerph21050630 -
Appetite May 2024Major Depressive Disorder in youth is associated with obesity and adult cardiovascular disease (CVD) risk. Eating in response to emotions (emotional eating) is a... (Review)
Review
Major Depressive Disorder in youth is associated with obesity and adult cardiovascular disease (CVD) risk. Eating in response to emotions (emotional eating) is a potential contributing factor to this association. Although emotional eating is associated with Major Depressive Disorder in adults, findings in children and adolescents are mixed. This systematic review and meta-analysis aims to determine the association between depression and emotional eating in children and adolescents. Systematic searches were conducted in seven databases. Studies were included if the study population had a mean age of ≤18 years and assessed both depression and emotional eating using validated measures. The search generated 12,241 unique studies, of which 37 met inclusion criteria. Random-effects meta-analyses of study outcomes were performed. Thirty-seven studies (26,026 participants; mean age = 12.4 years, SD = 3.1) were included. The mean effect size was significant for both cross-sectional and longitudinal data (Hedges' g = 0.48, p < 0.0001; g = 0.37, p = 0.002, respectively), revealing a positive moderately strong association between depressive symptoms and emotional eating in youth. Among longitudinal studies, the association was stronger when depressive symptoms and emotional eating were assessed using child and adolescent self-report versus parent-report. No studies examined youth with a clinical diagnosis of depression. Meta-analyses revealed that depressive symptoms and emotional eating are positively associated in children and adolescents. However, further research in clinical samples is needed. Results raise the possibility for the importance of emotional eating in the link between depression and early CVD risk, though further examination is required to determine whether emotional eating is a potential treatment target to decrease CVD risk among adolescents with increased depression symptoms.
PubMed: 38788931
DOI: 10.1016/j.appet.2024.107511 -
Medicine May 2024The aim of this study is to examine the impact of the Orlistat on glucose levels and glucose tolerance in individuals with prediabetes, as well as assess its efficacy... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The aim of this study is to examine the impact of the Orlistat on glucose levels and glucose tolerance in individuals with prediabetes, as well as assess its efficacy and safety in preventing the progression to diabetes.
METHODS
For achieving the appropriate randomized controlled trials, we enrolled the public datas from the following electronic databases: The Cochrane library, Embase, China National Knowledge Infrastructure, VIP, Wan-Fang, and China Biology Medicine disc. The article focused on the orlistat intervention of glucose tolerance and glycemic status in prediabetic patients. We restricted the publication time from the creation to May 2023.
RESULTS
Six subjects were included in the study, with a total of 1076 participants (532 in the control group vs 544 in the experimental group). The results indicated that the orlistat can reduce the fasting blood glucose [relative risk (RR) = -2.18, 95% confidence intervals (CI) (-2.471, -1.886)], as well as the 2 hour postprandial blood glucose [RR = -1.497, 95% CI (-1.811, -1.183)]. Furthermore, it can prevent the impaired glucose tolerance patients to type 2 diabetes mellitus [RR = 0.605, 95% CI (0.462, 0.791)], and reversal the impaired glucose tolerance [RR = 2.092, 95% CI (1.249, 3.503)].
CONCLUSIONS
In prediabetic people, the orlistat can control weight, reduce the fasting blood glucose and the 2 hour postprandial blood glucose, and then delay the progression of diabetes. However, due to the quantitative restrictions, additional high-quality study needs to be conducted to improve the reliability of the results.
Topics: Humans; Orlistat; Prediabetic State; Diabetes Mellitus, Type 2; Blood Glucose; Disease Progression; Anti-Obesity Agents; Randomized Controlled Trials as Topic; Lactones
PubMed: 38787971
DOI: 10.1097/MD.0000000000038354 -
Biology May 2024Obesity is a major global health concern linked to cognitive impairment and neurological disorders. Circulating brain-derived neurotrophic factor (BDNF), a protein... (Review)
Review
Exploring the Effect of Acute and Regular Physical Exercise on Circulating Brain-Derived Neurotrophic Factor Levels in Individuals with Obesity: A Comprehensive Systematic Review and Meta-Analysis.
Obesity is a major global health concern linked to cognitive impairment and neurological disorders. Circulating brain-derived neurotrophic factor (BDNF), a protein crucial for neuronal growth and survival, plays a vital role in brain function and plasticity. Notably, obese individuals tend to exhibit lower BDNF levels, potentially contributing to cognitive decline. Physical exercise offers health benefits, including improved circulating BDNF levels and cognitive function, but the specific impacts of acute versus regular exercise on circulating BDNF levels in obesity are unclear. Understanding this can guide interventions to enhance brain health and counter potential cognitive decline in obese individuals. Therefore, this study aimed to explore the impact of acute and regular physical exercise on circulating BDNF in individuals with obesity. The target population comprised individuals classified as overweight or obese, encompassing both acute and chronic protocols involving all training methods. A comprehensive search was conducted across computerized databases, including PubMed, Academic Search Complete, and Web of Science, in August 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Initially, 98 studies were identified, from which 16 studies, comprising 23 trials, met the selection criteria. Substantial heterogeneity was observed for both acute (I = 80.4%) and long-term effects (I = 88.7%), but low risk of bias for the included studies. A single session of exercise increased circulating BDNF levels among obese patients compared to the control group (ES = 1.25, 95% CI = 0.19 to 2.30, = 0.021). However, with extended periods of physical exercise, there was no significant increase in circulating BDNF levels when compared to the control group (ES = 0.49, 95% CI = -0.08 to 1.06, = 0.089). These findings highlight the need to consider exercise duration and type when studying neurobiological responses in obesity and exercise research. The study's results have implications for exercise prescription in obesity management and highlight the need for tailored interventions to optimize neurotrophic responses. Future research should focus on elucidating the adaptive mechanisms and exploring novel strategies to enhance BDNF modulation through exercise in this population. However, further research is needed considering limitations such as the potential age-related confounding effects due to diverse participant ages, lack of sex-specific analyses, and insufficient exploration of how specific exercise parameters (e.g., duration, intensity, type) impact circulating BDNF.
PubMed: 38785805
DOI: 10.3390/biology13050323 -
Frontiers in Nutrition 2024Obesity is a chronic, complex, and multifactorial disease resulting from the interaction of genetic, environmental, and behavioral factors. It is characterized by...
Obesity is a chronic, complex, and multifactorial disease resulting from the interaction of genetic, environmental, and behavioral factors. It is characterized by excessive fat accumulation in adipose tissue, which damages health and deteriorates the quality of life. Although dietary treatment can significantly improve health, high attrition is a common problem in weight loss interventions with serious consequences for weight loss management and frustration. The strategy used to improve compliance has been combining dietary prescriptions and recommendations for physical activity with cognitive behavioral treatment (CBT) for weight management. This systematic review determined the dropout rate and predictive factors associated with dropout from CBT for adults with overweight and obesity. The data from the 37 articles selected shows an overall dropout rate between 5 and 62%. The predictive factors associated with attrition can be distinguished by demographics (younger age, educational status, unemployed status, and ethnicity) and psychological variables (greater expected 1-year Body Mass Index loss, previous weight loss attempts, perceiving more stress with dieting, weight and shape concerns, body image dissatisfaction, higher stress, anxiety, and depression). Common reasons for dropping out were objective (i.e., long-term sickness, acute illness, and pregnancy), logistical, poor job conditions or job difficulties, low level of organization, dissatisfaction with the initial results, lack of motivation, and lack of adherence. According to the Mixed Methods Appraisal quality analysis, 13.5% of articles were classified as five stars, and none received the lowest quality grade (1 star). The majority of articles were classified as 4 stars (46%). At least 50% of the selected articles exhibited a high risk of bias. The domain characterized by a higher level of bias was that of randomization, with more than 60% of the articles having a high risk of bias. The high risk of bias in these articles can probably depend on the type of study design, which, in most cases, was observational and non-randomized. These findings demonstrate that CBT could be a promising approach for obesity treatment, achieving, in most cases, lower dropout rates than other non-behavioral interventions. However, more studies should be conducted to compare obesity treatment strategies, as there is heterogeneity in the dropout assessment and the population studied. Ultimately, gaining a deeper understanding of the comparative effectiveness of these treatment strategies is of great value to patients, clinicians, and healthcare policymakers. : PROSPERO 2022 CRD42022369995 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022369995.
PubMed: 38784136
DOI: 10.3389/fnut.2024.1250683