Effect of metformin treatment during pregnancy on women with PCOS: a systematic review and meta-analysis

Purpose: Some previous studies have found that continued metformin use is beneficial in the management of polycystic ovary syndrome (PCOS) in pregnant women. A systemic review and meta-analysis were needed to more fully assess the effects of metformin on pregnant PCOS patients. Methods: The literature was fully searched using MEDLINE, EMBASE, SCOPUS, and COCHRANE for continued metformin use during pregnancy in women with PCOS. A systematic review and meta-analysis were performed to evaluate the comprehensive effects of continued metformin treatment on pregnancy-related outcomes in these women. Results: Eleven eligible studies out of 127 relevant publications were included in meta-analysis. The rates of early pregnancy loss and preterm delivery were found to be significantly decreased in metformin-treated PCOS women. A non-significant difference was found in fetal abnormality and fetal birth weight between the metformin-treated and the non-treated groups. The incidence of gestational diabetes mellitus (GDM) and hypertension/preeclampsia were not significantly different in the two groups, probably because of inconsistent results in the subgroup analysis. Conclusions: Our results showed that continued use during of metformin, during pregnancy in women with PCOS, had no effect on incidence of fetal abnormalities or fetal birth weight. The effects of metformin on GDM and hypertension/preeclampsia should be determined through high-quality randomized controlled trials.

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Regional and chronological differences in prevalences of olfactory and gustatory dysfunction in coronavirus disease (COVID-19): a systemic review and meta-analysis

10.21203/rs.3.rs-58460/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Jeong-Whun Kim ◽

Seung Cheol Han ◽

Hyung Dong Jo ◽

Sung-Woo Cho ◽

Jin Youp Kim

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Olfactory Dysfunction ◽

Systemic Review ◽

Effect Model ◽

Geographical Regions ◽

Significant Difference ◽

Subgroup Analyses

Abstract Olfactory and gustatory dysfunction are frequently reported in patients with coronavirus disease (COVID-19). However, the reported prevalence of olfactory and/or gustatory dysfunction varies widely, and the reason for the inter-study differences is unclear. Hence, in this meta-analysis, we performed subgroup analyses to investigate the factors that contribute to the inter-study variability in the prevalence of olfactory and gustatory dysfunction. Out of 943 citations, we included 55 eligible studies with 13,527 patients with COVID-19 for a systematic review. The overall pooled prevalences of olfactory and gustatory dysfunction were 51.4% and 47.5%, respectively, in the random-effect model. In subgroup analyses, the prevalences of olfactory and gustatory dysfunction were significantly different among four geographical regions (both P < 0.001, respectively). Although the prevalences of olfactory and gustatory dysfunction did not significantly differ according to the time of enrollment, the subgroup analyses including only studies from the same geographical region (Europe) revealed a significant difference in olfactory dysfunction according to the time of enrollment. The regional and chronological differences in the prevalences of olfactory and gustatory dysfunctions partly explain the wide inter-study variability.

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Effect of Prophylactic Thoracic Duct Ligation in Reducing the Incidence of Postoperative Chylothorax during Esophagectomy: A Systematic Review and Meta-analysis

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0037-1602259 ◽

2017 ◽

Vol 66 (05) ◽

pp. 370-375 ◽

Cited By ~ 7

Author(s):

Yiyan Lei ◽

Yanfen Feng ◽

Bo Zeng ◽

Xin Zhang ◽

Jingfu Chen ◽

...

Keyword(s):

Systematic Review ◽

Relative Risk ◽

Confidence Interval ◽

Thoracic Duct ◽

Meta Analysis ◽

Relevant Literature ◽

Systemic Review ◽

Thoracic Duct Ligation ◽

Duct Ligation ◽

Significant Difference

Objectives There is no consensus on the effectiveness of prophylactic thoracic duct ligation (PLG) in esophagectomy for reducing the incidence of postoperative chylothorax. We performed a systemic review and meta-analysis to study its efficacy. Methods A systemic review of the publications was performed on three databases to identify all the relevant literature on comparative outcomes of PLG and nonprophylactic thoracic duct ligation (NPLG). The primary end point was the incidence of postoperative chylothorax. Results Seven studies with comparative data on PLG (n = 2,178) versus NPLG (n = 3,048) were identify from the current publications. Comparison showed no significant difference between PLG and NPLG on the incidence of postoperative chylothorax (relative risk = 0.431; 95% confidence interval, 0.186 to 1.002; p = 0.050). Conclusions Although some studies showed that PLG during the esophagectomy was effective to lower the incidence of postoperative chylothorax, no evidence was observed in the present meta-analysis. Further research is warranted to validate the findings.

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The Effects of Salvia miltiorrhiza on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/9971403 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Wenjuan Shen ◽

Bao Jin ◽

Yaguang Han ◽

Hongwei Wang ◽

Huan Jiang ◽

...

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Salvia Miltiorrhiza ◽

Meta Analysis ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Cochrane Library ◽

Ovary Syndrome ◽

Significant Difference

Objective. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. As a traditional medicine, Salvia miltiorrhiza (S. miltiorrhiza) has been widely used in the treatment of many gynecological diseases, but the efficacy of S. miltiorrhiza in women with PCOS has not been assessed. The purpose of this systematic review and meta-analysis was to evaluate the effectiveness and safety of S. miltiorrhiza in women with PCOS. Methods. We conducted searches in PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure, the Wanfang Database, the Chinese Scientific Journal Database, and the Chinese BioMedical database from inception to December 23, 2020, to identify studies that met the inclusion criteria. The quality of the evidence was estimated using the Cochrane Reviewer Handbook 5.0.0, and the meta-analysis was performed using RevMan 5.3.5 software. Results. Six randomized controlled trials (RCTs) involving 390 patients with PCOS were included. The studies suggested that S. miltiorrhiza extract combined with letrozole (LET) was more effective in improving pregnancy rate (RR: 2.60, 95% CI: 1.06 to 6.39, P = 0.04 ) compared to LET alone. S. miltiorrhiza extract was associated with decreased fasting blood glucose (MD: –0.25, 95% CI: –0.37 to –0.13, P < 0.0001 ), fasting insulin (MD: –1.16, 95% CI: –1.74 to –0.58, P < 0.0001 ), total cholesterol (TC) (MD: –0.58, 95% CI: –0.72 to –0.43, P < 0.00001 ), and triglycerides (TG) (MD: –0.31, 95% CI: –0.35 to –0.26, P < 0.00001 ) compared with placebo, but not with improvements in body mass index or waist-to-hip ratio (MD: –1.41, 95% CI: –4.81 to 2.00, P = 0.42 ; MD: –0.02, 95% CI: –0.05 to 0.01, P = 0.16 , respectively). There was a significant difference between S. miltiorrhiza extract combined with cyproterone acetate (CPA) and CPA alone in terms of decreasing TC (MD: –0.77, 95% CI: –0.89 to –0.65, P < 0.00001 ), TG (MD: –0.43, 95% CI: –0.65 to –0.20, P < 0.0001 ), and low-density lipoprotein cholesterol (MD: –0.49, 95% CI: –0.66 to –0.33, P < 0.00001 ) and increasing high-density lipoprotein cholesterol (MD: 0.30, 95% CI: 0.20, 0.40, P < 0.00001 ). In addition, S. miltiorrhiza extract also decreased testosterone, follicle-stimulating hormone, and luteinizing hormone. The studies did not mention any adverse events with S. miltiorrhiza extract. Conclusion. The current studies indicate that S. miltiorrhiza has beneficial effects on reproduction and glucose and lipid metabolism in patients with PCOS, and it is generally safe for clinical application. However, more prospective RCTs with large samples, multiple centers, and longer intervention duration are needed in the future to obtain more reliable conclusions.

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The Association Between Antioxidant Status and Excess Weight in Children: A Systematic Review and Meta-analysis

Journal of Pediatrics Review ◽

10.32598/jpr.9.3.962.1 ◽

2021 ◽

Vol 9 (3) ◽

pp. 175-196

Author(s):

Bahareh Vard ◽

◽

Maryam Mahdieh ◽

Roya Riahi ◽

Motahar Heidari-Beni ◽

...

Keyword(s):

Systematic Review ◽

Vitamin E ◽

Childhood Obesity ◽

Antioxidant Status ◽

Meta Analysis ◽

Mean Difference ◽

Systemic Review ◽

Significant Heterogeneity ◽

Obese Children ◽

Significant Difference

Background: The prevalence of childhood obesity with its complications has increased in the world. Obesity, along with antioxidants deficiency (due to an unhealthy diet), might change the balance in favor of oxidative stress. Objectives: The current study aims to assess the literature on the relationship between obesity and antioxidant status through a systematic review and meta-analysis Results: β-Carotene levels was significantly lower in obese children than non-obese ones (mean difference: 0.13, 95%CI: 0.09-0.16, P<0.001), with significant heterogeneity (P<0.001, I2=85%). There was a significant difference between obese and non-obese children in both α-tocopherol (pooled mean difference respectively: 0.36, 95% CI: 0.04-0.96, P<0.001 ) with non-significant heterogeneity (P>0.05, I2=0.0% ) and α-tocopherol per lipoid (pooled mean difference: 0.42, 95%CI: 0.28-0.55, P<0.001), with significant heterogeneity (P=0.048, I2=58.8%). There was no significant association between vitamin E level and obesity (pooled mean difference: 0.40, 95%CI: -0.05-0.85, P>0.05), with significant heterogeneity (P<0.001, I2=84.5%). There was significant association between zinc, magnesium, copper, and selenium level and obesity (P>0.05), with significant heterogeneity (P<0.001). Conclusions: This review revealed a significant inverse relationship between childhood obesity and serum antioxidant levels. More studies are necessary to find the underlying mechanisms and clinical impacts of this finding. Data Sources: This systematic review and meta-analysis were performed among English language articles published until September 2020 without any time limit. An electronic search was conducted in international databases of Google Scholar, PubMed, Web of Science, Scopus, Medline, and Cochrane. Study Selection: First, 1255 papers were found. After removing duplicates and quality assessment, 46 were used in the systemic review, and 19 articles were entered into the meta-analysis. Data Extraction: Two researchers independently searched the following keywords in the databases: “Vitamin C”, “Vitamin E”, “Vitamin A”, “Carotenoids”, “Antioxidants”, “Selenium”, “Magnesium”, “Copper”, “Zinc”, “Ascorbic acid”, “Tocopherol”, “Obesity”, “Overweight”, “Childhood”, “Pediatric”, and “Adolescence”. Articles that examined the association between obesity and antioxidant status were included in the study. The research on animals, interventional studies, case studies, case reports, and irrelevant studies were excluded. The research team determined the quality of studies using the STROBE (strengthening the reporting of observational studies in epidemiology) checklist. Heterogeneity of studies was evaluated using index (I2) and probability of diffusion bias by funnel plot and Begg’s and Egger’s tests.

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Prenatal Amino Acid Supplementation to Improve Fetal Growth: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu12092535 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2535 ◽

Cited By ~ 1

Author(s):

Fieke Terstappen ◽

Angela J. C. Tol ◽

Hendrik Gremmels ◽

Kimberley E. Wever ◽

Nina D. Paauw ◽

...

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Amino Acid ◽

Fetal Growth ◽

Animal Studies ◽

Meta Analysis ◽

Control Diet ◽

Methyl Donors ◽

Methyl Donor ◽

Fetal Birth Weight

Aberrant fetal growth remains a leading cause of perinatal morbidity and mortality and is associated with a risk of developing non-communicable diseases later in life. We performed a systematic review and meta-analysis combining human and animal studies to assess whether prenatal amino acid (AA) supplementation could be a promising approach to promote healthy fetal growth. PubMed, Embase, and Cochrane libraries were searched to identify studies orally supplementing the following AA groups during gestation: (1) arginine family, (2) branched chain (BCAA), and (3) methyl donors. The primary outcome was fetal/birth weight. Twenty-two human and 89 animal studies were included in the systematic review. The arginine family and, especially, arginine itself were studied the most. Our meta-analysis showed beneficial effects of arginine and (N-Carbamyl) glutamate (NCG) but not aspartic acid and citrulline on fetal/birth weight. However, no effects were reported when an isonitrogenous control diet was included. BCAA and methyl donor supplementation did not affect fetal/birth weight. Arginine family supplementation, in particular arginine and NCG, improves fetal growth in complicated pregnancies. BCAA and methyl donor supplementation do not seem to be as promising in targeting fetal growth. Well-controlled research in complicated pregnancies is needed before ruling out AA supplements or preferring arginine above other AAs.

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Faculty Opinions recommendation of Inositol supplementation in women with polycystic ovary syndrome undergoing intracytoplasmic sperm injection: a systematic review and meta-analysis of randomized controlled trials.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.734283508.793559362 ◽

2019 ◽

Author(s):

Fernando Reis

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Randomized Controlled Trials ◽

Intracytoplasmic Sperm Injection ◽

Polycystic Ovary ◽

Meta Analysis ◽

Controlled Trials ◽

Ovary Syndrome ◽

Randomized Controlled

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Copper Concentrations in Breast Cancer: A Systematic Review and Meta-Analysis

Current Medicinal Chemistry ◽

10.2174/0929867326666190918120209 ◽

2020 ◽

Vol 27 (37) ◽

pp. 6373-6383 ◽

Cited By ~ 1

Author(s):

Leila Jouybari ◽

Faezeh Kiani ◽

Farhad Islami ◽

Akram Sanagoo ◽

Fatemeh Sayehmiri ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Breast Tissue ◽

Reference Lists ◽

Meta Analysis ◽

Cancer Risks ◽

Hair Samples ◽

Significant Difference ◽

Mean Differences ◽

Very High

: Breast cancer is the most common neoplasm, comprising 16% of all women's cancers worldwide. Research of Copper (Cu) concentrations in various body specimens have suggested an association between Cu levels and breast cancer risks. This systematic review and meta-analysis summarize the results of published studies and examine this association. We searched the databases PubMed, Scopus, Web of Science, and Google Scholar and the reference lists of relevant publications. The Standardized Mean Differences (SMDs) between Cu levels in cancer cases and controls and corresponding Confidence Intervals (CIs), as well as I2 statistics, were calculated to examine heterogeneity. Following the specimens used in the original studies, the Cu concentrations were examined in three subgroups: serum or plasma, breast tissue, and scalp hair. We identified 1711 relevant studies published from 1984 to 2017. There was no statistically significant difference between breast cancer cases and controls for Cu levels assayed in any studied specimen; the SMD (95% CI) was -0.01 (-1.06 - 1.03; P = 0.98) for blood or serum, 0.51 (-0.70 - 1.73; P = 0.41) for breast tissue, and -0.88 (-3.42 - 1.65; P = 0.50) for hair samples. However, the heterogeneity between studies was very high (P < 0.001) in all subgroups. We did not find evidence for publication bias (P = 0.91). The results of this meta-analysis do not support an association between Cu levels and breast cancer. However, due to high heterogeneity in the results of original studies, this conclusion needs to be confirmed by well-designed prospective studies.

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Is there Sex-related Outcome Difference According to oral P2Y12 Inhibitors in Patients with Acute Coronary Syndromes? A Systematic Review and Meta-Analysis of 107,126 Patients

Current Vascular Pharmacology ◽

10.2174/1570161116666180123092054 ◽

2019 ◽

Vol 17 (2) ◽

pp. 191-203

Author(s):

Oliver Brown ◽

Jennifer Rossington ◽

Gill Louise Buchanan ◽

Giuseppe Patti ◽

Angela Hoye

Keyword(s):

Systematic Review ◽

Acute Coronary Syndromes ◽

Meta Analysis ◽

Indirect Comparison ◽

Bleeding Risk ◽

Cardiovascular Death ◽

P2y12 Inhibitors ◽

Significant Difference ◽

Coronary Syndromes ◽

Randomised Controlled

Background and Objectives: The majority of patients included in trials of anti-platelet therapy are male. This systematic review and meta-analysis aimed to determine whether, in addition to aspirin, P2Y12 blockade is beneficial in both women and men with acute coronary syndromes. Methods: Electronic databases were searched and nine eligible randomised controlled studies were identified that had sex-specific clinical outcomes (n=107,126 patients). Risk Ratios (RR) and 95% Confidence Intervals (CI) were calculated for a composite of cardiovascular death, myocardial infarction or stroke (MACE), and a safety endpoint of major bleeding for each sex. Indirect comparison analysis was performed to statistically compare ticagrelor against prasugrel. Results: Compared to aspirin alone, clopidogrel reduced MACE in men (RR, 0.79; 95% CI, 0.68 to 0.92; p=0.003), but was not statistically significant in women (RR, 0.88; 95% CI, 0.75 to 1.02, p=0.08). Clopidogrel therapy significantly increased bleeding in women but not men. Compared to clopidogrel, prasugrel was beneficial in men (RR, 0.84; 95% CI, 0.73 to 0.97; p=0.02) but not statistically significant in women (RR, 0.94; 95% CI, 0.83 to 1.06; p=0.30); ticagrelor reduced MACE in both men (RR, 0.85; 95% CI, 0.77 to 0.94; p=0.001) and women (RR, 0.84; 95% CI, 0.73 to 0.97; p=0.02). Indirect comparison demonstrated no significant difference between ticagrelor and prasugrel in either sex. Compared to clopidogrel, ticagrelor and prasugrel increased bleeding risk in both women and men. Conclusion: In summary, in comparison to monotherapy with aspirin, P2Y12 inhibitors reduce MACE in women and men. Ticagrelor was shown to be superior to clopidogrel in both sexes. Prasugrel showed a statistically significant benefit only in men; however indirect comparison did not demonstrate superiority of ticagrelor over prasugrel in women.

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