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 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.     

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.     

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.     

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.     

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.     

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.     

Impact of flaxseed supplementation on plasma lipoprotein(a) concentrations: A systematic review and meta‐analysis of randomized controlled trials

The aim of the study was to investigate the impact of supplementation with flaxseed on plasma lipoprotein(a) [Lp(a)] levels through a systematic review and meta‐analysis of eligible randomized placebo‐controlled trials. PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched for randomized controlled trials (RCTs) which have been published up to November 2019. RCTs that investigated the effect of flaxseed supplementation on plasma Lp(a) levels in adults were included for final analysis. The random effects model was used for calculating the overall effects. Meta‐analysis of 7 selected RCTs with 629 individuals showed significant lowering effect of flaxseed supplementation on Lp(a) (MD ?2.06 mg/dl; 95% CI: ?3.846, ?0.274, p = .024), without considerable heterogeneity between studies (p = .986, I² = 0%). Subgroup analysis also revealed that longer duration only showed significant lowering effect of flaxseed supplementation on Lp(a). This meta‐analysis has shown that flaxseed supplementation might significantly decrease plasma Lp(a) levels. Future well‐designed and long‐term clinical trials are required to confirm 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.     

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 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.     

Dietary citrus and/or its extracts intake contributed to weight control: Evidence from a systematic review and meta‐analysis of 13 randomized clinical trials

Randomized controlled trials, being published in English and investigating the associations of at least 4 weeks intervention of citrus and/or its extracts on weight loss among adults, were searched from PubMed, Web of Science, Scopus, and Cochrane by June 2019 to conduct a meta‐analysis. Thirteen articles, including 921 participants, were selected and evaluated by modified Jadad scale. Pooled results by the random‐effects model showed that citrus and/or its extracts administration significantly reduced 1.280 kg body weight (95% CI: ?1.818 to ?0.741, p = 0.000, I² = 81.4%), 0.322 kg/m² BMI (95% CI: ?0.599 to ?0.046, p = 0.022, I² = 87.0%), 2.185 cm WC (95% CI: ?3.804 to ?0.566, p = 0.008, I² = 98.3%), and 2.137 cm HC (95% CI: ?3.775 to ?0.500, p = 0.011, I² = 96.2%), respectively, but no significantly decreased effects on WHR and body fat were observed. Subgroup analysis deduced the different effects of study location, intervention duration on body weight associated indices. No publication bias was observed. Our meta‐analysis supported the beneficial effects of citrus and/or its extracts supplement on body weight control, and future well‐designed studies are required to firmly establish the clinical efficacy of citrus and/or its extracts intervention on body weight.     

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.     

The efficacy of sour tea (Hibiscus sabdariffa L.) on selected cardiovascular disease risk factors: A systematic review and meta‐analysis of randomized clinical trials

This study sought to summarize clinical evidence of sour tea (Hibiscus sabdariffa L.) administration on cardiovascular disease risk factors. PubMed, Scopus, Institute for Scientific Information Web of Science, and Google Scholar were systematically searched from inception to June 2019 to identify randomized clinical trials, which assessed the effect of sour tea consumption on lipid profiles, fasting plasma glucose, and blood pressure in adult populations. Mean and standard deviation for each parameter were extracted to calculate effect size. Cochrane Collaboration tools were used to evaluate risk of bias assessment. A total of seven randomized clinical trials consisting 362 participants were included in the meta‐analysis. Pooled effect size demonstrated that sour tea consumption significantly reduces fasting plasma glucose (?3.67 mg/dl, 95% confidence interval, CI [?7.07, ?0.27]; I² = 37%), systolic blood pressure (?4.71 mmHg, 95% CI [?7.87, ?1.55]; I² = 53%), and diastolic blood pressure (?4.08 mmHg, 95% CI [?6.48, ?1.67]; I² = 14%). Although no significant effect was observed on triacylglycerol, total cholesterol, and high‐density lipoprotein cholesterol following sour tea consumption, a trend toward a significant reduction was found in low‐density lipoprotein cholesterol serum concentrations (p = 0.08). This systematic review and meta‐analysis suggests that sour tea consumption could have beneficial effect in controlling glycemic status and blood pressure among adult population.     

The effect of l‐carnitine supplementation on serum levels of omentin‐1, visfatin and SFRP5 and glycemic indices in patients with pemphigus vulgaris: A randomized,double‐blind,placebo‐controlled clinical trial

Pemphigus vulgaris (PV) is a chronic autoimmune disorder with potentially fatal outcomes. The aim of this study was to investigate the effect of l ‐carnitine (LC) on secreted frizzled‐related protein‐5 (SFRP5), omentin, visfatin, and glycemic indices in PV patients under corticosteroid treatment. In this randomized, double‐blind, placebo‐controlled clinical trial, 52 patients with PV were divided randomly into two groups to receive 2 g of LC or a placebo for 8 weeks. Serum levels of SFRP5, omentin, visfatin, and also glycemic indices were evaluated at the baseline and end of the study. LC supplementation significantly decreased the serum level of visfatin (95% CI [?14.718, ?0.877], p = .05) and increased the serum levels of SFRP5 (95%CI [1.637, 11.380], p < .006) and omentin (95% CI [9.014, 65.286], p < .01). However, LC supplementation had no significant effects on the serum levels of glycemic factors such as insulin (95% CI [?1.125, 3.056], p = .426), fasting blood sugar (95% CI [?4.743, 3.642], p = .894), homeostatic model assessment of insulin resistance (95% CI [?0.305, 0.528], p = .729), and quantitative insulin‐sensitivity check index (95% CI [?0.016, ?0.010], p = .81). LC supplementation decreased visfatin serum level and increased omentin‐1 and SFRP5 serum levels in patients with PV. However, it has no significant effect on the serum levels of insulin and glycemic indices.     

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.     

Adjuvant Treatment with Yupingfeng Formula for Recurrent Respiratory Tract Infections in Children: A Meta‐analysis of Randomized Controlled Trials

This meta‐analysis aimed to evaluate the immunomodulating function of Yupingfeng Formula (YPFF) in children with recurrent respiratory tract infections (RRTIs). The PubMed, EMBASE, Cochrane Library, CNKI and WanFang databases were searched for randomized controlled trials comparing with and without YPFF for RRTIs in children. Twelve trials with 1236 patients were identified. Adjuvant treatment with YPFF significantly increased serum levels of IgA (weighted mean difference [WMD] 0.33 mg/mL; 95% confidence interval [CI] 0.20 to 0.45), IgG (WMD 1.36 mg/mL; 95% CI 1.06 to 1.65), IgM (WMD 0.16 mg/mL; 95% CI 0.02 to 0.31), and CD3⁺ T‐lymphocytes (WMD 10.16%; 95% CI 4.62 to 15.69) but not CD4⁺ T‐lymphocytes (WMD 3.16%; 95% CI ?0.27 to 6.59) and CD8⁺ T‐lymphocytes (WMD ?0.84%; 95% CI ?2.50 to 0.81). YPFF also reduced the frequency of RRTIs (WMD ?3.80 times; 95% CI ?4.86 to ?2.74) and increased total effective rates of symptom improvement (risk ratio: 1.44; 95% CI 1.19 to 1.75). Adjuvant treatment with YPFF could improve total clinical effective rate and decrease the frequency of respiratory tract infections in children with RRTIs. The beneficial effects of YPFF may be correlated to its immunomodulating action. More well‐designed trials with larger sample sizes are needed to evaluate its efficacy and safety. Copyright © 2016 John Wiley & Sons, Ltd.     

Effect of purslane on blood lipids and glucose: A systematic review and meta‐analysis of randomized controlled trials

Despite a history of purslane usage as a herbal treatment for dyslipidemia and hyperglycemia management, existing evidence from clinical trials is controversial. The aim for the current study was to evaluate the efficacy of purslane supplementation on lipid parameters and glycemic status in adult populations. A systematic review was conducted in PubMed, Scopus, ISI Web of Science, and Google Scholar up to January 15, 2018, searching for randomized controlled trials that assessed the impact of purslane on fasting blood glucose (FBG), triglycerides, total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), and high‐density lipoprotein cholesterol (HDL‐C). Based on the detected heterogeneity between studies, a random‐ or fixed‐effect model was applied in the meta‐analysis. The findings from six randomized controlled trials, comprising 352 participants, indicated that purslane can reduce FBG (?4.54 mg/dl, 95% CI [?7.54, ?1.53]; I² = 0.53%) and triglycerides (?19.16 mg/dl, 95% CI [?38.17, ?0.15]; I² = 0%) levels. Changes in TC, LDL‐C, and HDL‐C concentrations did not reach a statistically significant level. Subgroup analysis showed a favorable effects of purslane on FBG, triglycerides, TC, and LDL‐C in a subset of studies in which purslane was administered >1.5 g/day. Categorization based on gender showed that purslane was more effective in improving FBG, TC and LDL‐C in females compared with males. This systematic review and meta‐analysis suggested that the purslane might be effective on the improvement of blood lipid and glucose levels. Further robust studies with sufficient durations and dosages of supplementation are needed to confirm these results.