P–639 The role of chronic inflammation in polycystic ovarian syndrome – a systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Amer ◽  
S Aboeldalyl ◽  
L Snell ◽  
H Shawky ◽  
E Seyam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Inflammation ◽  
Molecular Mechanisms ◽  
Polycystic Ovarian Syndrome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Low Grade ◽  
High Quality ◽  
Ovarian Syndrome

Abstract Study question Is polycystic ovarian syndrome (PCOS) associated with chronic inflammation as determined by elevated serum C-reactive protein (CRP) level independent of obesity? Summary answer: Circulating CRP is moderately elevated in women with PCOS (independent of obesity), which is indicative of low-grade chronic inflammation. What is known already Although current literature associates polycystic ovarian syndrome (PCOS) with chronic inflammation, the evidence for this link remains inconclusive and its causal nature remains unclear. A systematic review and meta-analysis involving 31 studies was published on this topic in 2011 providing evidence for increased circulating CRP (96% higher than controls). However, since that review there have been over 100 published studies assessing CRP in PCOS women utilising more advanced CRP assays. Study design, size, duration This systematic review involved an extensive search of electronic databases for studies investigating CRP and other inflammatory makers in PCOS women from January 2000 to March 2020. Searched databases included PUBMED, EMBASE and MEDLINE, SCOPUS, DynaMed plus, TRIP, ScienceDirect and Cochrane Library. Inclusion criteria were using Rotterdam criteria for PCOS diagnosis, measuring CRP with high-sensitivity assay, matching/adjusting participants for BMI, and including drug naïve participants who were free from conditions that could affect inflammatory markers. Participants/materials, setting, methods The review included all studies comparing circulating CRP between women with and without PCOS. Articles’ quality and risk of bias were assessed using modified Newcastle-Ottawa scale. CRP data were extracted from eligible studies and entered into RevMan software for calculation of standardized mean difference (SMD) and 95% Confidence Interval (CI). Sensitive analysis was performed for high-quality studies providing data for non-obese participants. Main results and the role of chance The systematic review included 95 eligible studies (n = 10,074), of which 68 (n = 7991) were included in a meta-analysis. Sixty-two of the 95 studies reported significantly higher circulating CRP in PCOS women (n = 5235) versus controls (n = 4839). The remaining studies showed no statistically significant differences between the two groups after adjusting for BMI. Pooled analysis of 68 studies revealed significantly higher circulating CRP in PCOS women (SMD 1.26, 95%CI, 1.01, 1.52; z = 9.60; p = 0.00001; I²=96%). Sensitivity meta-analysis for non-obese women in 37 high-quality studies showed significantly higher circulating CRP in PCOS women versus controls (SMD 1.84, 95%CI, 1.40, 2.28; z = 8.19; p < 0.00001; I²=97%). Circulating TNF- α was measured in 13 studies, of which seven reported higher levels in PCOS women versus controls and six showed no difference. Circulating IL–6 was measured in 19 articles, of which eight reported significantly higher levels in PCOS women versus controls and 11 found no difference. Four studies (n = 512) reported increased white cell count in PCOS women (n = 323) compared with healthy controls (n = 189). Nine studies (n = 922) assessed circulating adiponectin, with seven showing significantly lower levels in PCOS women (n = 368) versus controls and one showing no difference. Meta-analysis of four of these studies (n = 355) revealed a SMD –1.48 (95% CI; –2.48,-.14). Limitations, reasons for caution High heterogeneity between studies and the small size of several studies are the main limitations. Heterogeneity is due to variation in laboratory methods used to measure CRP and variations between participants e.g. age, BMI and PCOS phenotypes. Sensitivity and sub-group analysis were performed to address this heterogeneity. Wider implications of the findings: Further research is required to understand the underlying molecular mechanisms and the pathophysiological role of chronic inflammation in PCOS. This could potentially identify targets for new treatments that could improve short- and long-term health problems associated with PCOS. Trial registration number N/A

scholarly journals The Role of Chronic Inflammation in Polycystic Ovarian Syndrome—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 22 (5) ◽  
pp. 2734
Author(s):  
Shaimaa Aboeldalyl ◽  
Cathryn James ◽  
Emaduldin Seyam ◽  
Emad Moussa Ibrahim ◽  
Hossam El-Din Shawki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Inflammation ◽  
Polycystic Ovarian Syndrome ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Low Grade ◽  
Obese Women ◽  
Inflammatory Status ◽  
Ovarian Syndrome

Although the current literature associates polycystic ovarian syndrome (PCOS) with chronic inflammation, the evidence for this link remains inconclusive and its causal nature remains unclear. The purpose of this systematic review was to assess the inflammatory status in PCOS women and to determine whether it is related to PCOS or to its associated adiposity. We searched electronic databases including PUBMED, EMBASE and MEDLINE, SCOPUS, DynaMed plus, TRIP, ScienceDirect and Cochrane Library, for studies investigating C-reactive protein (CRP) and other inflammatory makers in PCOS women versus healthy controls. Quality and risk of bias for selected studies were assessed using the modified Newcastle–Ottawa scale. CRP data were extracted and pooled using RevMan for calculation of the standardized mean difference (SMD) and 95% confidence interval (CI). Eighty-five eligible studies were included in the systematic review, of which 63 were included in the meta-analysis. Pooled analysis of the 63 studies revealed significantly higher circulating CRP in PCOS women (n = 4086) versus controls (n = 3120) (SMD 1.26, 95%CI, 0.99, 1.53). Sensitivity meta-analysis of 35 high quality studies including non-obese women showed significantly higher circulating CRP in PCOS women versus controls (SMD 1.80, 95%CI, 1.36, 2.25). In conclusion, circulating CRP is moderately elevated in PCOS women independent of obesity, which is indicative of low-grade chronic inflammation.

scholarly journals Association between melatonin receptor gene polymorphisms and polycystic ovarian syndrome: a systematic review and meta-analysis

2020 ◽  
Vol 40 (6) ◽  
Author(s):  
Shiqi Yi ◽  
Jiawei Xu ◽  
Hao Shi ◽  
Wenbo Li ◽  
Qian Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Single Nucleotide Polymorphisms ◽  
Polycystic Ovarian Syndrome ◽  
Meta Analysis ◽  
Genetic Models ◽  
Cochrane Library ◽  
Nucleotide Polymorphisms ◽  
Melatonin Receptor ◽  
Single Nucleotide ◽  
Ovarian Syndrome

Abstract Background: Polycystic ovarian syndrome (PCOS) is a kind of common gynecological endocrine disorder. And the mutations of melatonin receptor (MTNR) genes are related to the occurrence of PCOS. But previous researches have shown opposite results. So, the object of our systematic review and meta-analysis is to investigate the relationship between MTNR 1A/B polymorphisms and PCOS. Methods: PubMed, Embase, Ovid, the Cochrane Library, Web of Science and three Chinese databases (VIP, CNKI and Wanfang) were used to retrieve eligible articles published between January 1980 and February 2020. And we used the odds ratio (OR) and its 95% confidence interval (CI) to investigate the strength of the association by six genetic models, allelic, codominant (homozygous and heterozygous), dominant, recessive and superdominant models. Review Manager 5.3, IBM SPSS statistics 25 and Stata MP 16.0 software were used to do this meta-analysis. Results: Our meta-analysis involved 2553 PCOS patients and 3152 controls, for two single nucleotide polymorphisms (rs10830963 C> G in MTNR1B and rs2119882 T> C in MTNR1A) and significant associations were found in some genetic models of these single nucleotide polymorphisms (SNPs). For rs10830963, strongly significant was found in the heterozygote model (GC vs. CC, P=0.02). Additionally, a slight trend was detected in the allelic (G vs. C), homozygote (GG vs. CC) and dominant (GG+GC vs. CC) model of rs10830963 (P=0.05). And after further sensitivity analysis, a study with high heterogeneity was removed. In the allelic (P=0.000), homozygote (P=0.001), dominant (P=0.000) and recessive (GG vs. GC+CC, P=0.001) model, strong associations between rs10830963 and PCOS were found. Moreover, for rs2119882, five genetic models, allelic (C vs. T, P=0.000), codominant (the homozygote (CC vs. TT, P=0.000) and heterozygote model (CT vs. TT, P=0.02), dominant (CC + CT vs. TT, P=0.03) and recessive model (CC vs. CT + TT, P=0.000) showed significant statistical associations with PCOS. Conclusion: MTNR1B rs10830963 and MTNR1B rs2119882 polymorphisms are associated with PCOS risk. However, the above conclusions still require being confirmed by much larger multi-ethnic studies.

scholarly journals Quantifying the benefit of chemotherapy and radiation in low-grade glioma: A systematic review and meta-analysis of numbers needed to treat.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 2057-2057
Author(s):  
Timothy J Brown ◽  
Daniela Annenelie Bota ◽  
Elizabeth A. Maher ◽  
Dawit Gebremichael Aregawi ◽  
Linda M. Liau ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Low Grade Glioma ◽  
Survival Advantage ◽  
Quality Data ◽  
Low Grade ◽  
High Quality ◽  
Quality Class ◽  
Numbers Needed To Treat

2057 Background: The optimal role of chemotherapy and radiation (RT) in adult low-grade glioma (LGG, WHO grade 1 & 2) is unclear. We conducted a systematic review and study-level meta-analysis of the literature on overall survival (OS) and progression free survival (PFS) in patients with LGG. Methods: Pubmed was queried with MeSH terms. All comparative studies of adults with newly diagnosed, supratentorial LGG were included. Comparisons of interest were OS and PFS at 2, 5, and 10 years in chemotherapy versus no chemotherapy and early RT versus delayed or no RT. Data were extracted from studies and synthesized with a random effects model. Quality of evidence was determined by American Academy of Neurology criteria and further analysis was performed, separating high quality (class I and II) from low quality (class III and IV) evidence. Numbers needed to treat (NNT) were determined from the risk difference. Results: 1531 articles were screened; 18 studies were included. Chemotherapy was not associated with a significant survival advantage compared to control. However, an analysis of high quality data revealed a survival advantage at 10 years associated with chemotherapy compared to control with NNT 5 (relative risk death chemo vs control 0.69 [0.56-0.86] p = 0.0006). Furthermore, NNT to prevent one progression with chemotherapy at 5 and 10 years was 6 and 3, respectively. Early RT was not associated with an OS advantage compared to control. However, early RT had progression benefit at all time points, with NNT of 10, 6, and 5 at 2, 5, and 10 years. Conclusions: Further study will be needed to confirm the optimal role of chemotherapy and RT. Caution must be used in interpretation as much of the literature consists of low-quality studies. [Table: see text]

scholarly journals Prognostic Role of miR-221 and miR-222 Expression in Cancer Patients: A Systematic Review and Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 970 ◽  
Author(s):  
Gloria Ravegnini ◽  
Sarah Cargnin ◽  
Giulia Sammarini ◽  
Federica Zanotti ◽  
Justo Lorenzo Bermejo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Fine Tuning ◽  
High Expression ◽  
Cochrane Library ◽  
Published Data ◽  
Significant Heterogeneity ◽  
Free Survival

Background: A wealth of evidence has shown that microRNAs (miRNAs) can modulate specific genes, increasing our knowledge on the fine-tuning regulation of protein expression. miR-221 and miR-222 have been frequently identified as deregulated across different cancer types; however, their prognostic significance in cancer remains controversial. In view of these considerations, we performed an updated systematic review and meta-analysis of published data investigating the effects of miR-221/222 on overall survival (OS) and other secondary outcomes among cancer patients. A systematic search of PubMed, Web of Knowledge, and Cochrane Library databases was performed. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to assess the strength of association. Results: Fifty studies, analyzing 6086 patients, were included in the systematic review. Twenty-five studies for miR-221 and 17 studies for miR-222 which assessed OS were included in the meta-analysis. High expression of miR-221 and miR-222 significantly predicted poor OS (HR: 1.48, 95% CI: 1.14–1.93, p = 0.003 and HR: 1.90, 95% CI: 1.43–2.54, p < 0.001, respectively). Subgroup analysis revealed that the finding on miR-221 was not as robust as the one on miR-222. Furthermore, high miR-222 expression was also associated with worse progression-free survival and disease-free survival pooled with recurrence-free survival. Conclusions: The meta-analysis demonstrated that high expression of miR-222 is associated with poor prognosis in cancer patients, whereas the significance of miR-221 remains unclear. More work is required to fully elucidate the role of miR-221 and miR-222 in cancer prognosis, particularly in view of the limitations of existing results, including the significant heterogeneity and limited number of studies for some cancers.

scholarly journals Prognostic Role of Tissue and Circulating MicroRNA-200c in Malignant Tumors: a Systematic Review and Meta-Analysis

2015 ◽  
Vol 35 (3) ◽  
pp. 1188-1200 ◽  
Author(s):  
Yingjie Shao ◽  
Yiting Geng ◽  
Wendong Gu ◽  
Jin Huang ◽  
Honglei Pei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Malignant Tumors ◽  
Early Stage ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Circulating Microrna ◽  
Prognostic Role ◽  
Altered Expression ◽  
High Level

Background: Recently, many studies have shown that microRNAs (miRNA) exhibit altered expression in various cancers and may serve as prognostic biomarkers. We performed a systematic review and meta-analysis to evaluate the prognostic role of miR-200c expression in different cancers. Methods: Studies were recruited by searching PubMed, Embase and the Cochrane Library (last search update was May 2014) and assessed by further quality evaluation. Results: A total of 25 studies dealing with various carcinomas were identified for systematic review. Among them, 18 studies were ultimately included in the meta-analysis. Our results indicated that the expression of tissue miR-200c was not associated with OS and PFS in various carcinomas; however, downregulation of tissue miR-200c did predict poor OS of patients with stage I disease (HR=0.41, 95% CI 0.25-0.68, P=0.001). Furthermore, overexpression of blood miR-200c was significantly related to poor OS and PFS (HR=3.07 95% CI 1.58-5.96 P=0.001, HR=2.26 95% CI 1.66-3.08 P<0.001, respectively), especially in patients with advanced disease. Conclusion: This systematic review and meta-analysis clarified that low expression of miR-200c in primary tissue was significantly associated with poor survival in cancer patients at early stage, whereas a high level of blood miR-200c predicted poor prognosis in patients with advanced tumors.

scholarly journals Acupuncture-Related Therapies for Parkinson's Disease: A Meta-Analysis and Qualitative Review

2021 ◽  
Vol 13 ◽  
Author(s):  
Xiaopeng Wen ◽  
Kunbin Li ◽  
Hao Wen ◽  
Qian Wang ◽  
Zhiyuan Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Hamilton Depression Scale ◽  
High Quality ◽  
Conventional Medication

Objective: This systematic review and meta-analysis aimed to assess the effects of the combination of acupuncture-related therapies with conventional medication compared with conventional medication in patients with Parkinson's disease (PD).Methods: A literature search within eight databases [including Medline, Embase, the Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP, and Wanfang Database] was performed covering a time frame from their inception to August 2020. Randomized controlled trials (RCTs) comparing acupuncture-related therapies combined with conventional medication vs. conventional medication in patients with PD were eligible. Two authors independently assessed the risk of bias. Assessments were performed with the total and subscales scores of the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), the dosage of Madopar, Mini-Mental State Examination (MMSE), and 17-item Hamilton Depression Scale (HAMD). Data were analyzed by adopting the Cochrane Collaboration's RevMan 5.4 (Review Man, Copenhagen, Denmark); and mean effect sizes and 95% confidence intervals were estimated. Tests for heterogeneity were used to assess differences in treatment effects across different types of acupuncture used.Results: Sixty-six trials met the inclusion criteria, of which 61 trials provided data for the meta-analysis. We defined high-quality articles as those with a low risk of bias in four or more domains; and only 10 (15.15%) articles were of high quality. Compared with the controls, acupuncture-related therapies with conventional medication achieved a benefit in the primary outcomes of UPDRS (motor subscore: −3.90, −4.33 to −3.49, P &lt; 0.01; total score: −7.37 points, −8.91 to −5.82, P &lt; 0.001; activities of daily living subscore: −3.96, −4.96 to −2.95, P &lt; 0.01). For the subgroup difference test among the effects of different acupuncture methods, significant differences existed in outcomes with the UPDRS-III, UPDRS-I, UPDRS-IV, and PDQ-39 scores and Madopar dosage, while non-significant differences existed with the UPDRS-total, UPDRS-II, HAMD, and MMSE scores.Conclusions: Acupuncture-related therapies combined with conventional medication may benefit individuals with PD. Our review findings should be considered with caution because of the methodological weaknesses in the included trials. Future, large randomized trials of acupuncture-related therapies for PD with high methodological quality are warranted.Systematic Review Registration: Identifier CRD42021228110.

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