scholarly journals Effects of statin therapy on coronary plaque volume by decreasing CRP/hsCRP levels: A meta-regression of randomized controlled trials

2021 ◽  
Author(s):  
Darui Gao ◽  
Rong Hua ◽  
Dina Jiesisibieke ◽  
Yanjun Ma ◽  
Chenglong Li ◽  
...  
Keyword(s):  
Statin Therapy ◽  
Meta Analysis ◽  
Coronary Plaque ◽  
Plaque Volume ◽  
Percent Change ◽  
Randomized Controlled ◽  
Atheroma Volume ◽  
Plaque Regression ◽  
Meta Regression ◽  
Meta Regression Analysis

Background and aims: Several clinical trials have indicated that statins stabilize and reverse atherosclerotic plaque. However, different studies have provided inconsistent findings regarding mechanisms and influencing factors of plaque regression under statin therapy. In this study, meta-analysis and meta-regression were used to determine the effect of statin medication on coronary plaque volume as determined by intravenous ultrasound. Meanwhile, the impact of statins on CRP/hsCRP reduction on plaque regression was discussed. Methods: Up to May 28, 2021, a systematic PubMed, EMBASE, and Cochrane search was performed for randomized controlled trials that assessed treatment effect using total atheroma volume (TAV), percent atheroma volume (PAV), or plaque volume (PV). Only CRP/hsCRP and LDL-C values reported before and after treatment were considered. Results: 12 studies fulfilled the inclusion criteria and were included in the systematic review. Compared with control groups, meta-analysis of 15 statin-treated arms reported change of TAV/PV showed standardized mean difference (SMD) at -0.27 (95% confidence intervals [CI]: -0.42, -0.12). Meta-analysis of 7 studies reported change of PAV revealed SMD at -0.16 (95% CI: -0.29, -0.03). Meta-regression analysis revealed percent change of CRP/hsCRP statistically influences SMD in change of TAV/PVafter adjusting for percent change of LDL-C, age and gender. Meta-regression analysis showed that percent change of CRP/hsCRP statistically influences SMD in change of PAV. Conclusion: In conclusion, statin therapy is beneficial for plaque regression. Statins promote plaque regression through their anti-inflammatory ability while lowering LDL-C is unaffected. Keywords: Statins; Reduction of atherosclerosis; C-reactive protein; Randomized controlled trial; Meta-analysis

The Influence of Breastfeeding Educational Interventions on Breast Engorgement and Exclusive Breastfeeding: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 089033442110292
Author(s):  
Mega Hasanul Huda ◽  
Roselyn Chipojola ◽  
Yen Miao Lin ◽  
Gabrielle T. Lee ◽  
Meei-Ling Shyu ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Meta Analysis ◽  
Educational Interventions ◽  
Random Effects Model ◽  
Breast Pain ◽  
Randomized Controlled ◽  
Effective Components ◽  
Breastfeeding Education ◽  
Meta Regression ◽  
Meta Regression Analysis

Background Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers. Research Aims (1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs. Methods Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted. Results Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR]: 0.27, 95% CI [0.15, 0.48] p < .001), 4 days (OR: 0.16, 95% CI [0.11, 0.22], p < .001), and 5–7 days (OR: 0.24, 95% CI [0.08, 0.74], p = .013) and breast pain (standardized mean difference: −1.33, 95% CI [−2.26, −0.40]) at postpartum 4–14 days. Participants who received interventions had higher odds of exclusive breastfeeding. Breastfeeding educational interventions provided through lecture combined with skills practical effectively reduced breast engorgement (OR: 0.21; 95% CI [0.15, 0.28]; p = .001) and improved exclusive breastfeeding at postpartum 1–6 weeks (OR: 2.16; 95% CI [1.65, 2.83]; p = .001). Conclusions Breastfeeding educational interventions have been effective in reducing breast engorgement, breast pain, and improved exclusive breastfeeding. A combination of knowledge and skill-based education has been beneficial for sustaining exclusive breastfeeding by mothers.

Statins and Cancer Risk: A Literature-Based Meta-Analysis and Meta-Regression Analysis of 35 Randomized Controlled Trials

2006 ◽  
Vol 24 (30) ◽  
pp. 4808-4817 ◽  
Author(s):  
Stefanos Bonovas ◽  
Kalitsa Filioussi ◽  
Nikolaos Tsavaris ◽  
Nikolaos M. Sitaras
Keyword(s):  
Regression Analysis ◽  
Cancer Risk ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Risk Of Cancer ◽  
Statin Use

Purpose A growing body of literature suggests that statins may have chemopreventive potential against cancer. Our aim was to examine the strength of this association through a detailed meta-analysis and meta-regression analysis of randomized controlled trials (RCTs). Methods A comprehensive search for trials published up to 2005 was performed, reviews of each study were conducted, and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random- and fixed-effects models. Subgroup, sensitivity, and meta-regression analyses were also conducted. Results Thirty-five RCTs of statins for cardiovascular outcomes contributed to the analysis (n = 109,143). The degree of variability between trials was consistent with what would be expected to occur by chance alone. Statin use was not associated with a substantially increased or decreased overall risk of cancer (RR = 0.99; 95% CI, 0.94 to 1.04). Similarly, statin use did not significantly affect respiratory cancer risk (RR = 0.95; 95% CI, 0.83 to 1.09). However, the meta-regression analysis indicated that age of study participants modified the association between statin use and cancer risk (P = .003). Conclusion Our findings do not support a protective effect of statins against cancer. However, this conclusion is limited by the relatively short follow-up periods (4.5 years on average) of the studies analyzed. Thus, it is important to continue monitoring the long-term safety profiles of statins. Until then, physicians need to be vigilant in ensuring that statin use remains restricted to the approved indications.

scholarly journals The Relationship Between Whole Grain Intake and Body Weight: Results of Meta-analyses of Observational Studies and Randomized Controlled Trials (FS18-07-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kevin Maki ◽  
Orsolya Palacios ◽  
Katie Koecher ◽  
Caleigh Sawicki ◽  
Kara Livingston ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Observational Studies ◽  
Weight Status ◽  
Meta Analysis ◽  
Whole Grain ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
The Relationship

Abstract Objectives To analyze data from observational studies and randomized controlled trials (RCTs) reporting on the relationship between whole grain (WG) intake and weight status. Methods A systematic literature search was conducted, using Ovid/Medline, to identify observational studies and RCTs assessing WG food intake and weight status in adults. Meta-regression analysis was used to derive pooled estimates from cross-sectional studies, and a meta-analysis with random effects modeling was used to derive pooled estimates from RCTs. Prospective cohort results were assessed qualitatively since differences in methods and outcomes prevented completion of a pooled analysis. Results Eleven publications (12 studies; 136,834 subjects) were included in the meta-regression analysis of cross-sectional data, 8 publications (9 studies; 973 subjects) were included in the meta-analysis of RCTs, and 6 publications were reviewed for qualitative assessment of prospective cohort data. RCT intervention lengths ranged from 12–16 weeks, and WG intake from foods ranged from 32–215 g/d in the WG intervention groups. Meta-regression of cross-sectional studies indicated a significant, inverse correlation between body mass index (BMI) and intake of WG from food: weighted slope −0.0141 kg/m2 per g/d [95% confidence interval (CI): −0.0207, −0.0077; r = −0.526, P = 0.0001]. Meta-analysis of data from RCTs showed a non-significant pooled standardized effect size of −0.049 kg (95% CI −0.297, 0.199, P = 0.698) for the mean difference in weight change for the WG intervention groups compared with controls. No significant differences were observed for secondary variables, including waist circumference and % body fat. Prospective cohort results generally showed inverse associations between weight change and baseline WG intake and change in WG intake over follow-up periods of 5 to 20 years. Conclusions Higher WG intake is significantly inversely associated with BMI in observational studies, but results from RCTs do not show an effect of WG intake on change in weight over periods of up to 16 weeks. RCTs with longer intervention periods are needed to further investigate the potential for WG intake to influence body weight and related anthropometrics. Funding Sources General Mills, Inc., Minneapolis, MN.

scholarly journals The effects of lipid-lowering therapy on coronary plaque regression: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yingrui Li ◽  
Songbai Deng ◽  
Bin Liu ◽  
Yulin Yan ◽  
Jianlin Du ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Final Analysis ◽  
Coronary Plaque ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Target Level ◽  
Plaque Volume ◽  
Lowering Therapy ◽  
Plaque Regression

AbstractTo assess the influence of lipid-lowering therapy on coronary plaque volume, and to identify the LDL and HDL targets for plaque regression to provide a comprehensive overview. The databases searched (from inception to 15 July 2020) to identify prospective studies investigating the impact of lipid-lowering therapy on coronary plaque volume and including quantitative measurement of plaque volume by intravascular ultrasound after treatment. Thirty-one studies that included 4997 patients were selected in the final analysis. Patients had significantly lower TAV (SMD: 0.123 mm3; 95% CI 0.059, 0.187; P = 0.000) and PAV (SMD: 0.123%; 95% CI 0.035, 0.212; P = 0.006) at follow-up. According to the subgroup analyses, TAV was significantly reduced in the LDL < 80 mg/dL and HDL > 45 mg/dL group (SMD: 0.163 mm3; 95% CI 0.092, 0.234; P = 0.000), and PAV was significantly reduced in the LDL < 90 mg/dL and HDL > 45 mg/dL group (SMD: 0.186%; 95% CI 0.081, 0.291; P = 0.001).Thirty-one studies that included 4997 patients were selected in the final analysis. Patients had significantly lower TAV (SMD: 0.123 mm3; 95% CI 0.059, 0.187; P = 0.000) and PAV (SMD: 0.123%; 95% CI 0.035, 0.212; P = 0.006) at follow-up. According to the subgroup analyses, TAV was significantly reduced in the LDL < 80 mg/dL and HDL > 45 mg/dL group (SMD: 0.163 mm3; 95% CI 0.092, 0.234; P = 0.000), and PAV was significantly reduced in the LDL < 90 mg/dL and HDL > 45 mg/dL group (SMD: 0.186%; 95% CI 0.081, 0.291; P = 0.001). Our meta-analysis suggests that not only should LDL be reduced to a target level of < 80 mg/dL, but HDL should be increased to a target level of > 45 mg/dL to regress coronary plaques.Trial Registration PROSPERO identifier: CRD42019146170.

scholarly journals The Body Weight Alteration and Incidence of Neoplasm in Patients With Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 11 ◽  
Author(s):  
Chu Lin ◽  
Xiaoling Cai ◽  
Wenjia Yang ◽  
Fang Lv ◽  
Lin Nie ◽  
...  
Keyword(s):  
Weight Change ◽  
Weight Reduction ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Uterine Neoplasm ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Reduced Risk

ObjectiveWhether hypoglycemic treatments with weight-alternating effects influence the incidence of neoplasm in type 2 diasbetes (T2D) remains uncertain. Therefore, we performed a meta-analysis to assess the association between the weight alteration and incidence of neoplasm in patients with T2D.Research Design and MethodsSystematic searches were conducted for studies published between the inception of 1950s and September 2019. Randomized controlled trials conducted in T2D patients with at least 48-week follow-up, significant weight change difference between treatment arms and reports of neoplasm events were included. Fixed-effects model and meta-regression analysis were accordingly used.ResultsIn all, 46 studies were included. Analysis indicated weight reduction was not associated with a decreased incidence of neoplasm (OR = 1.01, 95% CI, 0.96 to 1.07, I2 = 17%) and weight elevation was not associated with an increased incidence of neoplasm (OR = 0.91, 95% CI, 0.76 to 1.09, I2 = 0%). Meta-regression analysis showed a slower weight reduction rate (β = −5.983, 95% CI, −11.412 to 0.553, P = 0.03) instead of weight change difference (β = −0.030, 95% CI, −0.068 to 0.007, P = 0.115) was significantly associated with reduced risk of neoplasm in patients with T2D. Moreover, a decreased incidence of prostate, bladder, and uterine neoplasm was observed in T2D patients with weight reduction difference while an increased incidence of thyroid neoplasm was found in glucagon-like peptide-1 receptor analog (GLP-1RA) users with weight reduction difference.ConclusionsAdditional weight change achieved by current hypoglycemic agents or strategies in short and medium periods was not associated with incidence of most neoplasm in patients with T2D. However, a decreased incidence of prostate, bladder, and uterine neoplasm was shown in T2D patients with weight reduction difference while an increased risk of thyroid neoplasm was observed in T2D patients on GLP-1RA treatments with weight reduction difference. A more sustained and persistent weight reduction process may confer reduced risk of neoplasm in patients with T2D.

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