scholarly journals Zinc supplementation improves glycemic control for diabetes prevention and management: a systematic review and meta-analysis of randomized controlled trials

2019 ◽  
Vol 110 (1) ◽  
pp. 76-90 ◽  
Author(s):  
Xinhui Wang ◽  
Wenhui Wu ◽  
Wanru Zheng ◽  
Xuexian Fang ◽  
Liyun Chen ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Randomized Controlled Trials ◽  
Zinc Supplementation ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Model Assessment ◽  
Zinc Supplement ◽  
Randomized Controlled

ABSTRACT Background Although many studies have shown that low zinc status is associated with diabetes, the putative effects of zinc supplementation on glycemic control are inconclusive. Objectives The aim of this meta-analysis of randomized controlled trials was to assess the effects of zinc supplementation in preventing and managing diabetes. Methods PubMed, Embase, and the Cochrane Library were searched for articles that were published through February 10, 2019 and contained estimates for the outcomes of interest. The pooled results were then analyzed with the use of a random-effects model. Results Thirty-two placebo-controlled interventions were extracted from 36 publications, involving a total of 1700 participants in 14 countries. Overall, compared with their respective control groups, the subjects in the zinc-supplementation group had a statistically significant reduction in fasting glucose [FG, weighted mean difference (WMD): −14.15 mg/dL; 95% CI: −17.36, −10.93 mg/dL], 2-h postprandial glucose (WMD: −36.85 mg/dL; 95% CI: −62.05, −11.65 mg/dL), fasting insulin (WMD: −1.82 mU/L; 95% CI: −3.10, −0.54 mU/L), homeostasis model assessment for insulin resistance (WMD: −0.73; 95% CI: −1.22, −0.24), glycated hemoglobin (WMD: −0.55%; 95% CI: −0.84, −0.27%), and high-sensitivity C-reactive protein (WMD: −1.31 mg/L; 95% CI: −2.05, −0.56 mg/L) concentrations. Moreover, subgroup analyses revealed that the effects of zinc supplementation on FG are significantly influenced by diabetic status and the formulation of the zinc supplement. Conclusions Our analysis revealed that several key glycemic indicators are significantly reduced by zinc supplementation, particularly the FG in subjects with diabetes and in subjects who received an inorganic zinc supplement. Together, these findings support the notion that zinc supplementation may have clinical potential as an adjunct therapy for preventing or managing diabetes. This trial was registered at PROSPERO as CRD42018111838.

Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis

2021 ◽  
Author(s):  
Rahele Tavakoly ◽  
Amir Hadi ◽  
Nahid Rafie ◽  
Behrouz Talaei ◽  
Wolfgang Marx ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Monocyte Count ◽  
Randomized Controlled ◽  
Immunological Markers ◽  
Online Databases ◽  
Immunological Effects

AbstractThe possible effect of probiotic interventions on immunological markers in athletes is inconclusive. Therefore, to synthesize and quantitatively analyze the existing evidence on this topic, systematic literature searches of online databases PubMed, Scopus, Cochrane Library, and ISI Web of Sciences was carried out up to February 2021 to find all randomized controlled trials (RCTs) concerning the immunological effects of probiotics in athletes. In the random-effects model, weighted mean difference (WMD) and 95% confidence interval (CI) explained the net effect. The authors assessed the likelihood of publication bias via Egger’s and Begg’s statistics. A total of 13 RCTs (836 participants) were retrieved. Probiotic consumption reduced lymphocyte T cytotoxic count significantly (WMD=−0.08 cells×109/L; 95% CI: −0.15 to −0.01; p=0.022) with evidence of moderate heterogeneity (I 2=59.1%, p=0.044) and monocyte count when intervention duration was ≤ 4 weeks (WMD=−0.08 cells×109/L; 95% CI: −0.16 to −0.001; I 2=0.0%). Furthermore, leukocyte count was significantly elevated (WMD=0.48 cells×109/L; 95% CI: 0.02 to 0.93; I 2=0.0%) when multi-strain probiotics were used. Probiotic supplements may improve immunological markers, including lymphocyte T cytotoxic, monocyte, and leukocyte in athletes. Further randomized controlled trials using diverse strains of probiotics and consistent outcome measures are necessary to allow for evidence-based recommendations.

scholarly journals Zinc Supplementation and Body Weight: A Systematic Review and Dose–Response Meta-analysis of Randomized Controlled Trials

2019 ◽  
Author(s):  
Shima Abdollahi ◽  
Omid Toupchian ◽  
Ahmad Jayedi ◽  
David Meyre ◽  
Vivian Tam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
Randomized Controlled Trials ◽  
Dose Response ◽  
Zinc Supplementation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Anthropometric Measures ◽  
Randomized Controlled

ABSTRACT The aim of this study was to determine the effect of zinc supplementation on anthropometric measures. In this systematic review and dose–response meta-analysis, we searched PubMed, Scopus, ISI Web of Science, and the Cochrane Library from database inception to August 2018 for relevant randomized controlled trials. Mean differences and SDs for each outcome were pooled using a random-effects model. Furthermore, a dose–response analysis for zinc dosage was performed using a fractional polynomial model. Quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Twenty-seven trials (n = 1438 participants) were included in the meta-analysis. There were no significant changes in anthropometric measures after zinc supplementation in the overall analysis. However, subgroup analyses revealed that zinc supplementation increased body weight in individuals undergoing hemodialysis (HD) [3 trials, n = 154 participants; weighted mean difference (WMD) = 1.02 kg; 95% CI: 0.38, 1.65 kg; P = 0.002; I2 = 11.4%] and decreased body weight in subjects who are overweight/obese but otherwise healthy (5 trials, n = 245 participants; WMD = −0.55 kg; 95% CI: −1.06, −0.04 kg; P = 0.03; I2 = 31.5%). Dose–response analyses revealed a significant nonlinear effect of supplementation dosage on BMI (P = 0.001). Our data suggest that zinc supplementation increases body weight in patients undergoing HD and decreases body weight in individuals who are overweight/obese but otherwise healthy, although after normalization for study duration, the association observed in subjects who are overweight/obese disappeared. Although more high-quality studies are needed to reach a definitive conclusion, our study supports the view that zinc may be associated with body weight.

scholarly journals Efficacy and safety of bempedoic acid alone or combining with other lipid-lowering therapies in hypercholesterolemic patients: a meta-analysis of randomized controlled trials

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiang Zhao ◽  
Xubiao Ma ◽  
Xing Luo ◽  
Zhihua Shi ◽  
Ziwen Deng ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Atp Citrate Lyase ◽  
Randomized Controlled

Abstract Background Bempedoic acid is a new drug that reduces cholesterol synthesis via inhibiting ATP citrate lyase. It remains unclear whether the combination of bempedoic acid and other lipid-lowering drugs is better than these drugs alone. This study systematically reviewed the efficacy and safety of bempedoic acid monotherapy or combination togethers in hypercholesterolemic patients. Methods Randomized controlled trials were searched across Medline, Embase, Cochrane library, web of science, etc. The net change scores [least squares mean (LSM) percentage change] in LDL-C level were meta-analyzed using weighted mean difference. The reductions in other lipids including total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein (ApoB) and high sensitivity C reactive protein (hsCRP) were also assessed. Odds ratio (OR) of the incidence of adverse events (AEs) were calculated to evaluate the safety of bempedoic acid. Results A total of 13 trials (4858 participates) were included. Pooled data showed that the combination togethers resulted in greater reductions in LDL-C level than monotherapies (bempedoic acid + statin vs. statin: LSM difference (%), − 18.37, 95% CI, − 20.16 to − 16.57, I2 = 0; bempedoic acid + ezetimibe vs. ezetimibe: LSM difference (%), − 18.89, 95% CI, − 29.66 to − 8.13, I2 = 87%). But the difference in efficacy between bempedoic acid and ezetimibe was not obvious. Meta-regression analysis showed the treatment duration was a source of heterogeneity (adj R2 = 16.92, 95% CI, 0.04 to 0.72). Furthermore, the background therapy of statin before screening decreased the efficacy of bempedoic acid. In addition, bempedoic acid also resulted in a significant reduction in TC, non-HDL-C, ApoB and hsCRP level. The OR of muscle-related AEs by the combination of bempedoic acid and statin was 1.29 (95% CI, 1.00 to 1.67, I2 = 0) when compared with statin alone. Conclusion This study showed the efficacy of combination togethers were similar but stronger than these drugs alone. Of note, a trend of high risk of muscle-related AEs by the combination of bempedoic acid and statin was observed, though it is not statistically significant, such risk is needed to be confirmed by more trials, because it is important for us to determine which is the better combinative administration for statin-intolerant patients.

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 50 (02) ◽  
pp. 93-105 ◽  
Author(s):  
Maryam Akbari ◽  
Reza Tabrizi ◽  
Kamran B. Lankarani ◽  
Seyed Taghi Heydari ◽  
Maryam Karamali ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Metabolic Diseases ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Model Assessment ◽  
Folate Supplementation ◽  
Randomized Controlled

AbstractAlthough several studies have evaluated the effect of folate supplementation on diabetes biomarkers among patients with metabolic diseases, findings are inconsistent. This review of randomized controlled trials (RCTs) was performed to summarize the evidence on the effects of folate supplementation on diabetes biomarkers among patients with metabolic diseases. Randomized-controlled trials (RCTs) published in PubMed, EMBASE, Web of Science and Cochrane Library databases up to 1 September 2017 were searched. Two review authors independently assessed study eligibility, extracted data, and evaluated risk of bias of included studies. Heterogeneity was measured with a Q-test and with I2 statistics. Data were pooled by using the fix or random-effect model based on the heterogeneity test results and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). A total of sixteen randomized controlled trials involving 763 participants were included in the final analysis. The current meta-analysis showed folate supplementation among patients with metabolic diseases significantly decreased insulin (SMD –1.28; 95% CI, –1.99, –0.56) and homeostasis model assessment of insulin resistance (HOMA-IR) (SMD –1.28; 95% CI, –1.99, –0.56). However, folate supplementation did not affect fasting plasma glucose (FPG) (SMD –0.30; 95% CI, –0.63, 0.02) and hemoglobin A1C (HbA1c) (SMD –0.29; 95% CI, –0.61, 0.03). The results of this meta-analysis study demonstrated that folate supplementation may result in significant decreases in insulin levels and HOMA-IR score, but does not affect FPG and HbA1c levels among patients with metabolic diseases.

scholarly journals Quantifying the Effect of Supplementation with Algae and Its Extracts on Glycolipid Metabolism: A Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1712
Author(s):  
Kun-xiang Ding ◽  
Tian-lin Gao ◽  
Rui Xu ◽  
Jing Cai ◽  
Hua-qi Zhang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Model Assessment ◽  
Glycolipid Metabolism ◽  
Randomized Controlled ◽  
Subgroup Analyses ◽  
The Impact

Aims: The effect of algae and its extract supplementation on glycolipid metabolism has not been finalized. Therefore, the purpose of the meta-analyses was to assess the effects of its supplementation on glycolipid metabolism concentration. Methods: We have systematically searched PubMed, Web of Science, the Cochrane Library and Embase to identify randomized controlled trials (RCTs) that investigated the impact of algae and its extracts supplementation on glycolipid metabolism. Effect size analysis was performed using weighted mean difference (WMD) and 95% CI between the methods of the experiment group and the control group. Subgroup analyses were performed to explore the possible influences of study characteristics. Publication bias and sensitivity analysis were also performed. Results: A total of 27 RCTs (31 trials) with 1221 participants were finally selected for the meta-analysis. The algae and its extract intervention significantly decreased glycosylated hemoglobin (HbA1c, WMD = −0.18%; 95% CI: −0.27 to −0.10; p < 0.001), high-density lipoprotein cholesterol (HDL-C, WMD = −0.22 mmol/L; 95% CI: −0.38 to −0.06; p = 0.008), and triglycerides (TC, WMD = −0.31 mmol/L; 95% CI: −0.37 to −0.25; p < 0.001) levels and increased insulin (WMD = 6.05 pmol/mL; 95% CI: 4.01 to 8.09; p < 0.001) levels. It did not significantly change the blood glucose, homeostasis model assessment-insulin resistance index (HOMA-IR), 2-h post-meal blood glucose (2hPBG) and other lipid profiles. Subgroup analyses based on the duration of intervention and subjects demonstrated that the intervention of algae and its extracts for 10 weeks or fewer and more than 40 subjects decreased TC levels (p < 0.05). Moreover, the intervention reduced TC and 2hPBG concentrations for East Asians (p < 0.05). Conclusions: Our findings provided evidence that algae and its extract interventions were beneficial for the regulation of human glycolipid metabolism. More precise RCTs on subjects are recommended to further clarify the effect of algae, seaweed polysaccharide, seaweed polypeptide, algae polyphenol and its products intervention on glycolipid metabolism.

scholarly journals Weekly Semaglutide vs. Liraglutide Efficacy Profile: A Network Meta-Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1125
Author(s):  
Hassan A. Alsugair ◽  
Ibrahim F. Alshugair ◽  
Turki J. Alharbi ◽  
Abdulaziz M. Bin Rsheed ◽  
Ayla M. Tourkmani ◽  
...  
Keyword(s):  
Body Weight ◽  
Glycemic Control ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Phase Iii ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Treatment Difference ◽  
Randomized Controlled

Introduction: Glucagon-like peptide 1 receptor agonist (GLP-1 RA) is a class of hypoglycemic medications. Semaglutide once-weekly (QW) and liraglutide once-daily (OD) significantly improved glycemic control compared to placebo. To date, no long-term phase III trials directly comparing semaglutide and liraglutide are available. This network meta-analysis (NMA) aims to compare the long-term efficacy of semaglutide and liraglutide. Methods: PubMed, Embase, and Cochrane Library were searched from inception until June 2019 to identify relevant articles. Nine long-term randomized controlled trials comparing once-weekly semaglutide or liraglutide with placebo or other active comparisons were identified. The outcomes of interest were changes in HbA1c and weight after 52 weeks. A Bayesian framework and NMA were used for data synthesis. This is a sub-study of the protocol registered in PROSPERO (number CRD42018091598). Results: The data showed significant superiority in HbA1c reduction of semaglutide 1 mg QW over liraglutide 1.2 and 1.8 mg with a treatment difference of 0.47% and 0.3%, respectively. Semaglutide 0.5 mg QW was found to be significantly superior to liraglutide 1.2 mg in HbA1c reduction with a treatment difference of 0.17%. Regarding weight reduction analysis, semaglutide 0.5 and 1 mg QW were significantly associated with a greater reduction than liraglutide 0.6 mg with a treatment difference of 2.42 and 3.06 kg, respectively. However, no significant reduction was found in comparison to liraglutide 1.2 and 1.8 mg. Conclusions: Semaglutide improved the control of blood glucose and body weight. The capacity of long-term glycemic control and body weight control of semaglutide appears to be more effective than other GLP-1 RAs, including liraglutide. However, considering the number of included studies and potential limitations, more large-scale, head-to-head, well-designed randomized-controlled trials (RCTs) are needed to confirm these findings.

scholarly journals The Effect of Saffron Supplementation on Blood Pressure in Adults: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2736
Author(s):  
Leila Setayesh ◽  
Damoon Ashtary-Larky ◽  
Cain C. T. Clark ◽  
Mahnaz Rezaei Kelishadi ◽  
Pardis Khalili ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Diastolic Blood Pressure ◽  
Metabolic Diseases ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Clinical Importance ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

Background: The favorable influences of saffron supplementation on metabolic diseases have previously been shown. We aimed to assess the effects of saffron supplementation on blood pressure in adults. Methods: A systematic search was performed in Scopus, Embase, and the Cochrane library databases to find randomized controlled trials (RCTs) related to the effect of saffron supplementation on blood pressure in adults up to March 2021. The primary search yielded 182 publications, of which eight RCTs were eligible. Results: Our results showed that saffron supplementation resulted in a significant decrease in systolic blood pressure (weighted mean difference (WMD): −0.65 mmHg; 95% CI: −1.12 to −0.18, p = 0.006) and diastolic blood pressure (DBP) (WMD: −1.23 mmHg; 95% CI: −1.64 to −0.81, p < 0.001). Moreover, saffron supplementation reduced DBP in a non-linear fashion, based on duration (r = −2.45, p-nonlinearity = 0.008). Conclusions: Saffron supplementation may significantly improve both systolic and diastolic blood pressure in adults. It should be noted that the hypotensive effects of saffron supplementation were small and may not reach clinical importance.

scholarly journals Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lajos Szakó ◽  
Nelli Farkas ◽  
Szabolcs Kiss ◽  
Szilárd Váncsa ◽  
Noémi Zádori ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Organ Failure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plasma Therapy ◽  
Monthly Basis ◽  
Randomized Controlled

Abstract Background Coronavirus disease 2019 (COVID-19) is an infection with possible serious consequences. The plasma of recovered patients might serve as treatment, which we aim to assess in the form of a prospective meta-analysis focusing on mortality, multi-organ failure, duration of intensive care unit stay, and adverse events. Methods A systematic search was conducted to find relevant registered randomized controlled trials in five trial registries. A comprehensive search will be done continuously on a monthly basis in MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to find the results of previously registered randomized controlled trials. The selection will be done by two independent authors. Data extraction will be carried out by two other independent reviewers. Disagreements will be resolved by a third investigator. An update of the search of the registries and the first search of the databases will be done on the 21st of July. Data synthesis will be performed following the recommendations of the Cochrane Collaboration. In the case of dichotomous outcomes (mortality and organ failure), we will calculate pooled risk ratios with a 95% confidence interval (CI) from two-by-two tables (treatment Y/N, outcome Y/N). Data from models with multivariate adjustment (hazard ratios, odds ratio, risk ratio) will be preferred for the analysis. P less than 0.05 will be considered statistically significant. In the case of ICU stay, weighted mean difference with a 95% confidence interval will be calculated. Heterogeneity will be tested with I2, and χ2 tests. Meta-analysis will be performed if at least 3 studies report on the same outcome and population. Discussion Convalescent plasma therapy is a considerable alternative in COVID-19, which we aim to investigate in a prospective meta-analysis.

scholarly journals Adjuvant Transarterial Chemoembolization Following Curative-Intent Hepatectomy Versus Hepatectomy Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Curative Intent ◽  
Randomized Controlled

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.

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