scholarly journals Association between Sarcopenia and Renal Function in Patients with Diabetes: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Satoshi Ida ◽  
Ryutaro Kaneko ◽  
Kanako Imataka ◽  
Kazuya Murata
Keyword(s):  
Renal Function ◽  
Protein Level ◽  
Observational Studies ◽  
Meta Analysis ◽  
Albumin Level ◽  
Urinary Albumin ◽  
Urinary Protein ◽  
Urinary Protein Level ◽  
Patients With Diabetes ◽  
Meta Analyses

Previous studies involving patients with diabetes have indicated that sarcopenia is related to renal function. The objective of the present study was to investigate the association between sarcopenia and urinary albumin level, urinary protein level, and estimated glomerular filtration rate (eGFR) in patients with diabetes. A meta-analysis of observational studies was conducted. A literature search was performed using MEDLINE, Cochrane Controlled Trials Registry, and ClinicalTrials.gov. Data were extracted from studies investigating the association between sarcopenia and urinary albumin level, urinary protein level, and eGFR and by calculating odds ratio (OR) and 95% confidence intervals (CIs). Statistical analysis was performed using a random-effects model to calculate pooled OR and 95% CI. Six studies (2662 patients) that met the criteria were included in the meta-analysis. Sarcopenia was significantly associated with urinary albumin level with a pooled OR of 2.11 (95% CI, 1.55–2.88; P<0.001). The pooled ORs of the associations between sarcopenia and urinary protein level and decreased eGFR were 1.82 (95% CI, 1.13–2.92; P=0.01) and 3.75 (95% CI, 1.24–11.41), respectively. Sarcopenia was significantly associated with urinary albumin level, urinary protein level, and decreased eGFR. However, further investigations are needed, including meta-analyses with a larger number of studies.

scholarly journals Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xinyu Yu ◽  
Ling Li ◽  
Liangtao Xia ◽  
Xin Feng ◽  
Fan Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Patients With Diabetes ◽  
Latent Tb Infection ◽  
Meta Analyses ◽  
Diabetes Mellitus Treatment ◽  
The Impact

Abstract Background Tuberculosis (TB) remains one of the infectious diseases with a leading cause of death among adults worldwide. Metformin, a first-line medication for the treatment of type 2 diabetes, may have potential for treating TB. The aims of the present systematic review were to evaluate the impact of metformin prescription on the risk of tuberculosis diseases, the risk of latent TB infection (LTBI) and treatment outcomes of tuberculosis among patients with diabetic mellitus. Methods Databases were searched through March 2019. Observational studies reporting the effect of metformin prescription on the risk and treatment outcomes of TB were included in the systematic review. We qualitatively analyzed results of included studies, and then pooled estimate effects with 95% confidence intervals (CIs) of different outcome using random-effect meta-analyses. Results This systematic review included 6980 cases from 12 observational studies. The meta-analysis suggested that metformin prescription could decrease the risk of TB among diabetics (pooled odds ratio [OR], 0.38; 95%CI, 0.21 to 0.66). Metformin prescription was not related to a lower risk of LTBI (OR, 0.73; 95%CI, 0.30 to 1.79) in patients with diabetes. Metformin medication during the anti-tuberculosis treatment is significantly associated with a smaller TB mortality (OR, 0.47; 95%CI, 0.27 to 0.83), and a higher probability of sputum culture conversion at 2 months of TB disease (OR, 2.72; 95%CI, 1.11 to 6.69) among patients with diabetes. The relapse of TB was not statistically reduced by metformin prescription (OR, 0.55; 95%CI, 0.04 to 8.25) in diabetics. Conclusions According to current observational evidence, metformin prescription significantly reduced the risk of TB in patients with diabetes mellitus. Treatment outcomes of TB disease could also be improved by the metformin medication among diabetics.

scholarly journals Gender Differences in Genetic Associations of RAB38 with Urinary Protein-to-Creatinine Ratio (UPCR) Levels in Diabetic Nephropathy Patients

2020 ◽  
Vol 10 (4) ◽  
pp. 184
Author(s):  
Zhi-Lei Yu ◽  
Chung-Shun Wong ◽  
Yi Ting Lai ◽  
Wan-Hsuan Chou ◽  
Imaniar Noor Faridah ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Meta Analysis ◽  
Urinary Albumin ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Genetic Associations ◽  
Male Population ◽  
Patients With Diabetes ◽  
European Populations

Renal dysfunction is common in patients with diabetes mellitus (DM). Previous findings from a meta-analysis of GWAS indicated that the variation of RAB38/CTSC is highly associated with the urinary albumin-to-creatinine ratio (UACR) in European populations. In addition, RAB38 knockout rats showed an increase in urinary albumins. Although the prevalence of chronic kidney disease is high in Taiwan, the role of genetic variants in diabetic renal function is still unclear. In the current study, 275 diabetic nephropathy (DN) patients were recruited to perform a genetic association study. Our results indicated that rs1027027, rs302647, and rs302646 in RAB38 were significantly associated with urinary protein-to-creatinine ratio (UPCR) levels in DN patients. Importantly, after analysis stratified by gender, a significant genetic influence on UPCR levels was observed in the male population. The findings confirmed the roles of gender and variants of RAB38 in the risk of UPCR in Diabetic Nephropathy patients.

Arthrodesis of First Metatarsophalangeal Joint by Plate and Screws for Treatment of Hallux Rigidus (Systematic Review and Meta-Analysis)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ossama Abdelraoof El Shazly ◽  
Mohamed Mokhtar Abdellah ◽  
Mostafa Abdelnabee Abouzaid
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Superficial Infection ◽  
First Metatarsophalangeal Joint ◽  
Non Union ◽  
Meta Analyses

Abstract Background With continued loss of dorsiflexion of the 1st MTP, degenerative changes occur within the joint with severe restriction of movement and increase in pain, which leads to the condition known as hallux rigidus. The amount of dorsiflexion may be reduced to 0-10 degrees with pain on both active and passive motion. Objectives Systematically reviewing available evidence from published articles to assess the effectiveness of arthrodesis of first metatarsophalangeal joint by plate and screws in hallux rigidus. The assessment also would encompass safety, side effects, and complications of this mode of treatment. Materials and Methods We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. Results Previous results for arthrodesis have been favourable with a union rate of almost 96%. In the present systematic review and meta-analysis, the overall effect estimates showed that the union rates after plate and screw arthrodesis for 1st MTPJ was 96.2% (95% CI 94 – 98.4%). In addition, the overall effect estimates showed that the non-union rates after plate and screw arthrodesis for 1st MTPJ was 4.2% (95% CI 2.4 – 6.1%). Moreover, the overall effect estimates showed that the satisfaction rates after plate and screw arthrodesis for 1st MTPJ was 94.5% (95% CI 90 – 99%). In the present study, the overall effect estimates showed that the overall complications rate after plate and screw arthrodesis for 1st MTPJ was 7.2% (95% CI 2.5 – 12%). The overall effect estimates showed that the malunion rates after plate and screw arthrodesis for 1st MTPJ was 2.7% (95% CI 0 – 6.4%). Additionally, the overall effect estimates showed that the hardware removal and superficial infection rates after plate and screw arthrodesis for 1st MTPJ were 2% and 2.9%, respectively. Conclusion Our analysis showed that plate and screws fixation is effective techniques that can be used for first MTPJ arthrodesis in patients with hallux rigidus. We found that the screw and plate fixation has a significantly lower rate of nonunion compared with the screw alone, as reported by the literature. However, owing to the small group sizes and methodologic shortcomings, we were unable to identify the clinically superior fixation technique for first MTPJ arthrodesis arthrodesis.

Dietary saturated fat and heart disease: a narrative review

2019 ◽  
Vol 78 (6) ◽  
pp. 474-485 ◽  
Author(s):  
Jeffery L Heileson
Keyword(s):  
Heart Disease ◽  
Randomized Controlled Trials ◽  
Observational Studies ◽  
Meta Analysis ◽  
Saturated Fat ◽  
Heart Association ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Disease Outcomes ◽  
Meta Analyses

Abstract The American Heart Association (AHA) recently published a meta-analysis that confirmed their 60-year-old recommendation to limit saturated fat (SFA, saturated fatty acid) and replace it with polyunsaturated fat to reduce the risk of heart disease based on the strength of 4 Core Trials. To assess the evidence for this recommendation, meta-analyses on the effect of SFA consumption on heart disease outcomes were reviewed. Nineteen meta-analyses addressing this topic were identified: 9 observational studies and 10 randomized controlled trials. Meta-analyses of observational studies found no association between SFA intake and heart disease, while meta-analyses of randomized controlled trials were inconsistent but tended to show a lack of an association. The inconsistency seems to have been mediated by the differing clinical trials included. For example, the AHA meta-analysis only included 4 trials (the Core Trials), and those trials contained design and methodological flaws and did not meet all the predefined inclusion criteria. The AHA stance regarding the strength of the evidence for the recommendation to limit SFAs for heart disease prevention may be overstated and in need of reevaluation.

scholarly journals E-Cigarette Use and Adult Cigarette Smoking Cessation: A Meta-Analysis

2020 ◽  
pp. e1-e17
Author(s):  
Richard J. Wang ◽  
Sudhamayi Bhadriraju ◽  
Stanton A. Glantz
Keyword(s):  
Public Health ◽  
Smoking Cessation ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Adult Population ◽  
Consumer Products ◽  
Cigarette Use ◽  
Quit Smoking ◽  
Meta Analyses

Objectives. To determine the association between e-cigarette use and smoking cessation. Methods. We searched PubMed, Web of Science Core Collection, and EMBASE and computed the association of e-cigarette use with quitting cigarettes using random effects meta-analyses. Results. We identified 64 papers (55 observational studies and 9 randomized clinical trials [RCTs]). In observational studies of all adult smokers (odds ratio [OR] = 0.947; 95% confidence interval [CI] = 0.772, 1.160) and smokers motivated to quit smoking (OR = 0.851; 95% CI = 0.684, 1.057), e-cigarette consumer product use was not associated with quitting. Daily e-cigarette use was associated with more quitting (OR = 1.529; 95% CI = 1.158, 2.019) and less-than-daily use was associated with less quitting (OR = 0.514; 95% CI = 0.402, 0.665). The RCTs that compared quitting among smokers who were provided e-cigarettes to smokers with conventional therapy found e-cigarette use was associated with more quitting (relative risk = 1.555; 95% CI = 1.173, 2.061). Conclusions. As consumer products, in observational studies, e-cigarettes were not associated with increased smoking cessation in the adult population. In RCTs, provision of free e-cigarettes as a therapeutic intervention was associated with increased smoking cessation. Public Health Implications. E-cigarettes should not be approved as consumer products but may warrant consideration as a prescription therapy. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e17. https://doi.org/10.2105/AJPH.2020.305999 )

scholarly journals Efficacy and Safety of Direct Oral Anticoagulants in Patients with Diabetes and Nonvalvular Atrial Fibrillation: Meta-Analysis of Observational Studies

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Bo Cao ◽  
Xingcan Yao ◽  
Lifang Zhang ◽  
Xiaobo Hu ◽  
Min Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Observational Studies ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Efficacy And Safety ◽  
Nonvalvular Atrial Fibrillation ◽  
Patients With Diabetes

Background. This meta-analysis was performed to compare the efficacy and safety of direct oral anticoagulants (DOACs) with vitamin K antagonists (VKAs) for stroke prevention in real-world patients with diabetes and nonvalvular atrial fibrillation (NVAF) through observational studies. Methods. PubMed, Embase, and Web of Science databases were searched up to August 2020 for eligible studies. Outputs were presented as risk ratios (RRs) and corresponding 95% confidence intervals (CIs) by using a random-effect model. Results. Seven observational studies involving 249,794 diabetic NVAF patients were selected. Compared with VKAs, the use of DOACs was associated with significantly reduced risks of stroke ( RR = 0.56 , 95% CI 0.45-0.70; p < 0.00001 ), ischemic stroke ( RR = 0.61 , 95% CI 0.48-0.78; p < 0.0001 ), stroke or systemic embolism (SSE) ( RR = 0.81 , 95% CI 0.68-0.95; p = 0.01 ), myocardial infarction ( RR = 0.69 , 95% CI 0.55-0.88; p = 0.002 ), major bleeding ( RR = 0.75 , 95% CI 0.63-0.90; p = 0.002 ), intracranial hemorrhage ( RR = 0.50 , 95% CI 0.44-0.56; p < 0.00001 ), and major gastrointestinal bleeding ( RR = 0.77 , 95% CI 0.62-0.95; p = 0.02 ), and a borderline significant decrease in major adverse cardiac events ( RR = 0.87 , 95% CI 0.75-1.00; p = 0.05 ) in NVAF patients with diabetes. Conclusion. For patients with NVAF and diabetes in real-world clinical settings, DOACs showed superior efficacy and safety profile over VKAs and significantly reduced risks of stroke, ischemic stroke, SSE, myocardial infarction, major bleeding, intracranial hemorrhage, and major gastrointestinal bleeding.

scholarly journals Interpretation of 24-Hour Urinary Protein Level for Diagnosis of Nephrotic Syndrome in Marked Hypoalbuminemia

2021 ◽  
Author(s):  
Raghvendra Narayan ◽  
Shivani Singh
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Albumin ◽  
Protein Level ◽  
Urinary Protein ◽  
Mantoux Test ◽  
Laboratory Methods ◽  
X Ray ◽  
Urinary Protein Level ◽  
Chest X Ray ◽  
Nephrotic Range Proteinuria

Nephrotic syndrome is a common renal problem in childhood and is characterised by generalised oedema, massive proteinuria, hypoalbuminemia and hyperlipidemia. There are various laboratory methods to quantify proteinuria. Among them 24-hour urinary protein estimation is considered a gold standard for diagnosis of nephrotic syndrome. Nephrotic range proteinuria is considered when 24-hour urinary protein is more than 40 mg/m2/hr. There is scarce literature available regarding the changes in quantitative proteinuria when there is marked hypoalbuminemia (serum albumin less than 2.5 gm/dL). This series is about three patients of nephrotic syndrome (6 yers old male, 4 years old male and 5 years old male), having marked hypoalbuminemia and their 24-hour urinary protein level resulted into non-nephrotic range. All the patients underwent relevant physical, clinical examinations and laboratory blood and urine investigations(Haemoglobin, Mantoux test, chest x-ray, urine routine, urine culture and sensitivity, lipid profile, serum albumin and 24 hour urinary protein). All the cases were managed with Prednisolone and diuretics like Furosemide and were followed up till the subside of proteinuria and oedema conditions.

scholarly journals Assessing the Association between the Methylenetetrahydrofolate Reductase (MTHFR) 677C->T Polymorphism on Blood Folate Concentrations: A Systematic Review and Meta-analysis of Trials and Observational Studies

2015 ◽  
pp. 650-651
Author(s):  
Becky Tsang ◽  
Amy Cordero ◽  
Claire Marchetta ◽  
Joseph Mulinare ◽  
Patricia Mersereau ◽  
...  
Keyword(s):  
Systematic Review ◽  
Protein Binding ◽  
Observational Studies ◽  
Methylenetetrahydrofolate Reductase ◽  
Meta Analysis ◽  
Mthfr C677t ◽  
Review Of Literature ◽  
Binding Assays ◽  
Lower Blood ◽  
Meta Analyses

Objectives: The methylenetetrahydrofolate reductase (MTHFR) 677C->T polymorphism is a risk factor for neural tube birth defects (NTDs). The T allele produces an enzyme with reduced folate processing capacity, which has been shown to produce lower blood folate concentrations in some studies. Our objective was to assess the association between MTHFR C677T genotypes (CC, CT, TT) and blood folate concentrations among women aged 12-49 years. Methods: We conducted a systematic review of literature published between 1/1992-7/2013 to identify controlled trials and observational studies that reported serum, plasma, or red blood cell (RBC) folate concentrations and MTHFR C677T genotype. We applied a Bayesian random-effects model to predict differences in blood folate concentrations between MTHFR C677T genotypes, stratified by folate assay. Results: Thirty-eight studies met criteria for inclusion. Serum/plasma folate concentrations showed a consistent genotype trend with the highest concentrations for CC (CC > CT > TT) regardless of assay type. RBC folate concentrations measured by microbiologic assay also demonstrated this trend; however, this trend was reversed (CC < CT < TT) in studies using protein-binding assays. Conclusions: Meta-analyses results showed blood folate concentrations differed by assay type and genotype. Previous evidence has shown that RBC folate concentrations measured with a radioimmunoassay requires adjustment for genotype-dependent folate recovery; our results suggest that other protein-binding assays could have similar limitations. Compared to CC individuals, TT individuals have lower blood folate concentrations, which may increase a woman's risk for an NTD-affected pregnancy.

scholarly journals Mortality rate and predictors of Stroke: A Meta-Analysis and Systematic Review

2019 ◽  
Author(s):  
Amanual Getnet Mersha ◽  
Tadesse Melaku Abegaz ◽  
Mohammed Assen Seid ◽  
Eyob Alemayehu Gebreyohannes ◽  
Akshaya Srikanth Bhagavath ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Stroke Mortality ◽  
Stroke Event ◽  
Meta Analyses ◽  
Random Effect Models ◽  
Overall Mortality

Abstract Background Global data on stroke mortality remained to be sparse. In light of this, we aimed to conduct a Meta-analysis and systematic review of observational studies to estimate the mortality of stroke and to identify risk factors that predispose patients for stroke-related death.Methods This study was conducted based on the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Overall mortality, in-hospital and 30- day mortality due to stroke were the primary outcome measures of the study. The meta-analysis was performed using Stata (Version 14, Stata Corp, College Station, Texas). Random-effect models were used for estimating pooled effects.Findings Overall, thirty two studies assessed overall mortality due to stroke. A total number of 2,885, 126 patients were recruited for the study. Pooled estimate indicated that the overall mortality of stroke was reported to be 20% (19%-22%). Whereas, the 30-day and In-hospital mortality were found to be 18% (16%-20%) and 16% (16%-19%), respectively. A subgroup analysis revealed that Africa registered the highest stroke-related death 29% (23%-36%). Hypertension was found to be an important risk factor for mortality secondary to stroke 61.9% (52.8%-71.1%).Conclusion Overall mortality of stroke was estimated to be twenty percent. The burden of stroke mortality was prominent in Africa region. Hypertension remained to be an independent risk factor for stroke mortality. Mortality of stroke can be minimized by establishing stroke centers that promptly deliver emergency management of stroke event.

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