scholarly journals Dietary intakes of flavan-3-ols and cardiometabolic health: systematic review and meta-analysis of randomized trials and prospective cohort studies

2019 ◽  
Vol 110 (5) ◽  
pp. 1067-1078 ◽  
Author(s):  
Gowri Raman ◽  
Esther E Avendano ◽  
Siyu Chen ◽  
Jiaqi Wang ◽  
Julia Matson ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Cardiometabolic Risk ◽  
Meta Analysis ◽  
Hdl Cholesterol ◽  
Future Research ◽  
Cardiometabolic Health ◽  
Model Assessment ◽  
Dietary Intakes ◽  
Prospective Cohorts ◽  
Cvd Mortality

ABSTRACT Background Although available data suggest that some dietary flavan-3-ol sources reduce cardiometabolic risk, to our knowledge no review has systematically synthesized their specific contribution. Objective We aimed to examine, for the first time, if there is consistent evidence that higher flavan-3-ol intake, irrespective of dietary source, reduces cardiometabolic risk. Methods MEDLINE, Cochrane Central, and Commonwealth Agricultural Bureau abstracts were searched for prospective cohorts and randomized controlled trials (RCTs) published from 1946 to March 2019 on flavan-3-ol intake and cardiovascular disease (CVD) risk. Random-effects models meta-analysis was used. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach assessed the strength of evidence. Results Of 15 prospective cohorts (23 publications), 4 found highest compared with lowest habitual intakes of flavan-3-ols were associated with a 13% reduction in risk of CVD mortality and 2 found a 19% reduction in risk of chronic heart disease (CHD) incidence. Highest compared with lowest habitual intakes of monomers were associated with a reduction in risk of type 2 diabetes mellitus (T2DM) (n = 5) and stroke (n = 4) (10% and 18%, respectively). No association was found for hypertension. Of 156 RCTs, flavan-3-ol intervention resulted in significant improvements in acute/chronic flow-mediated dilation (FMD), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), LDL and HDL cholesterol, triglycerides (TGs), hemoglobin A1c (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR). All analyses, except HbA1c, were associated with moderate/high heterogeneity. When analyses were limited to good methodological quality studies, improvements in TC, HDL cholesterol, SBP, DBP, HOMA-IR, and acute/chronic FMD remained significant. In GRADE evaluations, there was moderate evidence in cohort studies that flavan-3-ol and monomer intakes were associated with reduced risk of CVD mortality, CHD, stroke, and T2DM, whereas RCTs reported improved TC, HDL cholesterol, SBP, and HOMA-IR. Conclusions Available evidence supports a beneficial effect of flavan-3-ol intake on cardiometabolic outcomes, but there was considerable heterogeneity in the meta-analysis. Future research should focus on an integrated intake/biomarker approach in cohorts and high-quality dose–response RCTs. This review was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42018035782.

scholarly journals Prospective association between a Mediterranean-style dietary score in childhood and cardiometabolic risk in young adults from the ALSPAC birth cohort

2021 ◽  
Author(s):  
Genevieve Buckland ◽  
Caroline M. Taylor ◽  
Pauline M. Emmett ◽  
Laura Johnson ◽  
Kate Northstone
Keyword(s):  
Young Adults ◽  
Cardiometabolic Risk ◽  
Eating Habits ◽  
Hdl Cholesterol ◽  
Cardiometabolic Health ◽  
Model Assessment ◽  
Logistic Regression Models ◽  
Arterial Blood ◽  
Parents And Children ◽  
Prospective Association

Abstract Purpose To investigate the prospective association between a children’s relative Mediterranean-style diet score (C-rMED) in childhood and a Cardiometabolic Risk (CMR) score in adolescence/young adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods A C-rMED was calculated at 7, 10 and 13 years from diet diary data. Anthropometric and biochemical data at 17 (N = 1940) and 24 years (N = 1961) were used to calculate CMR scores (sum of sex-specific log-transformed z-scores from triacylglycerol, HDL cholesterol, LDL cholesterol, mean arterial blood pressure, homeostatic model assessment of insulin resistance (HOMA-IR) and fat mass index (FMI)). Adjusted logistic regression models examined associations between C-rMED (categorical and 2-unit increments) and a high CMR score (≥ 80th percentile) and individual CMR components (≥ 80th percentile). Results A high C-rMED at 13 was associated with a 32% (OR 0.68 (95% CI: 0.49, 0.94)) decreased adjusted odds of having a high CMR score at 24 years, compared to participants with a low C-rMED. No associations were evident at other ages. Tracking of the C-rMED across the three ages showed a stronger negative association between C-rMED and CMR at 24 years when children had at least two high C-rMED scores from 7 to 13 years (adjusted OR: 0.49, 95% CI: 0.29, 0.85), compared to all low scores. FMI and HOMA-IR were the main CMR components contributing to this association. Conclusion Higher Mediterranean-style diet scores in early adolescence were associated with a better CMR profile in young adults (24 year olds). This underscores the importance of establishing healthy eating habits early in life for future cardiometabolic health.

scholarly journals Dose–Response Relation between Tea Consumption and Risk of Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis of Population-Based Studies

2020 ◽  
Vol 11 (4) ◽  
pp. 790-814 ◽  
Author(s):  
Mei Chung ◽  
Naisi Zhao ◽  
Deena Wang ◽  
Marissa Shams-White ◽  
Micaela Karlsen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Lower Risk ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Tea Consumption ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cvd Mortality

ABSTRACT Tea flavonoids have been suggested to offer potential benefits to cardiovascular health. This review synthesized the evidence on the relation between tea consumption and risks of cardiovascular disease (CVD) and all-cause mortality among generally healthy adults. PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Food Science and Technology Abstracts, and Ovid CAB Abstract databases were searched to identify English-language publications through 1 November 2019, including randomized trials, prospective cohort studies, and nested case-control (or case-cohort) studies with data on tea consumption and risk of incident cardiovascular events (cardiac or peripheral vascular events), stroke events (including mortality), CVD-specific mortality, or all-cause mortality. Data from 39 prospective cohort publications were synthesized. Linear meta-regression showed that each cup (236.6 mL)  increase in daily tea consumption (estimated 280 mg  and 338 mg  total flavonoids/d for black and green tea, respectively) was associated with an average 4% lower risk of CVD mortality, a 2% lower risk of CVD events, a 4% lower risk of stroke, and a 1.5% lower risk of all-cause mortality. Subgroup meta-analysis results showed that the magnitude of association was larger in elderly individuals for both CVD mortality (n = 4; pooled adjusted RR: 0.89; 95% CI: 0.83, 0.96; P = 0.001), with large heterogeneity (I2 = 72.4%), and all-cause mortality (n = 3; pooled adjusted RR: 0.92; 95% CI: 0.90, 0.94; P < 0.0001; I2 = 0.3%). Generally, studies with higher risk of bias appeared to show larger magnitudes of associations than studies with lower risk of bias. Strength of evidence was rated as low and moderate (depending on study population age group) for CVD-specific mortality outcome and was rated as low for CVD events, stroke, and all-cause mortality outcomes. Daily tea intake as part of a healthy habitual dietary pattern may be associated with lower risks of CVD and all-cause mortality among adults.

scholarly journals Intake of Fish and Marine n-3 Polyunsaturated Fatty Acids and Risk of Cardiovascular Disease Mortality: A Meta-Analysis of Prospective Cohort Studies

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2342
Author(s):  
Lan Jiang ◽  
Jinyu Wang ◽  
Ke Xiong ◽  
Lei Xu ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Polyunsaturated Fatty Acids ◽  
Cohort Studies ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Pufa Intake ◽  
Prospective Cohort Studies ◽  
Cvd Mortality

Previous epidemiological studies have investigated the association of fish and marine n-3 polyunsaturated fatty acids (n-3 PUFA) consumption with cardiovascular disease (CVD) mortality risk. However, the results were inconsistent. The purpose of this meta-analysis is to quantitatively evaluate the association between marine n-3 PUFA, fish and CVD mortality risk with prospective cohort studies. A systematic search was performed on PubMed, Web of Science, Embase and MEDLINE databases from the establishment of the database to May 2021. A total of 25 cohort studies were included with 2,027,512 participants and 103,734 CVD deaths. The results indicated that the fish consumption was inversely associated with the CVD mortality risk [relevant risk (RR) = 0.91; 95% confidence intervals (CI) 0.85−0.98]. The higher marine n-3 PUFA intake was associated with the reduced risk of CVD mortality (RR = 0.87; 95% CI: 0.85–0.89). Dose-response analysis suggested that the risk of CVD mortality was decreased by 4% with an increase of 20 g of fish intake (RR = 0.96; 95% CI: 0.94–0.99) or 80 milligrams of marine n-3 PUFA intake (RR = 0.96; 95% CI: 0.94–0.98) per day. The current work provides evidence that the intake of fish and marine n-3 PUFA are inversely associated with the risk of CVD mortality.

scholarly journals Dietary and circulating vitamin C, vitamin E, β-carotene and risk of total cardiovascular mortality: a systematic review and dose–response meta-analysis of prospective observational studies

2019 ◽  
Vol 22 (10) ◽  
pp. 1872-1887 ◽  
Author(s):  
Ahmad Jayedi ◽  
Ali Rashidy-Pour ◽  
Mohammad Parohan ◽  
Mahdieh Sadat Zargar ◽  
Sakineh Shab-Bidar
Keyword(s):  
Systematic Review ◽  
Vitamin E ◽  
Vitamin C ◽  
Dose Response ◽  
Observational Studies ◽  
Meta Analysis ◽  
Dietary Intakes ◽  
Relative Risks ◽  
Β Carotene ◽  
Cvd Mortality

AbstractObjectiveThe present review aimed to quantify the association of dietary intake and circulating concentration of major dietary antioxidants with risk of total CVD mortality.DesignSystematic review and meta-analysis.SettingSystematic search in PubMed and Scopus, up to October 2017.ParticipantsProspective observational studies reporting risk estimates of CVD mortality across three or more categories of dietary intakes and/or circulating concentrations of vitamin C, vitamin E and β-carotene were included. A random-effects meta-analysis was conducted.ResultsA total of fifteen prospective cohort studies and three prospective evaluations within interventional studies (320 548 participants and 16 974 cases) were analysed. The relative risks of CVD mortality for the highest v. the lowest category of antioxidant intakes were as follows: vitamin C, 0·79 (95 % CI 0·68, 0·89; I2=46 %, n 10); vitamin E, 0·91 (95 % CI 0·79, 1·03; I2=51 %, n 8); β-carotene, 0·89 (95 % CI 0·73, 1·05; I2=34 %, n 4). The relative risks for circulating concentrations were: vitamin C, 0·60 (95 % CI 0·42, 0·78; I2=65 %, n 6); α-tocopherol, 0·82 (95 % CI 0·76, 0·88; I2=0 %, n 5); β-carotene, 0·68 (95 % CI 0·52, 0·83; I2=50 %, n 6). Dose–response meta-analyses demonstrated that the circulating biomarkers of antioxidants were more strongly associated with risk of CVD mortality than dietary intakes.ConclusionsThe present meta-analysis demonstrates that higher vitamin C intake and higher circulating concentrations of vitamin C, vitamin E and β-carotene are associated with a lower risk of CVD mortality.

Abstract P240: Discrimination Mediates the Adverse Effect of Neighborhood Problems on Cardiometabolic Risk Among Latino/a Adults

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Maryam Hussain
Keyword(s):  
Sex Education ◽  
Cardiometabolic Risk ◽  
Negative Impact ◽  
High Body Mass Index ◽  
Mediating Effect ◽  
Health Study ◽  
Future Research ◽  
Cardiometabolic Health ◽  
Positive Health ◽  
Neighborhood Problems

Introduction: Latino/as in the US on average present with low high-density lipoprotein (HDL) cholesterol and high body-mass index (BMI), putting them at higher risk for future cardiometabolic disease. Neighborhoods have been implicated, directly and indirectly, in poorer cardiometabolic health among ethnic minorities. US Latino/as often live in neighborhoods where they may not have access to engage in positive health behaviors, such as proper diet and physical activity. However, the mediating role of discrimination experienced in these neighborhoods has hardly been examined within the context of Latino/a cardiometabolic health. Methods: We analyzed data from the Texas City Stress and Health Study. Participants were self-identified Latino/a/Hispanic ( N = 500, 61.8% female, M age = 49.08, SD age = 15.80) who reported on their perceived experience of discrimination (higher scores reflecting more discrimination) and their perception of their neighborhood (higher scores reflecting more positive environment) validated survey measures. A trained phlebotomist drew blood in a clinic or in the participant’s home between 8 and 11 AM after fasting for HDL (mg/dL). Blood samples were centrifuged to obtain plasma, which was stored at –70°C until testing. All specimen were batch analyzed and read blind-coded. Additionally, they took clinical measures of participant’s height and weight, to calculate BMI (adjusted for sex). To estimate the mediating effect of discrimination through perception of neighborhood on cardiometabolic risk, path analysis with bootstrapped linear regression models were conducted. We conducted analyses unadjusted and adjusted for age, sex, education, and nativity. All analyses were conducted in the PROCESS macro in SPSS. Results: Participants on average had high HDL levels ( M mg/dL = 51.00, SD = 15.59). Males on average were overweight ( M BMI = 29.78, SD = 5.49) and females ( M BMI = 31.42, SD = 7.27) on average were obese. Bootstrapped estimates showed that perception of neighborhood fully mediated the effect of discrimination on HDL (b = -.43, SE = .18 p = .015) and BMI (b = .02, SE = .01, p = .023), unadjusted for covariates. Although the fully mediated model for BMI withstood adjustment for covariates, the model for HDL did not withstand adjustment. Conclusion: Discrimination accounts for the negative impact that neighborhood problems have on poor cardiometabolic health among adult Latino/as. Future research should examine how positive neighborhood interactions (e.g., walking clubs or playgroups) can mitigate the adverse effects on cardiometabolic health among this at-risk population.

scholarly journals Food groups and intermediate disease markers: a systematic review and network meta-analysis of randomized trials

2018 ◽  
Vol 108 (3) ◽  
pp. 576-586 ◽  
Author(s):  
Lukas Schwingshackl ◽  
Georg Hoffmann ◽  
Khalid Iqbal ◽  
Carolina Schwedhelm ◽  
Heiner Boeing
Keyword(s):  
Systematic Review ◽  
Randomized Trials ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Hdl Cholesterol ◽  
Whole Grains ◽  
Red Meat ◽  
Model Assessment ◽  
Food Groups ◽  
Disease Markers

ABSTRACT Background In previous meta-analyses of prospective observational studies, we investigated the association between food groups and risk of chronic disease. Objective The aim of the present network meta-analysis (NMA) was to assess the effects of these food groups on intermediate-disease markers across randomized intervention trials. Design Literature searches were performed until January 2018. The following inclusion criteria were defined a priori: 1) randomized trial (≥4 wk duration) comparing ≥2 of the following food groups: refined grains, whole grains, nuts, legumes, fruits and vegetables, eggs, dairy, fish, red meat, and sugar-sweetened beverages (SSBs); 2) LDL cholesterol and triacylglycerol (TG) were defined as primary outcomes; total cholesterol, HDL cholesterol, fasting glucose, glycated hemoglobin, homeostasis model assessment insulin resistance, systolic and diastolic blood pressure, and C-reactive protein were defined as secondary outcomes. For each outcome, a random NMA was performed, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined. Results A total of 66 randomized trials (86 reports) comparing 10 food groups and enrolling 3595 participants was identified. Nuts were ranked as the best food group at reducing LDL cholesterol (SUCRA: 93%), followed by legumes (85%) and whole grains (70%). For reducing TG, fish (97%) was ranked best, followed by nuts (78%) and red meat (72%). However, these findings are limited by the low quality of the evidence. When combining all 10 outcomes, the highest SUCRA values were found for nuts (66%), legumes (62%), and whole grains (62%), whereas SSBs performed worst (29%). Conclusion The present NMA provides evidence that increased intake of nuts, legumes, and whole grains is more effective at improving metabolic health than other food groups. For the credibility of diet-disease relations, high-quality randomized trials focusing on well-established intermediate-disease markers could play an important role. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42018086753.

HDL cholesterol and risk of diabetic nephropathy in patient with type 1 diabetes: A meta-analysis of cohort studies

2016 ◽  
Vol 122 ◽  
pp. 84-91 ◽  
Author(s):  
Ying Chen ◽  
Yunqing Zhi ◽  
Chengqian Li ◽  
Ying Liu ◽  
Lifang Zhang ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Hdl Cholesterol

scholarly journals Ten-year change in sedentary behaviour, moderate-to-vigorous physical activity, cardiorespiratory fitness and cardiometabolic risk: independent associations and mediation analysis

2016 ◽  
Vol 52 (16) ◽  
pp. 1063-1068 ◽  
Author(s):  
Sara Knaeps ◽  
Jan G Bourgois ◽  
Ruben Charlier ◽  
Evelien Mertens ◽  
Johan Lefevre ◽  
...  
Keyword(s):  
Physical Activity ◽  
Waist Circumference ◽  
Sedentary Behaviour ◽  
Cardiorespiratory Fitness ◽  
Cardiometabolic Risk ◽  
Fasting Glucose ◽  
Vigorous Physical Activity ◽  
Hdl Cholesterol ◽  
Cardiometabolic Health ◽  
Mediation Effects

BackgroundWe aimed to study the independent associations of 10-year change in sedentary behaviour (SB), moderate-to-vigorous physical activity (MVPA) and objectively measured cardiorespiratory fitness (CRF), with concurrent change in clustered cardiometabolic risk and its individual components (waist circumference, fasting glucose, high-density lipoprotein (HDL) cholesterol, triglycerides and blood pressure). We also determined whether associations were mediated by change in CRF (for SB and MVPA), waist circumference (for SB, MVPA and CRF) and dietary intake (for SB).MethodsA population-based sample of 425 adults (age (mean±SD) 55.83±9.40; 65% men) was followed prospectively for 9.62±0.52 years. Participants self-reported SB and MVPA and performed a maximal cycle ergometer test to estimate peak oxygen uptake at baseline (2002–2004) and follow-up (2012–2014). Multiple linear regression and the product of coefficients method were used to examine independent associations and mediation effects, respectively.ResultsGreater increase in SB was associated with more detrimental change in clustered cardiometabolic risk, waist circumference, HDL cholesterol and triglycerides, independently of change in MVPA. Greater decrease in MVPA was associated with greater decrease in HDL cholesterol and increase in clustered cardiometabolic risk, waist circumference and fasting glucose, independent of change in SB. Greater decrease in CRF was associated with more detrimental change in clustered cardiometabolic risk and all individual components. Change in CRF mediated the associations of change in SB and MVPA with change in clustered cardiometabolic risk, waist circumference and, only for MVPA, HDL cholesterol. Change in waist circumference mediated the associations between change in CRF and change in clustered cardiometabolic risk, fasting glucose, HDL cholesterol and triglycerides.ConclusionsA combination of decreasing SB and increasing MVPA, resulting in positive change in CRF, is likely to be most beneficial towards cardiometabolic health.

scholarly journals Plant-Based Dietary Patterns and Cardiometabolic Risk: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 416-416
Author(s):  
Sarah Jarvis ◽  
Maria Tinajero ◽  
Tauseef Khan ◽  
Anthony Hanley ◽  
David Jenkins ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Dose Response ◽  
Prospective Cohort ◽  
Fixed Effects ◽  
Cardiometabolic Risk ◽  
Risk Of Bias ◽  
Cardiometabolic Health ◽  
Inverse Association ◽  
Prospective Cohort Studies ◽  
Meta Analyses

Abstract Objectives Plant-based diets defined by limited animal food consumption have been extensively associated with cardiometabolic health benefits in Western nations. Diet indices are increasingly used to distinguish the protective characteristics of a plant-based diet at different levels of adherence. We aimed to synthesize evidence on the association between adherence to plant-based diet indices and cardiometabolic risk. A plant-based diet index (PDI) is hypothesized to be inversely associated with type 2 diabetes (T2D) and cardiovascular disease (CVD) with a stronger association with the healthful index (hPDI) that emphasizes higher quality plant-based foods. Methods We systematically searched MEDLINE, EMBASE and CINAHL databases through January 2021. Prospective cohort studies assessing the association of plant-based diet indices with T2D and CVD in adults were included and appraised for risk of bias and quality (NutriGrade). We followed the PRISMA-P, Cochrane and MOOSE guidelines. Random and fixed-effects meta-analyses were conducted to pool risk ratios (RR) of extreme quantiles. Dose-response meta-analyses were conducted after harmonizing all diet index scores. I2-values of 30–60%, 50–90%, and 75–100% denoted moderate, substantial, and considerable heterogeneity respectively. Results We included a total of 10 studies from 5927 retrievals. Across 6 studies there were 22 135 cases of T2D over 4 817 308 person-years. Across 7 studies there were 15 077 cases of CVD over 6 117 016 person-years. The PDI was associated with a lower risk of T2D (RR = 0.82, 95% CI [0.75, 0.91], I2 = 55.4%), and CVD (RR = 0.88, 95% CI [0.8, 0.96], I2 = 16.2%). The hPDI had a stronger inverse association with T2D (RR = 0.73, 95% CI [0.68, 0.77], I2 = 84.3%) and CVD (RR = 0.8, 95% CI [0.77, 0.88], I2 = 55.9%). All dose-response relationships were linear (except hPDI with CVD). All studies had acceptable risk of bias and the quality of evidence was moderate. Conclusions Adherence to a plant-based diet was inversely associated with T2D and CVD with a stronger association for a healthful plant-based diet pattern. Since highest quantiles of the index still included moderate meat consumption, linear dose-responses emphasized potential benefits on risk of T2D and CVD with any incremental progression towards a plant-based diet. Funding Sources Nora Martin Fellowship, Ontario Graduate Scholarship.

scholarly journals Comparative Safety of Therapies for Hyperthyroidism Planning Pregnancy: A Network Meta-analysis

2020 ◽  
Author(s):  
Xiaohua Fang ◽  
Huibin Huang ◽  
Wei Lin ◽  
Jixing Liang ◽  
Junping Wen ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cohort Studies ◽  
Lower Risk ◽  
Birth Defect ◽  
Meta Analysis ◽  
Research Direction ◽  
Future Research ◽  
Retrospective Cohort Studies ◽  
Comparative Safety ◽  
Future Pregnancy

Objective: Our intention was to compare the pregnancy safety in women with hyperthyroidism seeking future pregnancy after ATD, RAI or thyroidectomy treatment and to explore the optimum treatment strategy. We hope the results will guide the choice for endocrinologists and patients, and be beneficial for promoting eugenics. Methods: We searched multiple databases though December 2019. The outcome indicators were abortion, preterm birth, IUGR and birth defect. We conducted a frequency-framework network meta-analysis by using Stata and R software. The results of the intervention comparison were expressed as OR with 95%CI, and ranking was assessed using surface under the cumulative ranking (SUCRA) probabilities. Results: The network meta-analysis included 4 retrospective cohort studies with a total enrollment of 480 patients. 1)Thyroidectomy had a lower risk of abortion than RAI [OR=0.77, 95%CI (0.23, 2.56)] and ATD [OR=0.68, 95%CI (0.21, 2.21)]. RAI had a lower risk of abortion than ATD [OR=0.88, 95%CI (0.45, 1.75)]. Based on SUCRA results, thyroidectomy (0.698) was followed by RAI (0.494), ATD (0.308). Thyroidectomy (60.7%) had the highest probability of being first compared to RAI (27.0%) and ATD (12.4%). 2)Thyroidectomy had a lower risk of preterm birth than RAI [OR=0.80, 95%CI (0.26, 2.44)] and ATD [OR=0.79, 95%CI (0.39, 1.59)]. RAI had a lower risk of preterm birth than ATD [OR=0.98, 95%CI (0.42, 2.33)]. Based on SUCRA results, thyroidectomy (0.703) was followed by RAI (0.430), ATD (0.367). Thyroidectomy (57.8%) had the highest probability of being first compared with RAI (30.5%) and ATD (11.8%). 3)Thyroidectomy had a lower risk of IUGR than RAI [OR=0.28, 95%CI (0.03, 3.02)] and ATD [OR=0.83, 95%CI (0.14, 4.86)]. RAI had a higher risk of IUGR than ATD [OR=3.02, 95%CI (0.60, 15.27)]. Based on SUCRA results, thyroidectomy (0.717) was followed by ATD (0.663), RAI (0.120). Thyroidectomy (56.6%) had the highest probability of being first compared with RAI (5.4%) and ATD (37.9%). 4)Thyroidectomy had a lower risk of birth defect than RAI [OR=0.70, 95%CI (0.02, 30.34)] and ATD [OR=0.23, 95%CI (0.01, 4.52)]. RAI had a lower risk of birth defect than ATD [OR=0.32, 95%CI (0.03, 3.12)] (Table 2). Based on SUCRA results, thyroidectomy (0.70) was followed by RAI (0.629), ATD (0.171). Thyroidectomy (55.9%) had the highest probability of being first compared with RAI (41.3%) and ATD (2.8%). Conclusion: Thyroidectomy was the optimum option for women with hyperthyroidism seeking near future pregnancy. The future research direction is to include more samples to conduct head-to-head randomized controlled trials or prospective cohort studies, establish inclusion criteria for various pre-pregnancy conditions or further subgroup analysis, and develop more acceptable, safer, and more manageable treatments that allow for the remission of both thyroid function and autoimmune abnormalities.

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