Metabolic syndrome in antipsychotic-naïve patients with first-episode psychosis: a systematic review and meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
Nathalia Garrido-Torres ◽  
Idalino Rocha-Gonzalez ◽  
Luis Alameda ◽  
Aurora Rodriguez-Gangoso ◽  
Ana Vilches ◽  
...  

Abstract Background It is unclear what the prevalence of metabolic syndrome (MetS) in drug-naïve first-episode of psychosis (FEP) is, as previous meta-analyses were conducted in minimally exposed or drug-naïve FEP patients with psychotic disorder at any stage of the disease; thus, a meta-analysis examining MetS in naïve FEP compared with the general population is needed. Methods Studies on individuals with FEP defined as drug-naïve (0 days exposure to antipsychotics) were included to conduct a systematic review. A meta-analysis of proportions for the prevalence of MetS in antipsychotic-naïve patients was performed. Prevalence estimates and 95% CI were calculated using a random-effect model. Subgroup analyses and meta-regressions to identify sources and the amount of heterogeneity were also conducted. Results The search yielded 4143 articles. After the removal of duplicates, 2473 abstracts and titles were screened. At the full-text stage, 112 were screened, 18 articles were included in a systematic review and 13 articles in the main statistical analysis. The prevalence of MetS in naïve (0 days) FEP is 13.2% (95% CI 8.7–19.0). Ethnicity accounted for 3% of the heterogeneity between studies, and diagnostic criteria used for MetS accounted for 7%. When compared with controls matched by sex and age, the odds ratio is 2.52 (95% CI 1.29–5.07; p = 0.007). Conclusions Our findings of increased rates of MetS in naïve FEP patients suggest that we are underestimating cardiovascular risk in this population, especially in those of non-Caucasian origin. Our findings support that altered metabolic parameters in FEPs are not exclusively due to antipsychotic treatments.

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Li Qiao ◽  
Deliang Ma ◽  
Hui Lv ◽  
Ding Shi ◽  
Min Fei ◽  
...  

Abstract Background Metabolic syndrome (MetS) has been related to the pathogenesis of variety categories of cancers. This meta-analysis aimed to determine the association between MetS and the incidence of lung cancer. Methods Relevant cohort studies were identified by search of PubMed, Embase, and Cochrane’s Library databases. Cochrane’s Q test and I2 statistic were used to analyze the heterogeneity. Random-effect model which incorporates the potential heterogeneity was used for the meta-analysis. Results Five cohort studies with 188,970 participants were included. A total of 1,295 lung cancer cases occurred during follow-up. Meta-analyses showed that neither MetS defined by the revised NCEP-ATP III criteria (hazard ratio [HR]: 0.94, 95% confidence interval [CI]: 0.84 to 1.05, p = 0.25; I2 = 0) nor the IDF criteria (HR: 0.82, 95% CI: 0.61 to 1.11, p = 0.20; I2 = 0) was associated with an affected risk of lung cancer. Subgroup analyses showed consistent results in women and in men, in studies performed in Asian and non-Asian countries, and in prospective and retrospective cohorts (p all > 0.05). Meta-analysis limited to studies with the adjustment of smoking status also showed similar results (HR: 0.91, 95% CI: 0.80 to 1.05, p = 0.21; I2 = 0). No publication bias was detected based on the Egger regression test (p = 0.32). Conclusions Current evidence from cohort studies does not support that MetS is an independent risk factor for the incidence of lung cancer.


Work ◽  
2020 ◽  
Vol 67 (4) ◽  
pp. 829-835
Author(s):  
Mohammadreza Soltaninejad ◽  
Hamed Yarmohammadi ◽  
Elham Madrese ◽  
Saeed Khaleghi ◽  
Mohsen Poursadeqiyan ◽  
...  

BACKGROUND: Metabolic syndrome is an increasing disorder, especially in night workers. Drivers are considered to work during 24 hours a day. Because of job characteristics such as stress, low mobility and long working hours, they are at risk of a metabolic syndrome disorder. OBJECTIVES: The purpose of this study is a meta-analysis and systematic review of the prevalence of metabolic syndrome in drivers. METHODS: In this systematic review, articles were extracted from national and international databases: Scientific Information Database (SID), Iran Medex, Mag Iran, Google Scholar, Science Direct, PubMed, ProQuest, and Scopus. Data analysis was performed using meta-analysis and systematic review (random effect model). The calculation of heterogeneity was carried out using the I2 index and Cochran’s Q test. All statistical analyses were performed using STATA software version 11. RESULTS: A total of nine articles related to the prevalence of metabolic syndrome in drivers in different regions of the world from 2008 to 2016 were obtained. The total sample size studied was 26156 with an average of 2906 samples per study. The prevalence of metabolic syndrome in drivers was 34% (95% CI: 30–37) CONCLUSIONS: According to the results of this study, the prevalence of metabolic syndrome in drivers is high. Occupational stress, unhealthy diet and physical inactivity cannot be cited as causes of metabolic syndrome prevalence in drivers. Therefore, to maintain and to improve the health of this group, the implementation of preventive, therapeutic and rehabilitation measures for these people as well as training should be considered.


Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 127
Author(s):  
David Núñez-Fuentes ◽  
Esteban Obrero-Gaitán ◽  
Noelia Zagalaz-Anula ◽  
Alfonso Javier Ibáñez-Vera ◽  
Alexander Achalandabaso-Ochoa ◽  
...  

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Atlaw ◽  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Kenbon Seyoum ◽  
Damtew Solomon ◽  
...  

Abstract Background Neural tube defects (NTDs) are a group of disorders that arise from the failure of the neural tube close between 21 and 28 days after conception. About 90% of neural tube defects and 95% of death due to these defects occurs in low-income countries. Since these NTDs cause considerable morbidity and mortality, this study aimed to determine the prevalence and associated factors of NTDs in Africa. Methods The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO number: CRD42020149356). All major databases such as PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, African Journals Online (AJOL), and Google Scholar search engine were systematically searched. A random-effect model was used to estimate the pooled prevalence of NTDs in Africa, and Cochran’s Q-statistics and I2 tests were used to assess heterogeneity between included studies. Publication bias was assessed using Begg ’s tests, and the association between determinant factors and NTDs was estimated using a random-effect model. Results Of the total 2679 articles, 37 articles fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled prevalence of NTDs in Africa was 50.71 per 10,000 births (95% CI: 48.03, 53.44). Folic acid supplementation (AOR: 0.40; 95% CI: 0.19–0.85), maternal exposure to pesticide (AOR: 3.29; 95% CI: 1.04–10.39), mothers with a previous history of stillbirth (AOR: 3.35, 95% CI: 1.99–5.65) and maternal exposure to x-ray radiation (AOR 2.34; 95% CI: 1.27–4.31) were found to be determinants of NTDs. Conclusions The pooled prevalence of NTDs in Africa was found to be high. Maternal exposure to pesticides and x-ray radiation were significantly associated with NTDs. Folic acid supplementation before and within the first month of pregnancy was found to be a protective factor for NTDs.


2021 ◽  
pp. 003435522110432
Author(s):  
Areum Han

Objective: Mindfulness- and acceptance-based intervention (MABI) is an emerging evidenced-based practice, but no systematic review incorporating meta-analyses for MABIs in stroke survivors has been conducted. The objective of this systematic review was to measure the effectiveness of MABIs on outcomes in people with stroke. Method: Three electronic databases, including PubMed, CINAHL, and PsycINFO, were searched to identify relevant studies published in peer-reviewed journals. The methodological quality of the included studies was assessed. Data were extracted and combined in a meta-analysis with a random-effect model to compute the size of the intervention effect. Results: A total of 11 studies met the eligibility criteria. Meta-analyses found a small-to-moderate effect of MABIs on depressive symptoms (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI] = [0.12, 0.66]) and a large effect on mental fatigue (SMD = 1.22, 95% CI = [0.57, 1.87]). No statistically significant effect of MABIs on anxiety, quality of life, and mindfulness was found, but there was a trend in favor of MABIs overall. Conclusions: This meta-analysis found positive effects of MABIs on depressive symptoms and mental fatigue in stroke survivors, but future high-quality studies are needed to guarantee treatment effects of MABIs on varied outcomes in stroke survivors.


2020 ◽  
pp. 106002802096445
Author(s):  
Enrica Di Martino ◽  
Alessio Provenzani ◽  
Patrizio Vitulo ◽  
Piera Polidori

Background: The comparative efficacy of pirfenidone, nintedanib, and pamrevlumab in slowing the rate of forced vital capacity (FVC) decline and mortality in patients with idiopathic pulmonary fibrosis (IPF) is unknown. Objective: To perform a systematic review and meta-analysis (MA) of these drugs for IPF. Methods: We searched CENTRAL, PubMed, EMBASE, ClincalTrials.gov, and the World Health Organization’s registry databases up to March 2020. Phase II/III randomized controlled trials in adults with IPF were eligible. The random-effect model was implemented calculating the effect size and respective 95% CI as Cohen’s d for change from baseline FVC (in percentage predicted and liters) and odds ratio (OR) for 10% reduction in FVC and all-cause mortality (ACM). Results: Six studies were included in the MA. For change from baseline in percentage predicted FVC, the MA indicated that the 3 drugs were more effective than placebo (pirfenidone: d=3.30%, 95% CI=2.15-4.45; nintedanib: d=3.15%, 95% CI=2.35-3.95; pamrevlumab: d=4.30%, 95% CI=0.45-8.15). These results are superimposable to those relating to change from baseline FVC in liters (pirfenidone: d=0.09L, 95% CI=0.04-0.14; nintedanib: d=0.13L, 95% CI=0.10-0.16; pamrevlumab: d=0.20L, 95% CI=0.05-0.35). Each drug had a positive effect on 10% reduction in FVC (pirfenidone: OR=0.57, 95% CI=0.45-0.74; nintedanib: OR=0.66, 95% CI=0.51-0.85; pamrevlumab: OR=0.24, 95% CI=0.08-0.73), but only pirfenidone showed an effect on ACM (OR=0.50; 95% CI=0.31-0.83). Conclusion and Relevance: This MA provided encouraging results on pamrevlumab efficacy in slowing the decline in FVC compared with pirfenidone and nintedanib. Actually, in phase 3, it could become a potential IPF treatment.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yipei Yang ◽  
Ziyue Li ◽  
Haifeng Liang ◽  
Jing Tian

Abstract Objective Metabolic syndrome (MetS) has been associated with hypercoagulative status. However, previous studies evaluating the association between MetS and incidence of venous thromboembolism (VTE) after total joint arthroplasty (TJA) showed inconsistent results. We performed a meta-analysis to evaluate the influence of MetS on the risk of VTE following TJA. Methods Cohort studies were identified by the search of PubMed, Embase, and the Cochrane’s Library databases. A random-effect model was used if considerable heterogeneity was detected; otherwise, a fixed-effect model was used. Subgroup analyses according to the category of VTE, definition of MetS, category of procedure, and follow-up durations were performed. Results Seven cohort studies with 1,341,457 patients that underwent TJA were included, with 118,060 MetS patients (8.8%) at baseline. With a follow-up duration up to 3 months after surgery, 9788 patients had VTE. Pooled results with a random-effect model showed that MetS was not associated with increased overall VTE after TJA (adjusted risk ratio [RR] = 1.24, 95% confidence interval [CI] 0.89 ~ 1.72, p = 0.20; I2 = 69%). The results were not significantly affected by the diagnostic criteria of MetS, category of the procedure, and follow-up durations. Subgroup analyses showed that MetS was not associated with an increased the risk of pulmonary embolism ([PE], RR 1.06, 95% CI 0.37 ~ 3.02, p = 0.91), but an increased risk of deep vein thrombosis (DVT) after TJA (RR 3.38, 95% CI 1.83 ~ 6.24, p < 0.001). Conclusions Current evidence from observational studies suggests MetS might be associated with an increased risk of DVT but not PE after TJA.


2020 ◽  
Author(s):  
Sintayehu Ambachew ◽  
Aklilu Endalamaw ◽  
Belete Biadgo ◽  
Abebaw Worede ◽  
Mulugeta Melku

Abstract Background: The metabolic syndrome is a clustering of hyperglycemia/insulin resistance, hypertension, dyslipidemia and obesity which are risk factors for cardiovascular disease, type 2 diabetes, stroke and all-cause mortality. The burden of metabolic syndrome is emerging alarmingly in low-and middle income countries like Ethiopia. This is the protocol to determine the pooled prevalence of metabolic syndrome in Ethiopian population.Methods: This systematic review and meta-analysis will include original articles of observational studies published in the English language. Searches will be carried out in PubMed, Google Scholar, and Africa Journals up to April 2019. A Fixed/Random-effect model will be used to estimate the pooled prevalence of metabolic syndrome in Ethiopia. Heterogeneity will be assessed using I² statistic. Sub-group analysis will also be conducted based on sex, study subjects, and methodological differences. Funnel plots and egger’s and Begg’s test will be used to asses publication bias.Ethics and dissemination: The review is based on published data; therefore, ethical approval is not required. The systematic review and meta-analysis will summarize the existing data on the prevalence of metabolic syndrome in Ethiopian population. This provides the empirical evidence necessary for researchers, policy-makers, and public health stakeholders to derive health-promoting policies, allocate resources, and set priorities for monitoring future trends. The final result will be presented at annual scientific meetings, conferences, and seminars. Moreover, it will also be published in the peer-reviewed reputable journal. We also plan to review every 5 years to provide updated information.Protocol registration number: PROSPERO International Prospective Register of Systematic Reviews (CRD42018090944)


2021 ◽  
Vol 33 (1) ◽  
pp. 9-24
Author(s):  
Swambhavi Awasthi ◽  
Sunil Sharma ◽  
Saurav Attri ◽  
Sakshi Malik Attri ◽  
Rajesh Sharawat ◽  
...  

COVID-19 made a huge impact on the world due to its rapid transmission and no treatments being available for it. The virus affected more people and spread to various countries than what was predicted when COVID-19 initially began spreading. There have been numerous pandemics and epidemics in the 21st century yet COVID-19 has affected more people and spread widely. The primary objective of the study was to explore history, spread and associated parameters of existing viruses especially COVID-19. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for a systematic search to identify eligible published articles. Clinical data, regarding COVID-19 patients, was obtained from previously published articles. The main cause of COVID-19 spreading rapidly was noted to be due to a high percentage of asymptomatic patients, transmission being air-borne, and the lack of knowledge and preventative measures being implemented when the virus began spreading. The common co-morbidity that found in patients was Diabetes Mellitus, Hypertension, and Coronary Heart Disease. The common symptoms, found through the Meta-analysis, that the patients faced included cough (55.4%), fever (68.4%), fatigue (20.3%), and shortness of breath (18.1%). The proportion of asymptotic positive cases was measured 58.3% (95%CI: 24.7% – 87.9%) while mortality proportion was found to be 6.7% (fixed-effect model) and 13.4% (random-effect model). The Meta-analysis indicated that a higher percentage of males were affected by COVID-19 than females and more patients are found to be asymptomatic. Moreover, the mortality rate of patients that have had COVID-19 was found to be low. 


2021 ◽  
Author(s):  
Sagar Tiwari ◽  
Niranjan KC ◽  
Sajan Thapa ◽  
Anuja Ghimire ◽  
Sanjeev M Bijukchhe ◽  
...  

Abstract Background: The novel beta-coronavirus disease (COVID-19) has infected millions of people globally with high risk among male then female. However, the effect of COVID-19 andrology is still a subject of dispute. We planned to analyze the overall consequences of COVID-19 on semen parameters and male sex hormones.Main text: Systematic search was performed on MEDLINE and Scopus database until June 11 2021. We included observational studies, which reported mean ± standard deviation of the semen parameters and serum sex hormones of those reproductive-aged male recovered from COVID-19 and controls who did not suffered from COVID-19. We used Random-effect model to pool the studies, as heterogeneity was present. Heterogeneity was evaluated by Q test and I2. All studies were assessed with their quality and publication bias.We assessed 966 articles for eligibility and found 7 eligible studies meeting PICO criteria. This include 934 participants with mean age 37.34 ± 10.5. Random-effect model meta-analysis showed that men recovered form COVID-19 had semen parameters less than those who had not suffered from COVID-19. The overall mean difference (MD) [95% confidence interval (CI)] in semen volume, sperm concentration, sperm number, and progressive sperm motility was -0.20 (-0.45, 0.05), -16.59 (-34.82, 1.65), -45.44 (-84.56, -6.31), -1.73(-8.20, 4.75) respectively. Considering sex hormones; Luteinizing hormone and prolactin was found more among those recovered with the significant MD (95% CI) of 3.47 (1.59, 5.35) and 3.21 (1.71, 4.72) respectively.Conclusion: Both the semen parameters and sexual hormones were found to be affected after infected with COVID-19. However, the mechanism for testicular involvement remains doubtful.This systematic review and meta-analysis has been registered in PROSPERO (ID: CRD42021259445)


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