The impact of argan oil on plasma lipids in humans: Systematic review and meta‐analysis of randomized controlled trials

The study aims to investigate the effect of argan oil on plasma lipid concentrations through a systematic review of the literature and a meta‐analysis of available randomized controlled trials. Randomized controlled trials that investigated the impact of at least 2 weeks of supplementation with argan oil on plasma/serum concentrations of at least 1 of the main lipid parameters were eligible for inclusion. Effect size was expressed as the weighted mean difference (WMD) and 95% confidence interval (95% CI). Meta‐analysis of data from 5 eligible trials with 292 participants showed a significant reduction in plasma concentrations of total cholesterol (WMD: ?16.85 mg/dl, 95% CI [?25.10, ?8.60], p < .001), low‐density lipoprotein cholesterol (WMD: ?11.67 mg/dl, 95% CI [?17.32, ?6.01], p < .001), and triglycerides (WMD: ?13.69 mg/dl, 95% CI [?25.80, ?1.58], p = .027) after supplementation with argan oil compared with control treatment, and plasma concentrations of high‐density lipoprotein cholesterol (WMD: 4.14 mg/dl, 95% CI [0.86, 7.41], p = .013) were found to be increased. Argan oil supplementation reduces total cholesterol, low‐density lipoprotein cholesterol, and triglycerides and increases high‐density lipoprotein cholesterol levels. Additionally, larger clinical trials are needed to assess the impact of argan oil supplementation on other indices of cardiometabolic risk and on the risk of cardiovascular outcomes.     

The influence of green coffee bean extract supplementation on blood glucose levels: A systematic review and dose–response meta‐analysis of randomized controlled trials

Studies regarding the influence of green coffee extract (GCE) on blood glucose levels are conflicting. Thus, we sought to conduct a meta‐analysis and systematic review of all available randomized controlled trials (RCTs) to quantify the effects of GCE and CGA intervention on blood glucose and insulin levels. We performed systematic online searches in Scopus, Web of science, and PubMed databases, from inception to July 2019. Data were combined analyzed using a random effects model (Der Simonian‐Laird method) and reported as weighted mean differences (WMD). Ten trials reported the influences of GCE on FBS and insulin and were subsequently entered into the meta‐analysis. Combined results highlighted that FBS was significantly altered after GCE consumption (WMD: ?1.791 mg/dl, 95% CI ?3.404, ?0.177), with no significant heterogeneity among the studies (I² = 35.0%, p = .128). However, overall results demonstrated that GCE administration did not result in any significant alteration in insulin levels (WMD: ?0.925 μU/ml, 95% CI:?1.915, 0.064), with significant heterogeneity found across studies (I² = 87.9%). In sub‐group analysis, insulin levels were significantly reduced when GCE was supplemented in dosages of ≥400 mg/day (WMD:?1.942 mg/dl, 95% CI:?1.184, ?0.975; I² = 0.0%). The results of present study support the use of GCE for the enhancement of blood glucose, while subgroup analysis highlighted significant improvements in insulin levels when GCE is supplemented in doses ≥400 mg/day.     

Effects of cardamom supplementation on lipid profile: A systematic review and meta‐analysis of randomized controlled clinical trials

Cardiovascular disease is a highly prevalent issue worldwide and one of its main manifestations, dyslipidemia, needs more attention. Recent studies have suggested that cardamom has favorable effects beyond lipid lowering, but the result are contradictory. Our objective was to conduct a systematic review and meta‐analysis on randomized controlled trials (RCTs) that assessed the effect of cardamom on lipids. The search included PubMed, Scopus, ISI Web of Science, Google Scholar, and the Cochrane library (up to March, 2019) to identify RCTs investigating the effects of cardamom supplementation on serum lipid parameters. Weighted mean differences (WMDs) were pooled using a random‐effect model. Meta‐analysis of data from five eligible RCTs showed that cardamom supplementation did not significantly change the concentrations of total cholesterol (WMD: ?6.11 mg/dl, 95% CI [?13.06, 0.83], I² = 0.0%), low‐density lipoprotein cholesterol (WMD: ?4.31 mg/dl, 95% CI [?9.75, 1.13], I² = 0.0%), or high‐density lipoprotein cholesterol (WMD: 1.75 mg/dl, 95% CI [?1.95 to 5.46], I² = 71.4%). However, a significant reduction was observed in serum triglyceride (TG; WMD: ?20.55 mg/dl, 95% CI [?32.48, ?8.63], I² = 0.0%) levels after cardamom supplementation. Cardamom might be able to change TG, but for confirming the results, more studies exclusively on dyslipidemia patients and considering the intake of lipid lowering agents as exclusion criteria are necessary.     

The effect of psyllium consumption on weight,body mass index,lipid profile,and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

Water‐soluble dietary fibers have been shown to improve lipid profile and glucose metabolism in diabetes. The aim of this study was to review the effects of psyllium consumption on weight, body mass index, lipid profiles, and glucose metabolism in diabetic patients in randomized controlled trials. A comprehensive systematic search was performed in PubMed/MEDLINE, Web of Sciences, Cochrane, and Scopus by two independent researchers up to August 2019 without any time and language restrictions. The DerSimonian and Laird random‐effects model method performed to calculate the pooled results. Inclusion criteria were randomized controlled trial design, adult subjects, and studies reporting the mean differences with the 95% confidence interval for outcome. Eight studies containing nine arms with 395 participants were identified and included in final analysis. Combined results found a significant reduction in triglycerides, low‐density lipoprotein, fasting blood sugar, and hemoglobin A1c following psyllium consumption (weighted mean differences [WMD]: ?19.18 mg/dl, 95% CI [?31.76, ?6.60], I² = 98%), (WMD: ?8.96 mg/dl, 95% CI [?13.39, ?4.52], I² = 97%), (WMD: ?31.71 ml/dl, 95% CI [?50.04, ?13.38], I² = 97%), and (WMD: ?0.91%, 95% CI [?1.31, ?0.51], I² = 99%), respectively. There was no significant change in high‐density lipoprotein, body mass index, cholesterol, and weight. In conclusion, the results demonstrated a significant reduction in triglycerides, low‐density lipoprotein, fasting blood sugar, and hemoglobin A1c by psyllium intervention among diabetic patients.     

The effects of grape seed extract on glycemic control,serum lipoproteins,inflammation, and body weight: A systematic review and meta‐analysis of randomized controlled trials

The aim of this systematic review and meta‐analysis was to analyze the effects of grape seed extract (GSE) on glycemic control and serum lipoproteins, inflammation and body weight. Two independent authors systematically searched online databases including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science from inception until May 30, 2019. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. The heterogeneity among the included studies was assessed using Cochrane's Q test and I‐square (I²) statistic. Data were pooled using a random‐effects model and weighted mean difference (WMD) was considered as the overall effect size. Fifty trials were included in this meta‐analysis. Pooling effect sizes from studies demonstrated a significant decrease in fasting plasma glucose (FPG) (WMD): ?2.01; 95% confidence interval (CI): ?3.14, ?0.86), total cholesterol (TC; WMD: ?6.03; 95% CI: ?9.71, ?2.35), low‐density lipoprotein (LDL) cholesterol (WMD: ?4.97; 95% CI: ?8.37, ?1.57), triglycerides (WMD: ?6.55; 95% CI: ?9.28, ?3.83), and C‐reactive protein (CRP) concentrations (WMD: ?0.81; 95% CI: ?1.25, ?0.38) following GSE therapy. Grape seed did not influence HbA1c, HDL cholesterol levels, and anthropometric measurements. This meta‐analysis demonstrated that GSE intake significantly reduced FPG, TC, LDL cholesterol, triglycerides, and CRP levels.     

益气活血法治疗非小细胞肺癌的Meta分析＊

目的 客观评价中医益气活血法治疗非小细胞肺癌的近期有效率、KPS评分、免疫功能、凝血功能及骨髓抑制的发生，为临床应用益气活血法治疗NSCLC提供理论指导。方法 计算机检索The Cochranne Library、PubMed、EMbase、中国生物医学文献数据库、中国期刊全文数据库、维普数据库、万方数据服务平台，2名研究者按照Cochrane评价标准单独筛选文献、提取资料，最终纳入10个研究，共340例非小细胞肺癌患者，运用软件RevMan5.3作Meta分析。结果 Meta分析结果显示：运用益气活血法治疗NSCLC，患者近期有效率[OR = 1.87,95%CI = (1.36,2.58)]、KPS[OR = 3.45,95%CI = (1.55,7.72)]的结果明显优于对照组；免疫功能指标CD3⁺[WMD = 7.07,95%CI = (1.75,13.58)]、CD4⁺[WMD = 9.30,95%CI = (5.71,12.89)]、CD4⁺/CD8⁺[WMD = 0.54,95%CI = (0.28，0.62)]、NK[WMD = 4.05,95%CI = (1.93,6.17)]较对照组明显提高，而CD8⁺[WMD = -3.30,95%CI = (-4.95,-1.65)]降低；凝血相关指标PT[WMD = 3.41,95%CI = (3.04,3.77)]、APTT[WMD = 2.26,95%CI = (0.09,4.43)]较对照组明显改善,FIB[WMD = -1.22,95%CI = (-2.55,-1.10)]无显著性差异；非小细胞肺癌患者化疗骨髓抑制的发生[OR = 0.31,95%CI(0.14,0.68)]明显低于对照组。临床使用益气活血中药频数居前10位置的分别为黄芪、白术、白花蛇舌草、茯苓、半枝莲、人参、川芎、当归、莪术、三七。结论 目前证据显示临床治疗非小细胞肺癌时，应当注重中医益气活血法的应用，益气活血法配合化疗能够提高患者短期有效率，提高非小细胞肺癌患者免疫功能及改善血液高凝状态，改善患者生活质量。     

The effect of nettle (Urtica dioica) supplementation on the glycemic control of patients with type 2 diabetes mellitus: A systematic review and meta‐analysis

Type 2 diabetes mellitus (T2DM) is a major health problem, worldwide, that is associated with increased morbidity and mortality. Several randomized controlled clinical trials (RCTs) have investigated the effect of nettle (Urtica dioica) supplementation on markers of glycemic status in patients with T2DM, with conflicting results. Therefore, the present study assessed the effect of nettle on some glycemic parameters in patients with T2DM. A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science, from database inception up to June 2019, to identify RCTs investigating the effect of nettle supplementation on glycemic markers, including fasting blood sugar (FBS) concentrations, insulin levels, homeostasis model assessment‐estimated insulin resistance index, and glycosylated hemoglobin percentage in adults with T2DM. The Cochrane Collaboration tool was used to assess the methodological quality of the included studies. Results of this meta‐analysis were reported based on the random effects model. Eight RCTs, comprising 401 participants, were included in the present systematic review and meta‐analysis. Based on the Cochrane Collaboration risk of bias tool, five studies were considered as good quality, one was fair, and two studies were poor, respectively. The results of the meta‐analysis revealed a significant reduction in FBS concentrations (weighted mean difference [WMD]: ?18.01 mg/dl, 95% confidence interval [CI]: ?30.04 to ?5.97, p < .001, I² = 94.6%) following nettle supplementation. However, no significant reduction was observed in insulin levels (WMD: 0.83 Hedges' g, 95% CI: ?0.26 to 1.92, p = .13, I² = 89.4%), homeostasis model assessment‐estimated insulin resistance index (WMD: ?0.22, 95% CI: ?0.83 to 0.40, p = .49, I² = 69.2%), or glycosylated hemoglobin percentage (WMD: ?0.77%, 95% CI: ?1.77 to 0.22, p = .12, I² = 83.0%). The findings of the present study suggest that nettle supplementation may be effective in controlling FBS for T2DM patients. However, further studies are needed to confirm the veracity of these results.     

Effects of saffron (Crocus sativus L.) supplementation on inflammatory biomarkers: A systematic review and meta‐analysis

The effect of saffron supplementation on subclinical inflammation remains inconclusive. We performed a systematic review and meta‐analysis to summarize available findings on the effect of saffron supplementation on inflammatory biomarkers (C‐reactive protein [CRP], tumor necrosis factor‐α [TNF‐α], and interleukin‐6 [IL‐6]) in adults. We searched PubMed/Medline, Scopus, Web of Science, and Google Scholar databases up to November 2019 using relevant keywords to identify eligible trials. All randomized controlled trials (RCTs) that examined the effect of oral saffron supplementation on plasma concentrations of CRP, TNF‐α, and IL‐6 were included. For each outcome, mean differences and SDs were pooled using a random‐effects model. Overall, eight RCTs were included in this meta‐analysis. The pooled results showed that saffron supplementation did not result in significant changes in serum CRP (weighted mean difference [WMD]: ?0.43 mg/L; 95% confidence interval [CI]: ?1.04 to 0.17; p = .16), serum TNF‐α (WMD: ?1.29 pg/mL; 95% CI: ?4.13 to 1.55; p = .37), and IL‐6 concentrations (WMD: 0.11 pg/mL; 95% CI: ?0.79 to 1.00; p = .81). Subgroup analysis indicated a significant reduction in serum CRP levels in studies with baseline CRP of ≥3 mg/L, saffron dosage of ≤30 mg/day, and intervention duration of <12 weeks, as well as trials that used crocin. Similarly, saffron was found to decrease TNF‐α in studies that recruited non‐diabetic subjects, subjects with baseline levels of ≥15 pg/mL, and participants with <50 years old, as well as trials that administered saffron at the dosage of ≤30 mg/day. We also found a significant non‐linear effect of saffron dosage on serum CRP concentrations (p_{non‐linearity} = .03). The overall results indicated that saffron supplementation did not affect inflammatory cytokines. Further high‐quality studies are needed to firmly establish the clinical efficacy of supplemental saffron on inflammatory biomarkers.     

The effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome and related disorders: A systematic review and meta‐analysis of randomized controlled trials

The aim of this systematic review and meta‐analysis was to evaluate the effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome (MetS) and related disorders. Two independent authors systematically searched online database including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science from inception until April 30, 2019. The Cochrane Collaboration's risk of bias tool was applied to assess the methodological quality of included trials. The heterogeneity among the included studies was assessed using Cochrane's Q test and I‐square (I²) statistic. Pooling effect sizes from studies showed a significant reduction in fasting plasma glucose (FPG; weighted mean difference [WMD]: ?10.31; 95% confidence interval, CI [?16.21, ?4.42]) and insulin concentrations (WMD: ?0.53; 95% CI [?0.62, ?0.44]) following the administration of spirulina. Pooled analysis showed also a significant reduction in total cholesterol (WMD: ?20.50; 95% CI [?38.25, ?2.74]), low‐density lipoprotein cholesterol (LDL‐C; WMD: ?19.02; 95% CI [?36.27, ?1.78]), and very low‐density lipoprotein cholesterol (VLDL‐C) concentrations (WMD: ?6.72; 95% CI [?9.19, ?4.26]) and a significant increase in high‐density lipoprotein cholesterol (HDL‐C) levels (WMD: 1.42; 95% CI [0.16, 2.68]) following spirulina therapy. This meta‐analysis demonstrated the beneficial effects of spirulina supplementation on improving FPG, insulin, total cholesterol, LDL‐C, VLDL‐C, and HDL‐C levels in patients with MetS and related disorders.     

The effects of curcumin supplementation on endothelial function: A systematic review and meta‐analysis of randomized controlled trials

Impaired endothelial function is an important risk factor for cardiovascular disease (CVD). Curcumin supplementation might be an appropriate approach to decrease the complications of CVD. Randomized controlled trials assessing the effects of curcumin supplementation on endothelial function were included. Two independent authors systematically searched online database including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science with no time restriction. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. Between‐study heterogeneities were estimated using the Cochran's Q test and I‐square (I²) statistic. Data were pooled using a random‐effects model, and weighted mean differences (WMDs) were considered as the overall effect sizes. Ten studies with 11 effect sizes were included. We found a significant increase in flow‐mediated dilation (FMD) following curcumin supplementation (WMD: 1.49; 95% CI [0.16, 2.82]). There was no effect of curcumin supplement on pulse wave velocity (PWV; WMD: ?41.59; 95% CI [?86.59, 3.42]), augmentation index (Aix; WMD: 0.71; 95% CI [?1.37, 2.79]), endothelin‐1 (ET‐1; WMD: ?0.30; 95% CI [?0.96, 0.37]), and soluble intercellular adhesion molecule‐1 (sICAM‐1; WMD: ?10.11; 95% CI [?33.67, 13.46]). This meta‐analysis demonstrated the beneficial effects of curcumin supplementation on improving FMD, though it did not influence PWV, Aix, Et‐1, and sICAM‐1.     

Effect of tomato consumption on fasting blood glucose and lipid profiles: A systematic review and meta‐analysis of randomized controlled trials

Tomato (Solanum lycopersicum) phytochemicals, which include phytoene, phytofluene, beta‐carotene, flavonoids, lycopene, and polyphenols, have been shown to improve the effects of fasting on plasma triglyceride (TG), low‐density lipoprotein cholesterol (LDL), high‐density lipoprotein cholesterol (HDL), total cholesterol (TC), and fasting blood sugar (FBS). The aim of this study was to systematically evaluate the effects of Tomato TC, TG, HDL, LDL, and FBS in humans. A systematic literature search was conducted in PubMed/MEDLINE, Web of sciences, and SCOPUS databases by two researchers for studies published until August of 2019 without language and time limitations. Results were combined with random effect models. Six studies were included in this meta‐analysis. Combined results reveal a significant reduction in cholesterol (weighted mean difference [WMD]: ?4.39 mg/dl, 95% CI: ?7.09, ?1.68, I² = % 48, p heterogeneity: .05), TG (WMD: ?3.94 mg/dl, 95% CI: ?7.67, ?0.21, I² = % 90, p heterogeneity: .001), LDL levels (WMD: ?2.09 mg/dl, 95% CI: ?3.73, ?0.81, I² = % 78, p heterogeneity: .001), and increasing in HDL levels (WMD: 2.25 mg/dl, 95% CI: 0.41, 4.10, I² = % 97, p heterogeneity: .001). Tomato was found to have a higher reduction effect on TG and LDL in younger participants. While pooled results indicate no significant effect on FBS levels (WMD: 0.59 mg/dl, 95% CI: ?0.28, 1.46, I² = % 95, p heterogeneity: .001). In conclusion, the results indicate a significant reduction in total cholesterol, TG, and LDL and increase in HDL levels that is caused by tomato consumption.     

Possible anti‐obesity effects of phytosterols and phytostanols supplementation in humans: A systematic review and dose–response meta‐analysis of randomized controlled trials

Present meta‐analysis investigates the effects of phytosterols and phytostanol (PS) supplementation on anthropometric indices, using data from randomized controlled trials. We performed a systematic search in the databases: PubMed, Scopus, Cochran, and Web of Science. Weighted mean difference (WMD) with 95% confidence intervals (CIs) were presented. Overall, 79 randomized controlled trials investigated the effects of PS on anthropometric indices. Meta‐analysis results did not reveal any significant effect of PS supplementation on weight (66 trials‐WMD: ?0.083 kg; CI [?0.233, 0.066]; I² = 42.5%), percentage fat mass (6 trials‐WMD: ?0.090%; CI [?0.789, 0.610]; I² = 0.0%), and waist circumference (WC; 5 trials‐WMD: ?0.039 cm; CI [?0.452, 0.374]; I² = 0.0%). However, body mass index (BMI) significantly decreased after PS supplementation (39 trials‐WMD: ?0.063 kg/m2, p = 0.024, I² = 25.1%). Subgroup analyses showed that PS supplementation in subjects with baseline BMI ≥25 and hyperlipidemic significantly decreased body weight and BMI. The overall results showed that although PS supplementation did not affect anthropometric indices (except BMI), baseline status regarding BMI and hyperlipidemia and also dose and duration could be contributing factors for favorable effects.     

Effect of Hibiscus sabdariffa (Roselle) supplementation in regulating blood lipids among patients with metabolic syndrome and related disorders: A systematic review and meta‐analysis

This study aimed to assess the efficacy of Hibiscus sabdariffa (Roselle) in regulating blood lipids among patients with metabolic syndrome and related disorders. PubMed, the Cochrane Library, Embase, Web of Science, and Clinical Trials were searched to identify the randomised controlled trials meeting the inclusion criteria. Study selection, data extraction, and risk assessment were performed according to Cochrane handbook; available data were analysed using STATA 15.0 software. Eventually, nine trials involving 503 participants were included in this meta‐analysis. The results showed that compared with the control group, H. sabdariffa supplementation could reduce total cholesterol (WMD = ?14.66; 95% CI [?18.22, ?11.10]; p = .000; I² = 46.9%) and low‐density lipoprotein cholesterol (WMD = ?9.46; 95% CI [?14.93, ?3.99]; p = .001; I² = 50.1%) but could not effectively reduce triglyceride (WMD = ?0.77; 95% CI [?7.87, 6.33]; p = 0.832; I² = 0%). Meanwhile, there were no serious adverse reactions reported in the included studies. To summarise, current evidence suggests that the benefits of H. sabdariffa supplementation to patients with metabolic diseases are associated with its cholesterol‐lowering effects; however, more high‐quality clinical trials are needed to confirm these results.     

Effects of quercetin supplementation on glycemic control among patients with metabolic syndrome and related disorders: A systematic review and meta‐analysis of randomized controlled trials

This systematic review and meta‐analysis of randomized controlled trials was performed to determine the effect of quercetin supplementation on glycemic control among patients with metabolic syndrome and related disorders. Databases including PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched until August 30, 2018. Nine studies with 10 effect sizes out of 357 selected reports were identified eligible to be included in current meta‐analysis. The pooled findings indicated that quercetin supplementation did not affect fasting plasma glucose (FPG), homeostasis model of assessment‐estimated insulin resistance, and hemoglobin A1c levels. In subgroup analysis, quercetin supplementation significantly reduced FPG in studies with a duration of ≥8 weeks (weighted mean difference [WMD]: ?0.94; 95% confidence interval [CI; ?1.81, ?0.07]) and used quercetin in dosages of ≥500 mg/day (WMD: ?1.08; 95% CI [?2.08, ?0.07]). In addition, subgroup analysis revealed a significant reduction in insulin concentrations following supplementation with quercetin in studies that enrolled individuals aged <45 years (WMD: ?1.36; 95% CI [?1.76, ?0.97]) and that used quercetin in dosages of ≥500 mg/day (WMD: ?1.57; 95% CI [?1.98, ?1.16]). In summary, subgroup analysis based on duration of ≥8 weeks and used quercetin in dosages of ≥500 mg/day significantly reduced FPG levels.     

The effect of Aronia consumption on lipid profile,blood pressure,and biomarkers of inflammation: A systematic review and meta‐analysis of randomized controlled trials

Plant derivatives, such as anthocyanin‐rich phytochemicals, have been reported to elicit a positive effect on lipid profile. Therefore, the aim of this study was to systematically review and meta‐analyze the effects of Aronia consumption on lipid profiles, blood pressure, and biomarkers of inflammation in randomized controlled trials. A systematic search was performed in PubMed/MEDLINE, Cochrane, and SCOPUS up to December 2018. Seven studies were identified and analyzed in this meta‐analysis. Our study found a significant increase in high‐density lipoprotein (HDL; weighted mean difference [WMD]: 1.48 mg/dl, 95% confidence interval, CI, [1.29, 1.68]) and diastolic blood pressure (WMD: 2.55 mmHg, 95% CI [0.63, 4.47]) following Aronia consumption. There was no significant effect on systolic blood pressure and C‐reactive protein, tumor necrosis factor, and interleukin‐1. Furthermore, subgroup analysis showed that cholesterol (WMD: ?7.18, 95% CI [?13.90, ?0.46]) and low‐density lipoprotein (LDL; WMD: ?5.84, 95% CI [?6.91, ?4.77]) decreased more significantly in interventions less than 10 weeks in duration. Dose–response analysis demonstrated a significant reduction in triglyceride levels when dose of Aronia was increased to 300 mg/day. In conclusion, the results demonstrated a significant increase in HDL and reduction in total cholesterol and LDL among patients supplementing with Aronia.     

Can Chinese Herbal Medicine Adjunctive Therapy Improve Outcomes of Senile Vascular Dementia? Systematic Review with Meta‐analysis of Clinical Trials

Many publications have reported the growing application of complementary and alternative medicine, particularly the use of Chinese herbal medicine (CHM) in combination with routine pharmacotherapy (RP) for senile vascular dementia (SVD), but its efficacy remains largely unexplored. The purpose of this study is to evaluate the efficacy of CHM adjunctive therapy (CHMAT), which is CHM combined with RP, in the treatment of SVD. Publications in seven electronic databases were searched extensively, and 27 trials with a total of 1961 patients were included for analysis. Compared with RP alone, CHMAT significantly increased the effective rate [odds ratio (OR) 2.98, 95% confidence interval (CI) 2.30, 3.86]. In addition, CHMAT showed benefits in detailed subgroups of the Mini‐Mental State Exam (MMSE) score from time of onset to 4 weeks (WMD 3.01, 95% CI 2.15, 3.87), 8 weeks (weighted mean difference (WMD) 2.30, 95% CI 1.28, 3.32), 12 weeks (WMD 2.93, 95% CI 2.17, 3.69), and 24 weeks (WMD 3.25, 95% CI 2.61, 3.88), and in the activity of daily living scale score from time of onset to 4 weeks (WMD ?4.64, 95% CI ?6.12, ?3.17), 8 weeks (WMD ?4.30, 95% CI ?6.04, ?2.56), 12 weeks (WMD ?3.89, 95% CI ?4.68, ?3.09), and 24 weeks (WMD ?4.04, 95% CI ?6.51, ?1.57). Moreover, CHMAT had positive effects on changes in the Hasegawa dementia scale, National Institutes of Health Stroke Scale, Clinical Dementia Rating, and Montreal Cognitive Assessment scores, as well as blood fat levels (total cholesterol, triglyceride, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, and apolipoprotein E), platelet aggregation rate (1‐min platelet aggregation rate, 5‐min platelet aggregation rate, and maximal platelet aggregation rate), and blood rheology (whole‐blood viscosity and hematocrit). No serious or frequently occurring adverse effects were reported. Weaknesses of methodological quality in most trials were assessed using the Cochrane risk of bias tool, while the quality level of Grades of Recommendations Assessment Development and Evaluation (GRADE) evidence classification indicated ‘very low’. This systematic review suggests that CHM as an adjunctive therapy can improve cognitive impairment and enhance immediate response and quality of life in SVD patients. However, because of limitations of methodological quality in the included studies, further research of rigorous design is needed. Copyright © 2015 John Wiley & Sons, Ltd.     

The effects of curcumin supplementation on body mass index,body weight,and waist circumference in patients with nonalcoholic fatty liver disease: A systematic review and dose–response meta‐analysis of randomized controlled trials

Nonalcoholic fatty liver disease (NAFLD) is a major cause of liver‐related morbidity; its prevalence is elevating due to the rising epidemic of obesity. Several clinical trials have examined the effects of curcumin supplementation on anthropometric variables in NAFLD patients with inconclusive results. This dose–response meta‐analysis aimed to evaluate the impact of curcumin supplementation on body mass index (BMI), body weight, and waist circumference (WC) in patients with NAFLD. A systematic review of the literature was conducted using PubMed/Medline, ISI Web of Science, Scopus, Cochrane Library, EMBASE, Google Scholar, Sid.ir, and Magiran.com to identify eligible studies up to March 2019. A meta‐analysis of eligible studies was performed using the random‐effects model to estimate the pooled effect size. Eight randomized controlled trials with 520 participants (curcumin group = 265 and placebo group = 255) were included. Supplementation dose and duration ranged from 70 to 3,000 mg/day and 8 to 12 weeks, respectively. Curcumin supplementation significantly reduced BMI (weighted mean difference [WMD] = ?0.34 kg/m², 95% CI [?0.64, ?0.04], p < .05) and WC (WMD = ?2.12 cm, 95% CI [?3.26, ?0.98], p < .001). However, no significant effects of curcumin supplementation on body weight were found. These results suggest that curcumin supplementation might have a positive effect on visceral fat and abdominal obesity that have been associated with NAFLD.     

Role of Medicinal Plants for Liver‐Qi Regulation Adjuvant Therapy in Post‐stroke Depression: A Systematic Review of Literature

Current evidence demonstrated certain beneficial effects of medicinal herbs as an adjuvant therapy for post‐stroke depression (PSD) in China; Chai‐hu (Chinese Thorowax Root, Radix Bupleuri) is an example of a medicinal plant for Liver‐Qi regulation (MPLR) in the treatment of PSD. Despite several narrative reports on the antidepressant properties of MPLR, it appears that there are no systematic reviews to summarize its outcome effects. Therefore, the aim of this review was to assess the effectiveness and safety of MPLR adjuvant therapy in patients with PSD. Seven databases were extensively searched from January 2000 until July 2016. Randomized control trials (RCTs) involving patients with PSD that compared treatment with and without MPLR were taken into account. The pooled effect estimates were calculated based on Cochrane Collaboration's software RevMan 5.3. Finally, 42 eligible studies with 3612 participants were included. Overall, MPLR adjuvant therapy showed a significantly higher effective rate (RR = 1.23; 95% CI = 1.19, 1.27; p < 0.00001) compared to those without. Moreover, the administration of MPLR was superior to abstainers regarding Hamilton Depression Scale (HAMD) score changes after 3 weeks (WMD = ?4.83; 95% CI = ?6.82, ?2.83; p < 0.00001), 4 weeks (WMD = ?3.25; 95% CI = ?4.10, ?2.40; p < 0.00001), 6 weeks (WMD = ?4.04; 95% CI = ?5.24, ?2.84; p < 0.00001), 8 weeks (WMD = ?4.72; 95% CI = ?5.57, ?3.87; p < 0.00001), and 12 weeks (WMD = ?3.07; 95% CI = ?4.05, ?2.09; p < 0.00001). In addition, there were additive benefits in terms of response changes for the National Institutes of Health Stroke Scale (NIHSS) and other self‐rating scores. No frequently occurring or serious adverse events were reported. We concluded that there is supporting evidence that adjuvant therapy with MPLR is effective in reducing the depressive symptoms and enhancing quality of life for patients with PSD. More well‐designed RCTs are necessary to explore the role of MPLR in the treatment of PSD. Copyright © 2016 John Wiley & Sons, Ltd.     

Effect of Nigella sativa (black seed) supplementation on glycemic control: A systematic review and meta‐analysis of clinical trials

This study was aimed to quantify the antihyperglycemic effect of Nigella sativa (N. sativa). An in‐depth search to identify clinical trials investigating the impact of N. sativa on glycemic indices via MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, and Google scholar databases were performed up to November 2018. We used a random effects model to estimate pooled effect size of fasting plasma glucose (FPG), postprandial blood glucose (PPBG), and hemoglobin A1c (HbA1c). A total of 17 randomized controlled trials investigating the effects of N. sativa on FPG, PPBG, and HbA1c were included. Meta‐analysis suggested a significant association between N. sativa supplementation and reduction in FPG (weighted mean difference [WMD]: ?9.93 mg/dl, 95% CI [?13.44, ?6.41]), PPBG (WMD: ?14.79 mg/dl, 95% CI [?24.19, ?5.39]), and HbA1c (WMD: ?0.57%, 95% CI [?0.77, ?0.37]). Subgroup analysis revealed that N. sativa oil was more effective than N. sativa powder in reduction of FPG. To sum up, N. sativa consumption has a significant lowering effect on glycemic status. Further studies with prolonged durations and powerful design are needed to specify the exact mechanism, optimal dosage, and duration of N. sativa supplementation to obtain a beneficial effect on glycemic status.     

The effect of soy intervention on insulin‐like growth factor 1 levels: A meta‐analysis of clinical trials

A low insulin‐like growth factor 1 (IGF‐1) level is known to be associated with many disorders. Several studies have shown that soy consumption may influence IGF‐1, but the findings remain inconclusive. In this work, we conducted a systematic review and meta‐analysis to provide a more accurate estimation of the effect of soy consumption on plasma IGF‐1. A comprehensive systematic search was performed in Scopus, Embase, Web of Science, and PubMed/MEDLINE databases from inception until October 2019. Eight studies fulfilled the eligibility criteria. The pooled weighted mean difference (WMD) of the eligible studies was calculated with random‐effects approach. Overall, a significant increment in plasma IGF‐1 was observed following soy intervention (WMD: 13.5 ng/ml, 95% CI: 5.2, 21.8, I² = 97%). Subgroup analyses demonstrated a significantly greater increase in IGF‐1, when soy was administered at a dosage of ≤40 g/day (WMD: 11.7 ng/ml, 95% CI: 10.9 to 12.6, I² = 98%), and when the intervention duration was <12 weeks (WMD: 26.6 ng/ml, 95% CI: 9.1 to 44.1, I² = 0.0%). In addition, soy intervention resulted in a greater increase in IGF‐1 among non‐healthy subjects (WMD: 36 ng/ml, 95% CI: 32.7 to 39.4, I² = 84%) than healthy subjects (WMD: 9.8 ng/ml, 95% CI: 8.9 to 10.7, I² = 90%). In conclusion, this study provided the first meta‐analytical evidence that soy intake may increase IGF‐1 levels, but the magnitude of the increase is dependent on the intervention dosage, duration, and health status of the participants.