Effect of cinnamon supplementation on blood pressure and anthropometric parameters in patients with type 2 diabetes: A systematic review and meta-analysis of clinical trials

Background and aimsThe present systematic review and meta-analysis was conducted to investigate the effect of cinnamon supplementation on blood pressure and anthropometric indices in patients with type 2 diabetes.MethodsPubMed, Embase, Scopus, Web of Science and Cochrane Library were systematically searched to find relevant records up to 22 August 2019. Standard mean difference (SMD) and 95% confidence interval (CI) were used to evaluate the effect of cinnamon supplementation on the outcomes of this study. In the case of heterogeneity, fixed and random effect models were used. The obtained data were analyzed by Stata 13. After excluding irrelevant records, 9 eligible articles were included.ResultsThis meta-analysis found a significant reduction in systolic blood pressure (SBP) (SMD: −0.532, 95% CI: [-1.032, −0.033], P = 0.037) and diastolic blood pressure (DBP) (SMD: −0.681, 95% CI: [-1.297, −0.065], P = 0.030) of patients with type 2 diabetes following cinnamon supplementation. Based on the results of the present study, cinnamon supplementation had no significant effect on the body weight (BW) (SMD: −0.309, 95% CI: [-0.793, 0.175], P = 0.211), body mass index (BMI) (SMD: −0.550, 95% CI: [-1.244, 0.144], P = 0.120). and waist circumference (WC) (SMD: −0.235, 95% CI: [-0.518, 0.047], P = 0.103).ConclusionsCinnamon supplementation significantly decreased SBP and DBP of patients with type 2 diabetes. Although cinnamon intake caused changes in anthropometric parameters, the observed changes were not statistically significant.     

High flow nasal cannula versus noninvasive ventilation in the treatment of acute hypercapnic respiratory failure: A systematic review and meta-analysis

Chronic obstructive pulmonary disease can lead to acute hypercapnic respiratory failure (AHRF), often treated using noninvasive ventilation (NIV). Emerging research suggests the potential utility of high flow nasal cannula (HFNC) for AHRF. This systematic review and meta-analysis aimed to determine the effect of HFNC versus NIV on AHRF management. A search of electronic databases (CINAHL, MEDLINE, and Academic Search Complete), web sources, and trial registries was last conducted on 9 February 2023. Quality and risk of bias assessments were conducted. Meta-analyses were used to synthesise data. Seven randomised controlled trials were included. No statistically significant differences between HFNC and NIV were found within the following outcomes of interest: (i) correction of pCO2: standardised mean difference (SMD) = −0.16, 95% confidence interval (CI) (−0.34 to 0.02), p = 0.08; (ii) correction of pH: SMD = −0.05, 95% CI (−0.25 to 0.14), p = 0.59; (iii) correction of pO2: SMD = −0.15, 95% CI (−0.40 to 0.09), p = 0.22; (iv) intubation rates: risk ratio (RR) = 0.87, 95% CI (0.41 to 1.82), p = 0.71; (v) mortality rates: RR = 0.85, 95% CI (0.47 to 1.56), p = 0.61; and (vi) treatment switch: RR = 1.30, 95% CI (0.43 to 3.94), p = 0.64. More controlled trials with large sample sizes are required to investigate the management of AHRF of various aetiologies. HFNC may be used as a final exhaustive measure for COPD-related AHRF where NIV is not tolerated, and when it is not clinically indicated to extend to endotracheal intubation.     

Effects of healthcare interventions on psychosocial factors of patients with multimorbidity: A systematic review and meta-analysis

PurposeA systematic review and meta-analysis was conducted to assess the types of healthcare intervention programs offered to patients with multimorbidity and their effects on key psychosocial factors.MethodsFor this systematic review and meta-analysis, we searched databases like Cochrane Library, PubMed, Embase, CINAHL RISS, KISS, etc. for studies published between January 1, 2009, and April 30, 2019. In total, 8,248 studies in English or Korean were reviewed. We included only randomized controlled trials or quasi-experimental studies that applied healthcare interventions and had major effects on the psychosocial factors in adult patients with multimorbidity. Methodological quality was assessed using Cochrane collaboration risk of bias tool. Meta-analysis was performed using the Review Manager 5.3 version to estimate the effect size.ResultsWe identified six randomized controlled trials and 1446 subjects were enrolled. The results reveal that healthcare interventions have an effect on self-rated health (SMD = 0.53 95 % CI: 0.26, 0.79, p < .001), reducing anxiety (SMD = −0.19 95 % CI: −0.36, −0.01, p = .030) and depression (SMD = −0.27 95 % CI: −0.44, −0.10, p = .002), and improving self-efficacy (SMD = 0.21 95 % CI: 0.06, 0.35, p = .005) for patients with multimorbidity. However, there was no significant effect on quality of life.ConclusionHealthcare interventions had significant positive effects on self-rated health, anxiety, depression, and self-efficacy of patients with multimorbidity. These results are expected to serve as basic data for the development of a community-based integrated healthcare intervention program and health policy, especially for the vulnerable older population with multimorbidity.     

Meta-analysis of blood parameters related to lipid and glucose metabolism between two subtypes of primary aldosteronism

It remains unclear whether metabolic profiles differ within the subtypes of primary aldosteronism (PA). This meta-analysis aimed to compare the blood parameters related to lipid and glucose metabolism at baseline between unilateral PA and bilateral PA. A search was performed using PubMed, Web of Science, and Sciencedirect databases, supplemented by hand-searching of related references. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for each parameter. Twenty-one studies involving 4197 patients with PA were included. Compared with bilateral PA groups, unilateral PA groups demonstrated significantly lower low-density lipoprotein cholesterol (LDL-C, SMD: −.14 mmol/L, 95% CI: −.20, −.07), total cholesterol (TC, SMD: −.16 mmol/L, 95% CI: −.23, −.09), triglyceride (TG, SMD: −.22 mmol/L, 95% CI: −.29, −.16), fasting blood glucose (FBG, SMD: −.11 mmol/L, 95% CI: −.18, −.04), hemoglobin A1c (HbA1c, SMD: −.21%, 95% CI: −.30, −.13), and homeostasis model assessment-insulin resistance (HOMA-IR, SMD: −.40, 95% CI: −.58, −.23). No significant difference was found in high-density lipoprotein cholesterol (HDL-C) level between the two groups (SMD: .40 mmol/L, 95% CI: −.02, .11). To sum up, comparison of several blood metabolic parameters between the two subtypes suggested that the bilateral PA may associate with a higher prevalence of impaired glucose and lipid metabolism than unilateral PA; however, results should be treated with caution. Additional well-designed studies are needed to prove the present results and better elucidate the link between metabolic abnormalities and etiologies of each PA subtype.     

The effects of Canola oil on cardiovascular risk factors: A systematic review and meta-analysis with dose-response analysis of controlled clinical trials

Background and aimsCanola oil (CO) is a plant-based oil with the potential to improve several cardiometabolic risk factors. We systematically reviewed controlled clinical trials investigating the effects of CO on lipid profiles, apo-lipoproteins, glycemic indices, inflammation, and blood pressure compared to other edible oils in adults.Methods and resultsOnline databases were searched for articles up to January 2020. Forty-two articles met the inclusion criteria. CO significantly reduced total cholesterol (TC, −0.27 mmol/l, n = 37), low-density lipoprotein cholesterol (LDL-C, −0.23 mmol/l, n = 35), LDL-C to high-density lipoprotein cholesterol ratio (LDL/HDL, −0.21, n = 10), TC/HDL (−0.13, n = 15), apolipoprotein B (Apo B, −0.03 g/l, n = 14), and Apo B/Apo A-1 (−0.02, n = 6) compared to other edible oils (P < 0.05). Compared to olive oil, CO decreased TC (−0.23 mmol/l, n = 9), LDL-C (−0.17 mmol/l, n = 9), LDL/HDL (−0.39, n = 2), and triglycerides in VLDL (VLDL-TG, −0.10 mmol/l, n = 2) (P < 0.05). Compared to sunflower oil, CO improved LDL-C (−0.14 mmol/l, n = 11), and LDL/HDL (−0.30, n = 3) (P < 0.05). In comparison with saturated fats, CO improved TC (−0.59 mmol/l, n = 11), TG (−0.08 mmol/l, n = 11), LDL-C (−0.49 mmol/l, n = 10), TC/HDL (−0.29, n = 5), and Apo B (−0.09 g/l, n = 4) (P < 0.05). Based on the nonlinear dose–response curve, replacing CO with ~15% of total caloric intake provided the greatest benefits.ConclusionCO significantly improved different cardiometabolic risk factors compared to other edible oils. Further well-designed clinical trials are warranted to confirm the dose–response associations.     

Effects of Tai Chi exercise on cardiovascular disease risk factors and quality of life in adults with essential hypertension: A meta-analysis

BackgroundHypertension is the major attributable risk factor for cardiovascular disease. The effect of Tai Chi on essential hypertension (EH) is contentious.ObjectivesIn this study, we investigated the effects of Tai Chi on the risk factors for cardiovascular disease and quality of life in adults with EH.MethodsUsing data collected from 15 databases up to December 2018, we meta-analyzed randomized controlled trials of the effect of Tai Chi on EH.ResultsTai Chi exercise was associated with lower systolic blood pressure (SBP) (WMD −12.47, 95%CI −16.00 to −8.94, P < 0.001) and diastolic blood pressure (DBP) (WMD −6.46, 95%CI −8.28 to −4.64, P < 0.001); better quality of life (SMD 0.62, 95% CI 0.35 to 0.90, P < 0.001); lower lipid profiles, including total cholesterol (WMD −0.49, 95% CI −0.62 to −0.37, P < 0.001), triglycerides (WMD −0.49, 95% CI −0.92 to −0.07, P = 0.02), and low-density lipoprotein-cholesterol (LDL-C) (WMD −0.86, 95% CI −1.30 to −0.43, P < 0.001); and lower blood glucose (WMD −0.91, 95% CI −1.59 to −0.23, P = 0.009). Tai Chi had no significant effect on high-density lipoprotein–cholesterol (WMD −0.92, 95% CI −2.21 to −0.37, P = 0.16).ConclusionsTai Chi lowers blood pressure, total cholesterol, triglycerides, LDL-C, and blood glucose and significantly increases the quality of life in adults with EH. There is strong evidence for the short-term efficacy of Tai Chi exercises. Larger well-designed RCTs focused on the long-term effect of Tai Chi exercises and patient adherence are needed.     

Iron supplementation for restless legs syndrome – A systematic review and meta-analysis

BackgroundIron supplementation, is recommended for the treatment of restless legs syndrome (RLS). We gathered evidence for the efficacy and safety of iron supplementation for RLS.MethodsA systematic review and meta-analysis of randomized controlled trials that compared iron supplementation versus no iron for patients with RLS was performed. Multiple databases were searched. The primary outcome was the effect of iron on the International Restless Legs Syndrome score (IRLSS) at 4 weeks after treatment. For dichotomous data, risk ratios (RR) with 95% confidence intervals (CIs) were estimated and pooled. For continuous data, weighted mean differences (WMD) were calculated.ResultsTen trials fulfilled the inclusion criteria. Iron therapy was associated with a significant decrease of the IRLSS of −3.55 [95% CI (−5.41) – (−1.68)] points and an increase in the percentage of patients with improvement of the IRLSS score, RR of 2.16 [95% CI 1.56–2.98]. IV FCM was associated with improvement in both the IRLSS (WMD of −2.79 (95% CI (−4.62) – (−0.96), 4 trials, I² = 0%) and on the RLS-QOL by WMD of 8.67 (95% CI 1.68–15). Iron was associated with an increased rate of adverse events RR 2.04 (95% CI 1.46–2.85), which were not severe and not associated with increased rate of treatment discontinuation.ConclusionIron supplementation is associated with improvement of the IRLSS score. Our meta-analysis supports the use of iron, oral or IV, as effective therapy for patients with RLS.Further studies should assess subgroups of patients most likely to benefit from iron supplementation.     

Effect of coffee consumption on dyslipidemia: A meta-analysis of randomized controlled trials

Background and aimDyslipidemia is a common metabolic disease worldwide and also an important predisposing factor for cardiovascular diseases (CVDs). Coffee is loved by people all over the world; however, the association between coffee consumption and blood lipids has yielded inconsistent results. So we carried this meta-analysis to explore the effects of coffee consumption on blood lipids.Methods and resultsMedline, PubMed, Web of science, Embase, and Cochrane Library databases were systematically searched until April 2020. Combined weighted mean differences (WMD) with their 95% confidence interval (CI) were calculated using random-effects models, and between-study heterogeneity was assessed by Cochran's Q test and I² statistics. Subgroup analysis and meta-regression analysis were also conducted to explore the potential heterogeneity. A total of 12 RCT studies involving the association between coffee consumption and blood lipid levels were included in the meta-analysis. The pooled results showed that coffee consumption significantly increased total cholesterol (TC) (WMD: 0.21 mmol/L, 95% CI: 0.04; 0.39, P = 0.017), triglyceride (TG) (WMD: 0.12 mmol/L, 95% CI: 0.03; 0.20, P = 0.006) and low-density lipoprotein (LDL-C) (WMD: 0.14 mmol/L, 95% CI: 0.05; 0.24, P = 0.003) while had no significant effect on high-density lipoprotein (HDL-C) (WMD: −0.01 mmol/L, 95% CI: −0.06; 0.04, P = 0.707). Dose–response analysis results revealed significant positive nonlinear associations between coffee consumption and the increase in TC, LDL-C, and TG levels.ConclusionsEvidence from this meta-analysis suggested that coffee consumption may be associated with an elevated risk for dyslipidemia and CVDs. So a reasonable habit of coffee consumption (<3 cups/d) is essential for the prevention of dyslipidemia.     

The impact of probiotic yogurt consumption on lipid profiles in subjects with mild to moderate hypercholesterolemia: A systematic review and meta-analysis of randomized controlled trials

Background and aimsPotential beneficial effect of probiotic yogurt on the lipid profile has raised much interest. However, the results are inconsistent in this regard. The aim of the study is to determine the effects of probiotic yogurt on serum lipid profile in individuals with mild to moderate hypercholesterolemia.Methods and resultsOnline databases including PubMed, Scopus, ISI Web of Science, Cochrane Central Register of Controlled Trials, Science Direct, Google Scholar and Igaku Chuo Zasshi were searched until March 19th 2019. The effect sizes were expressed as the weighted mean difference (WMD) with 95% confidence interval (CI). Seven eligible trials with 274 participants were included in this systematic review. Pooling of 9 effect sizes from these seven articles revealed a significant reduction in total cholesterol and low density lipoprotein cholesterol levels following probiotic yogurt consumption (mean difference: −8.73 mg/dl, 95% CI: −15.98, −1.48, p-value = 0.018 and mean difference: −10.611 mg/dl, 95% CI: −16.529, −4.693, p-value = 0.000, respectively) without significant heterogeneity among the studies (I² = 40.6%, p-value = 0.1 and I² = 24.2%, p-value = 0.229, respectively). The results showed no significant changes in high density lipoprotein cholesterol and triglyceride levels. Also, none of the variables showed a significant change for sensitivity analysis.ConclusionAvailable evidence suggests that probiotic yogurt can significantly reduce total cholesterol and LDL-c in subjects with mild to moderate hypercholesterolemia without a significant effect on HDL-c and triglyceride levels.     

Long-term follow-up of participants in a health promotion program for treated hypertensives (ADAPT)

Background and aimsImprovements in a lifestyle modification program for hypertensives were maintained 1 year later. Longer follow-up in such studies is limited; we therefore re-assessed participants after an additional 2 years in which there was no contact with program facilitators.Methods and resultsParticipants randomised to usual care (N = 118) or a 4-month lifestyle program (N = 123) were previously assessed after 4 months and 1 year. After a further 2 years, diet, alcohol intake, physical activity, weight, waist girth, ambulatory blood pressure (BP), blood lipids, glucose and insulin were measured (usual care N = 64; program N = 76). Statistically significant net changes, relative to usual care, included blood cholesterol (−0.2 mmol/L, 95% CI 0.1–0.4); physical activity (53 min/week, 95% CI 15–91); dietary saturated fat (−1.9% energy, 95% CI −0.1 to −3.8); fish (3.2 serves/month, 95% CI 0.7–5.7); vegetables (9.1 serves/month, 95% CI 3.2–15.1); and sweet foods (−6.2 serves/month, 95% CI −1.1 to −11.3). Between-group changes in weight (−0.7 kg, 95% CI −1.8–0.4), BP (systolic 1.4 mmHg, 95% CI −0.7–3.5)/diastolic 1.0 mmHg, 95% CI −0.3–2.4) and Framingham risk (usual care: men 12.1%, women 3.7%; program: men 12.2%; women 3.5%) did not differ significantly.ConclusionContinued reinforcement with long-term follow-up is needed in lifestyle modification programs.     

Effects of nut consumption on blood lipid profile: A meta-analysis of randomized controlled trials

Background & aimsSeveral randomized controlled trials (RCTs) have assessed the effects of nut consumption on blood lipid profile. The aim of this study was to conduct a meta-analysis to quantitatively estimate the effects of nut consumption on blood lipid profile.Methods and resultsThe PubMed, EMBASE, Cochrane Library, and Google Scholar databases were systematically searched to identify RCTs examining the effects of nut intake on blood total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs) from inception until March 2021. A random-effects model was used to pool standardized mean differences (SMDs) and 95% confidence intervals (CIs). Potential publication bias was assessed using Begg's test and Egger's test. Sensitivity analysis was performed to assess the impact of each individual study on the pooled results. The meta-analysis showed that nut consumption had no significant effect on the blood lipid profile. However, there was a significant reduction in TC (SMD: ?2.89, 95% CI: ?4.80, ?0.98, I² = 97.4) for pistachio consumption, and cashew consumption significantly increased HDL-C (SMD: 0.24, 95% CI: 0.04, 0.43, I² = 0.0) compared with that in controls. There was no significant publication bias in the meta-analysis. The sensitivity analysis showed that removing one study at a time did not change the significance of the results.ConclusionThere was no overall effect of nut consumption on lipid profile, and the results may vary depending on nut type. We found that pistachio consumption may reduce TC levels, while cashew consumption increases HDL-C.Registry numberPROSPERO CRD42021249147.     

Effects of long-term exercise therapy on knee joint structure in people with knee osteoarthritis: A systematic review and meta-analysis

ObjectiveTo investigate effects of long-term exercise therapy for people with knee osteoarthritis (OA) on radiographic disease severity and cartilage integrity (primary outcomes) as well as severity of bone marrow lesions (BMLs), synovitis and/or effusion (secondary outcomes).MethodsWe sourced randomized controlled trials in people with clinical and/or radiographic OA investigating the effect of land-based exercise therapy of > 6 months on radiographic disease severity and magnetic resonance imaging outcomes of cartilage integrity (morphology or composition) as well as BML, synovitis and/or effusion severity, when compared to no exercise. Two independent reviewers extracted data and assessed risk of bias. Random-effects meta-analysis was used to pool standardised mean differences (SMD) (95% confidence intervals (CI)) or odds ratios (OR) (95% CI) and estimate heterogeneity (I², %). Quality of the pooled body of evidence was rated implementing the GRADE approach. Studies unsuitable for meta-analysis were summarized in a best-evidence synthesis.ResultsMeta-analysis showed moderate quality evidence of no treatment effect on tibiofemoral radiographic disease severity ((SMD) 95% (CI): 0.06 (−0.07, 0.20), I²= 0%) and low-quality evidence of no effect on tibiofemoral cartilage morphology (SMD (95%): 0.06 (−0.20, 0.36), I²= 0%). Low quality evidence revealed no treatment effect on the odds of change in synovitis ((OR) (95% CI): 0.90 (0.51,1.60), I²= 0%) and effusion ((OR (95% CI): 0.88 (0.64, 1.20), I²= 0%), but greater odds of tibiofemoral BMLs worsening (OR (95% CI): 1.90 (1.11, 3.26), I²= 0%). In best-evidence synthesis, limited evidence was found for changes in patellar cartilage composition following exercise in women with mild knee OA compared to no exercise, but not for tibiofemoral cartilage.ConclusionLong-term exercise therapy did not change tibiofemoral radiographic disease severity, cartilage morphology or synovitis/effusion, but may slightly increase the likelihood for increased BML severity. Overall, meta-analysis findings were limited in directness and precision and restricted to relatively imprecise effect estimates in people who were obese on average. Limited evidence suggested some protective effects on patellar cartilage composition.     

The efficacy and safety of metformin combined with simvastatin in the treatment of polycystic ovary syndrome: A meta-analysis and systematic review

Background:Several previous randomized controlled trials (RCTs) evaluated the efficacy of metformin combined with simvastatin in the treatment of polycystic ovary syndrome (PCOS), yet the results of the researches are not consistent. It is necessary to conduct a meta-analysis to explore the efficacy and safety of metformin combined with simvastatin in the treatment of PCOS, to provide evidence supports for the treatment of PCOS.Methods:We searched PubMed, EMbase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Chinese biomedical literature databases online to identify the RCTs evaluating the efficacy of metformin combined with simvastatin in the treatment of PCOS. Standardized mean difference (SMD) and 95% confidence interval (95% CI) were calculated to evaluate the synthesized effects.Results:Nine RCTs with a total of 746 PCOS patients were included. The synthesized results indicated that the combined use of metformin and simvastatin are more beneficial to reduce the total cholesterol (SMD –2.66, 95% CI –3.65 to –1.66), triglycerides (SMD –1.25, 95% CI –2.02 to –0.49), low density lipoprotein (SMD –2.91, 95% CI –3.98 to –1.84), testosterone (SMD –0.64, 95% CI –1.13 to –0.15), fasting insulin (SMD –1.17, 95% CI –2.09 to –0.26) than metformin alone treatment in PCOS patients (all P < .001), and there was no significant difference in the high density lipoprotein (SMD –0.05, 95% CI –0.56–0.46), luteinizing hormone (SMD –0.58, 95% CI –1.66 to –0.50), follicle stimulating hormone (SMD 0.41, 95% CI –0.78–1.59), prolactin (SMD –1.38, 95% CI –2.93–0.17), fasting blood sugar (SMD 0.23, 95% CI –0.52–0.97), and insulin sensitivity index (SMD –0.17, 95% CI –0.48–0.15) between experimental and control groups (all P > .05).Conclusions:Metformin combined with simvastatin is superior to metformin alone in the treatment of PCOS patients with more advantages in improving the levels of sex hormones, blood lipids, and blood sugar. However, the safety of this therapy still needs to be further explored in clinical studies with high-quality and large samples.     

Effectiveness of short message service intervention to improve glycated hemoglobin control and medication adherence in type-2 diabetes: A meta-analysis of prospective studies

BackgroundDistance education or reminder by texting short message may improve HbA1c level and medication adherence to type-2 diabetes.MethodsElectronic databases (PubMed, EBSCO, Elsevier, Springer, Wiley, and Cochrane) were searched systematically for published studies up to Mar 2019. SMD and 95% confidence interval (CI) were used to evaluate the intervention effect on HbA1c level and medication adherence. The heterogeneity of the study was estimated with the I2 statistic. The publication bias was described by Beggs’ test, Egger’s test and plot.ResultsTen studies with 380 interventions and 275 controls were included in this meta-analysis. The Hba1c overall SMD was −0.49%, 95% CI −0.75 to 0.22%, and the overall SMD was 0.96%, 95% CI 0.45–1.47 for medication adherence. The I² and P were 64.90%, 0.002 and 56.40%, 0.10 respectively for Hba1c level and medication adherence.ConclusionSMS intervention was effective for HbA1c level and medication adherence according to this study for T2DM over first 6 months.     

Duodenal–jejunal bypass liners are superior to optimal medical management in ameliorating metabolic dysfunction: A systematic review and meta-analysis

This systematic review and meta-analysis evaluates metabolic and anthropometric outcomes of duodenal–jejunal bypass liners (DJBLs) compared to optimal medical management for the treatment of obesity and its associated metabolic complications. A systematic search of MEDLINE, Embase, Scopus, and Web of Science databases was conducted. Studies were reviewed and data were extracted following the PRISMA guidelines. The primary outcome was glycated hemoglobin (HbA1c) change at device explant with secondary outcomes including body mass index (BMI), weight, fasting plasma glucose (FPG), and adverse events. Twenty-eight studies met inclusion criteria evaluating a total of 1229 patients undergoing DJBL treatment. When compared to medical management, DJBLs provided superior reductions in HbA1c (mean difference, MD −0.96%; 95% CI −1.43, −0.49; p < 0.0001), FPG (MD −1.76 mmol/L; 95% CI −2.80, −0.72; p = 0.0009), BMI (MD −2.80 kg/m²; 95% CI −4.18, −1.41; p < 0.0001), and weight (MD −5.45 kg; 95% CI −9.80, −1.09, p = 0.01). Post-explant data reveals a gradual return to baseline status. Incidence of early device explant was 20.2%. Complications were resolved conservatively or with device explant without long-term morbidity or mortality. We conclude that DJBLs provide significant metabolic and anthropometric improvements for patients with obesity. Uncertainty about the extent to which improvements are maintained after device removal may limit the use of DJBLs as a standalone treatment for obesity and associated metabolic complications.     

Efficacy and safety of macitentan for pulmonary hypertension: A meta-analysis

Introduction

Our purpose of this study is to evaluate the effect and safety of macitentan in the treatment of pulmonary hypertension (PH).

Methods

We retrieved the safety and efficacy of macitentan treatment for PH using PubMed, the Cochrane Library, EMBASE databases and clinicaltrials.gov . The Cochrane Risk of Bias Tool was used for literature screening and quality assessment. Data analysis was conducted using RevMan 5.4.1 and Stata/SE 15.1 software. Results are presented as standardization mean differences (SMDs) and odds ratio (OR).

Results

Meta-analysis of seven randomized controlled trial (RCT) studies and four non-RCT studies with 2769 patients was included, involving 723 in the macitentan group and 599 in the placebo group. The results of the study showed that macitentan had effectively decreased pulmonary vascular resistance (PVR) (SMD = −0.53, 95% CI: −0.77–−0.29, p < 0.05), cardiac index (CI) (SMD = 0.60, 95% CI: 0.37–0.83, p < 0.05) and N-terminal pro-brain natriuretic peptide (NT-proBNP) (SMD = −0.22, 95% CI: −0.40–−0.03, p < 0.05). Furthermore, macitentan also significantly reduced PVR (SMD = −0.58, 95% CI: −0.80–−0.35, p < 0.05), 6-min walk distance (6WMD) (SMD = 0.33, 95% CI: 0.15–0.50, p < 0.05), CI (SMD = 0.48, 95% CI: 0.28–0.69, p < 0.05), mean pulmonary arterial pressure (mPAP) (SMD = −0.43, 95% CI: −0.64–−0.23, p < 0.05) and NT-proBNP (SMD = −0.55, 95% CI: −1.07–−0.03, p < 0.05) between baseline and follow-up. The adverse reactions to macitentan were mild, with headache, anaemia and bronchitis. Other efficacy and safety outcomes did not reach statistical differences.

Conclusion

Macitentan therapy for PH is effective and safe. The effectiveness on PVR, mPAP, mean right atrial pressure (mRAP), mortality and other indicators still needs to be further confirmed.     

Probiotics and synbiotics show clinical efficacy in treating gestational diabetes mellitus: A meta-analysis

BackgroundThis study performed a systematic and meta-analysis of randomized controlled trials (RCTs) to explore the efficacy of probiotic- and symbiotic-based supplements in the treatment of gestational diabetes mellitus (GDM).MethodsWe performed a meta-analysis to evaluate the efficacy of probiotics/synbiotics in GDM treatment, following a systematic search in Web of Science, PubMed, Cochrane Library, and EBSCO databases for articles published up to July 2020.ResultsIn total, 12 RCTs comprising 894 participants, were analyzed. Compared to the placebo, patients administered with probiotic and synbiotic supplements benefited more with regards to glucose and lipid metabolism as well as anti-inflammation and antioxidant capacity including insulin of change (WMD: 3.57, 95%CI: −5.26, −1.88), very-low-density lipoprotein (VLDL) (WMD: −5.03, 95%CI: −8.26, −1.79), nitric oxide (NO) at the end of trial (WMD: 2.31, 95%CI: 0.91, 3.70), total antioxidant capacity (TAC) at the end of trial (SMD: 0.74, 95%CI: 0.21, 1.27), high-sensitivity C-reactive protein (hsCRP) at the end of trial (SMD: −1.23, 95%CI: −1.97, −0.49). Besides, probiotic and synbiotic supplements improved outcomes on fetal hyperbilirubinemia risk (RR: 0.26, 95%CI: 0.12, 0.55), fetal macrosomia risk (RR: 0.47, 95%CI: 0.27, 0.83) and newborn weight (SMD: −0.29, 95%CI: −0.50, −0.09).ConclusionsFindings from this work demonstrate that probiotic/symbiotic-based interventions improve glucose and lipid metabolism, anti-inflammatory and antioxidant ability in diet-controlled GDM patients, and exert beneficial outcomes on fetal hyperbilirubinemia, fetal macrosomia, and newborn weight.     

The effect of probiotic fermented milk products on blood lipid concentrations: A systematic review and meta-analysis of randomized controlled trials

AimFermented milk products are suggested as a supplementary therapy to help reduce blood lipid levels. However, the results of clinical studies are conflicting.Data synthesisThis study systematically reviewed 39 randomized controlled trials (n = 2237 participants) to investigate the effect of probiotic fermented milk products on blood lipids. A meta-analysis was performed using random effects models, with weighted mean differences (WMDs) and 95% confidence interval (CI). Statistically significant reductions in blood low-density lipoprotein cholesterol (LDL-C) (WMD: ?7.34 mg/dL, 95% CI: from ?10.04 to ?4.65, and P < 0.001) and total cholesterol (TC) concentrations (WMD: ?8.30 mg/dL, 95% CI: from ?11.42 to ?5.18, and P < 0.001) were observed. No statistically significant effect of probiotic fermented milk was observed on blood high-density lipoprotein cholesterol (HDL-C) and triacylglycerol (TAG) levels. The effect on TC and LDL-C level was more pronounced in men, and a greater reduction in TAG was observed in trials with longer interventions (≥8 weeks) as compared to their counterparts.ConclusionsAvailable evidence suggests that probiotic fermented milk products may help to reduce serum TC and LDL-C cholesterol levels, particularly in men and when they are consumed for ≥8 weeks.     

The effects of green coffee bean extract supplementation on lipid profile in humans: A systematic review and meta-analysis of randomized controlled trials

Background and aimThis systematic review and meta-analysis aimed to assess the effects of green coffee bean extract (GCBE) supplementation on lipid profile in adults.Methods and resultsThe PubMed/Medline, Scopus, Web of sciences, and Google Scholar were systematically searched for randomized controlled trials available in English and published before February 2019. The meta-analysis was conducted using fixed effects models, and between-study heterogeneity was assessed by Cochran's Q test and I². A total of 17 effect sizes were included in the meta-analysis. Combined effect sizes on serum total cholesterol concentrations revealed significant effects of GCBE supplementation on serum total cholesterol [weighted mean difference (WMD): −4.51 mg/dL, 95% confidence interval (CI): −6.89, −2.12, p < 0.001], low density lipoprotein-cholesterol (LDL-C) (WMD: −4.38 mg/dL, 95% CI: −6.44, −2.31, p < 0.001), and high density lipoprotein-cholesterol (HDL-C) (WMD: 2.63 mg/dL, 95% CI: 2.20, 3.07, p < 0.001) compared to controls. Nevertheless, no significant changes were observed in serum triglycerides levels (WMD: −4.34 mg/dL, 95% CI: −9.00, 0.32, p = 0.068).ConclusionThe evidence from available studies suggests that the GCBE supplementation leads to significant reductions in total cholesterol, HDL-C, and LDL-C levels, and has modest, but, non-significant effects on triglycerides levels.     

Lipid levels and risk of new-onset atrial fibrillation: A systematic review and dose-response meta-analysis

Lipid levels are closely associated with health, but whether lipid levels are associated with atrial fibrillation (AF) remains controversial. We thought that blood lipid levels may influence new-onset AF. Here, we used a meta-analysis to examine the overall association between lipid levels and new-onset AF. PubMed and EMBASE databases were searched up to 20 December 2019. We conducted a systematic review and quantitative meta-analysis of prospective studies to clarify the association between lipid levels and the risk of new-onset AF. Sixteen articles with data on 4 032 638 participants and 42 825 cases of AF were included in this meta-analysis. The summary relative risk (RR) for a 1 mmol/L increment in total cholesterol (TC) was 0.95 (95% CI 0.93-0.96, I² = 74.6%, n = 13). Subgroup analyses showed that follow-up time is a source of heterogeneity; for low-density lipoprotein cholesterol (LDL-C), RR was 0.95 (95% CI 0.92-0.97, I² = 71.5%, n = 10). Subgroup analyses indicated that adjusting for heart failure explains the source of heterogeneity; for high-density lipoprotein cholesterol (HDL-C), RR was 0.97 (95% CI 0.96-0.99, I² = 26.1%, n = 11); for triglycerides (TGs), RR was 1.00 (95% CI 0.96-1.03, I² = 81.1%, n = 8). Subgroup analysis showed that gender, age, follow-up time, and adjustment for heart failure are sources of heterogeneity. Higher levels of TC, LDL-C, and HDL-C were associated with lower risk of new-onset AF. TG levels were not associated with new-onset AF in all subjects.