scholarly journals Calorie Restriction With Exercise Intervention Improves Inflammatory Response in Overweight and Obese Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yubo Liu ◽  
Feng Hong ◽  
Veeranjaneya Reddy Lebaka ◽  
Arifullah Mohammed ◽  
Lei Ji ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Response ◽  
Sedentary Lifestyle ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Inflammatory Biomarkers ◽  
Obese Adults ◽  
Lifestyle Behavior ◽  
Tnf Α ◽  
Meta Regression

Background/Purpose: In this systematic review and meta-analysis, we assessed the effects of exercise (EX) combined with calorie restriction (CR) intervention on inflammatory biomarkers, and correlations between biomarkers and participants’ characteristics were calculated in overweight and obese adults.Methods: An article search was conducted through PubMed, Web of Science, EMBASE, the Cochrane database, Scopus, and Google Scholar to identify articles published up to April 2021. Studies that examined the effect of EX + CR intervention on inflammatory biomarkers, including C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), and compared them with a CR trial in overweight and obese adults were included. We calculated the pooled effect by meta-analysis, identified the correlations (between inflammatory biomarkers and participants’ characteristics) through meta-regression, and explored the beneficial variable through subgroup analysis. The Cochrane risk of bias tool and Methodological Index for Non-randomized Studies were used to assess the risk of bias for the included trials.Results: A total of 23 trials, including 1196 overweight and obese adults, were included in the meta-analysis. The pooled effect showed that EX + CR intervention significantly decreased CRP levels (P = 0.02), but had no effect on IL-6 (P = 0.62) and TNF-α (P = 0.11). Meta-regression analysis showed that the effect of EX + CR on CRP, IL-6, and TNF-α changes was correlated with lifestyle behavior of adults (Coef. = −0.380, P = 0.018; Coef. = −0.359, P = 0.031; Coef. = −0.424, P = 0.041, respectively), but not with age and BMI. The subgroup analysis results revealed that participants with sedentary lifestyle behavior did not respond to EX + CR intervention, as we found no changes in CRP, IL-6, and TNF-α concentrations (P = 0.84, P = 0.16, P = 0.92, respectively). However, EX + CR intervention significantly decreased CRP (P = 0.0003; SMD = −0.39; 95%CI: −0.60 to −0.18), IL-6 (P = 0.04; SMD = −0.21; 95%CI: −0.40 to −0.01) and TNF-α (P = 0.006; SMD = −0.40, 95%CI: −0.68 to −0.12) in adults without a sedentary lifestyle or with a normal lifestyle. Furthermore, the values between sedentary and normal lifestyle subgroups were statistically significant for CRP, IL-6, and TNF-α.Conclusion: Our findings showed that combination EX + CR intervention effectively decreased CRP, IL-6, and TNF-α in overweight and obese adults with active lifestyles, but not with sedentary lifestyle behavior. We suggest that ‘lifestyle behavior’ is a considerable factor when designing new intervention programs for overweight or obese adults to improve their inflammatory response.

scholarly journals The Efficacy of Triptolide in Preventing Diabetic Kidney Diseases: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Dongning Liang ◽  
Hanwen Mai ◽  
Fangyi Ruan ◽  
Haiyan Fu
Keyword(s):  
Systematic Review ◽  
Serum Creatinine ◽  
Blood Urea Nitrogen ◽  
Meta Analysis ◽  
Renin Angiotensin System ◽  
Risk Of Bias ◽  
Urea Nitrogen ◽  
Angiotensin System ◽  
Meta Regression ◽  
Ras Inhibitors

Ethnopharmacological Relevance: Triptolide (TP), the primary biologically active ingredient of Tripterygium wilfordii Hook F (TWHF), possesses the potential to solve the shortcomings of TWHF in treating diabetic kidney disease (DKD) in the clinic.Aim of the Study: We conducted a meta-analysis to evaluate the efficacy of TP in treating DKD and offer solid evidence for further clinical applications of TP.Materials and Methods: Eight databases (CNKI, VIP, CBM, WanFang, PubMed, Web of Science, EMBASE, and Cochrane library) were electronically searched for eligible studies until October 17, 2020. We selected animal experimental studies using TP versus renin–angiotensin system inhibitors or nonfunctional liquids to treat DKD by following the inclusion and exclusion criteria. Two researchers independently extracted data from the included studies and assessed the risk of bias with the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias tool. Fixed-effects meta-analyses, subgroup analyses, and meta-regression were conducted using RevMan 5.3 software. Inplasy registration number: INPLASY2020100042.Results: Twenty-six studies were included. Meta-analysis showed that TP significantly reduced albuminuria (14 studies; standardized mean difference SMD: −1.44 [−1.65, −1.23], I2 = 87%), urine albumin/urine creatinine ratio (UACR) (8 studies; SMD: –5.03 [–5.74, −4.33], I2 = 84%), total proteinuria (4 studies; SMD: –3.12 [–3.75, −2.49], I2 = 0%), serum creatinine (18 studies; SMD: –0.30 [–0.49, −0.12], I2 = 76%), and blood urea nitrogen (12 studies; SMD: –0.40 [–0.60, −0.20], I2 value = 55%) in DKD animals, compared to the vehicle control. However, on comparing TP to the renin–angiotensin system (RAS) inhibitors in DKD treatment, there was no marked difference in ameliorating albuminuria (3 studies; SMD: –0.35 [–0.72, 0.02], I2 = 41%), serum creatinine (3 studies; SMD: –0.07 [–0.62, 0.48], I2 = 10%), and blood urea nitrogen (2 studies; SMD: –0.35 [–0.97, 0.28], I2 = 0%). Of note, TP exhibited higher capacities in reducing UACR (2 studies; SMD: –0.66 [–1.31, −0.01], I2 = 0%) and total proteinuria (2 studies; SMD: –1.18 [–1.86, −2049], I2 = 0%). Meta-regression implicated that the efficacy of TP in reducing DKD albuminuria was associated with applied dosages. In addition, publication bias has not been detected on attenuating albuminuria between TP and RAS inhibitors after the diagnosis of DKD.Systematic Review Registration:https://clinicaltrials.gov/, identifier INPLASY2020100042

scholarly journals Placebo response in trials of drug treatments for cancer-related fatigue: a systematic review, meta-analysis and meta-regression

2020 ◽  
Vol 10 (4) ◽  
pp. 385-394 ◽  
Author(s):  
Rocio Roji ◽  
Patrick Stone ◽  
Federico Ricciardi ◽  
Bridget Candy
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Placebo Response ◽  
Risk Of Bias ◽  
Small Samples ◽  
Contributing Factors ◽  
Cancer Related Fatigue ◽  
Study Results ◽  
Meta Regression ◽  
Multiple Drugs

BackgroundCancer-related fatigue (CRF) is one of the most distressing symptoms experienced by patients. There is no gold standard treatment, although multiple drugs have been tested with little evidence of efficacy. Randomised controlled trials (RCTs) of these drugs have commented on the existence or size of the placebo response (PR). The objective of this systematic review was to establish the magnitude of the PR in RCTs of drugs to relieve CRF and to identify contributing factors.MethodRCTs were included in which the objective was to treat CRF. A meta-analysis was conducted using the standardised mean change (SMC) between baseline and final measurement in the placebo group. To explore factors that may be associated with the PR (eg, population or drug), a meta-regression was undertaken. Risk of bias was assessed using the revised Cochrane tool.ResultsFrom 3916 citations, 30 relevant RCTs were identified. All had limitations that increased their risk of bias. The pooled SMC in reduction in fatigue status in placebo groups was −0.23 (95% confidence intervals −0.42 to −0.04). None of the variables analysed in the meta-regression were statistically significant related to PR.ConclusionThere is some evidence, based on trials with small samples, that the PR in trials testing drugs for CRF is non-trivial in size and statistically significant. We recommend that researchers planning drug studies in CRF should consider implementing alternative trial designs to better account for PR and decrease impact on the study results.

The effect of Nigella sativa on oxidative stress and inflammatory biomarkers: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sanaz Malekian ◽  
Nafiseh Ghassab-Abdollahi ◽  
Mojgan Mirghafourvand ◽  
Azizeh Farshbaf-Khalili
Keyword(s):  
Oxidative Stress ◽  
Systematic Review ◽  
Superoxide Dismutase ◽  
Total Antioxidant Capacity ◽  
Nigella Sativa ◽  
Meta Analysis ◽  
Inflammatory Biomarkers ◽  
Controlled Trials ◽  
Tnf Α ◽  
Total Antioxidant

Abstract Objectives The present systematic review of literature was conducted to study the effect of Nigella sativa (N.S) on oxidative stress and inflammatory biomarkers. Content Different online databases such as Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Scopus, Web of Sciences, EMBASE, and Clininaltrial.gov for English articles and national databases of SID, Magiran, Irandoc, and Iranmedex for Persian articles, which were published until March; 2019 were scrutinized. All Randomised Controlled Trials (RCTs) and quasi-experimental studies that aimed to compare the impact of N.S along, with placebo or without supplementation, on inflammatory factors and oxidative stress were entered in the present study. Summary Finally, 11 RCTs covering 710 women and men, in total, were participated in the present meta-analysis. Significant differences were observed in Tumor Necrosis Factor alpha (TNF-α) (Weighted Mean Difference (WMD) =−2.15 pg/mL, 95% Confidence Interval (CI) =−3.22–−1.09, I2=32%; 5 trials with 262 participants) superoxide dismutase (WMD=63.79 µ/gHb, 95% CI=6.84–120.75, I2=0%; 2 trials, with 88 participants), and total antioxidant capacity (WMD=0.34 mmol/L, 95% CI=0.04 to 0.63, I2=94%; 5 trials with 232 participants). Nevertheless, there was no significant difference in high sensitivity C-reactive protein (WMD=−0.98 mg/L, 95% CI=−1.98–0.03, I2=78%; 5 trials with 267 participants), Interleukin 6 (IL-6) (WMD=−0.25 pg/mL, 95% CI=−0.65 to 0.16, I2=0%; 2 trials with 134 participants), and malondialdehyde (WMD=−0.95 nmol/mL, 95% CI=−1.97–0.08, I2=68%; 4 trials with 179 participants). Outlook Generally speaking, N.S probably results in the improvement of superoxide dismutase serum levels, TNF-α, and total antioxidant capacity. Thus, further studies are required to fully assess its impacts on all oxidative stress and inflammatory biomarkers.

scholarly journals Pheochromocytomas and paragangliomas in von Hippel-Lindau disease: not a needle in a haystack

2021 ◽  
Author(s):  
João Castro-Teles ◽  
Bernardo Sousa-Pinto ◽  
Sandra Rebelo ◽  
Duarte Pignatelli
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Internal Validity ◽  
Risk Of Bias ◽  
Bias Analysis ◽  
Von Hippel Lindau ◽  
Von Hippel Lindau Disease ◽  
Meta Regression ◽  
Meta Regression Analysis

Objective: Pheochromocytomas are a hallmark feature of von Hippel-Lindau disease (vHL). To our knowledge, this is the first systematic review with meta-analysis evaluating the frequency of pheochromocytomas and/or paragangliomas (PPGL) in patients with vHL, as well as among patients with different vHL subtypes. Design: Systematic review with meta-analysis. Methods: We searched on MEDLINE, Scopus and Web of Science. We included primary studies assessing participants with vHL and reporting on the frequency of PPGL. We performed random-effects meta-analysis to quantitatively assess the frequency of PPGL, followed by meta-regression and subgroup analysis. Risk of bias analysis was performed to assess primary studies’ methodological quality. Results: We included 80 primary studies. In 4263 patients with vHL, the pooled frequency of PPGL was 19.4% (95% confidence interval (CI)=15.9-23.6%, I²=86.1%). The frequency increased to 60.0% in patients with vHL type 2 (95%CI=53.4-66.3%, I²=54.6%) and was determined to be of 58.2% in patients with vHL type 2A (95%CI=49.7-66.3%, I²=36.2%), compared to 49.8% in vHL type 2B (95%CI=39.9-59.7%, I²=42.7%), and 84.1% in vHL type 2C (95%CI=75.1-93.1%, I²=0%). In meta-regression analysis, more recent studies were associated with a higher frequency of PPGL. All studies had at least one internal validity item classified as 'high risk of bias', with 13% studies having low risk of bias in all external validity items. Conclusions: PPGL are a common manifestation of vHL. Despite methodological limitations and differences across primary studies, our results point to the importance of PPGL screening in patients with vHL.

scholarly journals Stigma for Common Mental Disorders in Racial Minorities and Majorities A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
ozlem eylem ◽  
Leonore de Wit ◽  
Annemieke van straten ◽  
Lena Steubl ◽  
Zaneta Melissourgaki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Racial Minorities ◽  
Mental Illness Stigma ◽  
Regression Analyses ◽  
Meta Regression

Abstract Background There is a strong stigma attached to mental disorders preventing those affected from getting psychological help. The consequences of stigma are worse for racial and/or ethnic minorities who often experience other social adversities such as poverty and discrimination within policies and institutions. This is the first systematic review and meta-analysis summarizing the evidence on the impact of differences in mental illness stigma between racial minorities and majorities. Methods This systematic review and meta-analysis included cross-sectional studies comparing mental illness stigma between racial minorities and majorities. Systematic searches were conducted in the bibliographic databases of PubMed, PsycINFO and EMBASE until 20th December 2018. Outcomes were extracted from published reports, meta-analyses and meta-regression analyses were conducted in CMA software. Results After screening 2,787 abstracts, 29 studies with 193,418 participants (N=35,836 in racial minorities) were eligible for analyses. Racial minorities showed more stigma than racial majorities (g=0.20 (95% CI: 0.12~0.27) for common mental disorders. Sensitivity analyses showed robustness of these results. Multivariate meta-regression analyses pointed to the possible moderating role of the number of studies with high risk of bias on the effect size. Racial minorities have more stigma for common mental disorders when compared with majorities. Limitations included moderate to high risk of bias, high heterogeneity, few studies in most comparisons, and the use of non-standardized outcome measures. Conclusions An important clinical implication of these findings would be to tailor anti-stigma strategies according to specific racial and/or ethnic backgrounds with the intention to improve mental health outreach. These limitations suggest a need for more high quality research on stigma. Key words: stigma; mental illness stigma; common mental disorders; racial minorities

scholarly journals Stigma for Common Mental Disorders in Racial Minorities and Majorities A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Ozlem Eylem ◽  
Leonore de Wit ◽  
Annemieke van straten ◽  
Lena Steubl ◽  
Zaneta Melissourgaki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Racial Minorities ◽  
Mental Illness Stigma ◽  
Regression Analyses ◽  
Meta Regression

Abstract Background There is a strong stigma attached to mental disorders preventing those affected from getting psychological help. The consequences of stigma are worse for racial and/or ethnic minorities compared to racial and/or ethnic majorities since the former often experience other social adversities such as poverty and discrimination within policies and institutions. This is the first systematic review and meta-analysis summarizing the evidence on the impact of differences in mental illness stigma between racial minorities and majorities. Methods This systematic review and meta-analysis included cross-sectional studies comparing mental illness stigma between racial minorities and majorities. Systematic searches were conducted in the bibliographic databases of PubMed, PsycINFO and EMBASE until 20 th December 2018. Outcomes were extracted from published reports, and meta-analyses, and meta-regression analyses were conducted in CMA software. Results After screening 2,787 abstracts, 29 studies with 193,418 participants (N=35,836 in racial minorities) were eligible for analyses. Racial minorities showed more stigma than racial majorities (g=0.20 (95% CI: 0.12~0.27) for common mental disorders. Sensitivity analyses showed robustness of these results. Multivariate meta-regression analyses pointed to the possible moderating role of the number of studies with high risk of bias on the effect size. Racial minorities have more stigma for common mental disorders when compared with majorities. Limitations included moderate to high risk of bias, high heterogeneity, few studies in most comparisons, and the use of non-standardized outcome measures. Conclusions Mental illness stigma is higher among ethnic minorities than majorities. An important clinical implication of these findings would be to tailor anti-stigma strategies related with mental illnesses according to specific racial and/or ethnic backgrounds with the intention to improve mental health outreach.

scholarly journals Multifactorial interventions for preventing falls in older people living in the community: a systematic review and meta-analysis of 41 trials and almost 20 000 participants

2019 ◽  
Vol 54 (22) ◽  
pp. 1340-1350 ◽  
Author(s):  
Sally Hopewell ◽  
Bethan Copsey ◽  
Philippa Nicolson ◽  
Busola Adedire ◽  
Graham Boniface ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Usual Care ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Moderate Quality ◽  
Recurrent Falls ◽  
Meta Regression ◽  
Quality Evidence

ObjectiveTo assess the longer term effects of multifactorial interventions for preventing falls in older people living in the community, and to explore whether prespecific trial-level characteristics are associated with greater fall prevention effects.DesignSystematic review with meta-analysis and meta-regression.Data sourcesMEDLINE, EMBASE, CINHAL, CENTRAL and trial registries were searched up to 25 July 2018.Study selectionWe included randomised controlled trials (≥12 months’ follow-up) evaluating the effects of multifactorial interventions on falls in older people aged 65 years and over, living in the community, compared with either usual care or usual care plus advice.Review methodsTwo authors independently verified studies for inclusion, assessed risk of bias and extracted data. Rate ratios (RaR) with 95% CIs were calculated for rate of falls, risk ratios (RR) for dichotomous outcomes and standardised mean difference for continuous outcomes. Data were pooled using a random effects model. The Grading of Recommendations, Assessment, Development and Evaluation was used to assess the quality of the evidence.ResultsWe included 41 trials totalling 19 369 participants; mean age 72–85 years. Exercise was the most common prespecified component of the multifactorial interventions (85%; n=35/41). Most trials were judged at unclear or high risk of bias in ≥1 domain. Twenty trials provided data on rate of falls and showed multifactorial interventions may reduce the rate at which people fall compared with the comparator (RaR 0.79, 95% CI 0.70 to 0.88; 20 trials; 10 116 participants; I2=90%; low-quality evidence). Multifactorial interventions may also slightly lower the risk of people sustaining one or more falls (RR 0.95, 95% CI 0.90 to 1.00; 30 trials; 13 817 participants; I2=56%; moderate-quality evidence) and recurrent falls (RR 0.88, 95% CI 0.78 to 1.00; 15 trials; 7277 participants; I2=46%; moderate-quality evidence). However, there may be little or no difference in other fall-related outcomes, such as fall-related fractures, falls requiring hospital admission or medical attention and health-related quality of life. Very few trials (n=3) reported on adverse events related to the intervention. Prespecified subgroup analyses showed that the effect on rate of falls may be smaller when compared with usual care plus advice as opposed to usual care only. Overall, heterogeneity remained high and was not explained by the prespecified characteristics included in the meta-regression.ConclusionMultifactorial interventions (most of which include exercise prescription) may reduce the rate of falls and slightly reduce risk of older people sustaining one or more falls and recurrent falls (defined as two or more falls within a specified time period).Trial registration numberCRD42018102549.

scholarly journals Stigma for Common Mental Disorders in Racial Minorities and Majorities: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Ozlem Eylem ◽  
Leonore de Wit ◽  
Annemieke van straten ◽  
Lena Steubl ◽  
Zaneta Melissourgaki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Racial Minorities ◽  
Mental Illness Stigma ◽  
Regression Analyses ◽  
Meta Regression

Abstract Background There is a strong stigma attached to mental disorders preventing those affected from getting psychological help. The consequences of stigma are worse for racial and/or ethnic minorities compared to racial and/or ethnic majorities since the former often experience other social adversities such as poverty and discrimination within policies and institutions. This is the first systematic review and meta-analysis summarizing the evidence on the impact of differences in mental illness stigma between racial minorities and majorities. Methods This systematic review and meta-analysis included cross-sectional studies comparing mental illness stigma between racial minorities and majorities. Systematic searches were conducted in the bibliographic databases of PubMed, PsycINFO and EMBASE until 20 th December 2018. Outcomes were extracted from published reports, and meta-analyses, and meta-regression analyses were conducted in CMA software. Results After screening 2,787 abstracts, 29 studies with 193,418 participants (N=35,836 in racial minorities) were eligible for analyses. Racial minorities showed more stigma than racial majorities (g=0.20 (95% CI: 0.12~0.27) for common mental disorders. Sensitivity analyses showed robustness of these results. Multivariate meta-regression analyses pointed to the possible moderating role of the number of studies with high risk of bias on the effect size. Racial minorities have more stigma for common mental disorders when compared with majorities. Limitations included moderate to high risk of bias, high heterogeneity, few studies in most comparisons, and the use of non-standardized outcome measures. Conclusions Mental illness stigma is higher among ethnic minorities than majorities. An important clinical implication of these findings would be to tailor anti-stigma strategies related with mental illnesses according to specific racial and/or ethnic backgrounds with the intention to improve mental health outreach.

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