1.
Signatures and Clinical Significance of Amino Acid Flux in Sarcopenia: A Systematic Review and Meta-Analysis.
Dai, M, Lin, T, Yue, J, Dai, L
Frontiers in endocrinology. 2021;:725518
Abstract
BACKGROUND Dysregulation of amino acids is closely linked to the initiation and progression of sarcopenia. We summarized recent advancements in the studies of amino acid profiles in sarcopenia and systematically presented the clinical significance of amino acid flux in sarcopenia. METHODS We systematically searched in MEDLINE, EMBASE, and Cochrane library from inception to June 1, 2021 to capture all studies examining metabolomics of sarcopenia. We used the following keywords: sarcopenia, metabonomics, metabolomics, amino acid profile, and mass spectrometry. Original articles comparing amino acid patterns between persons with and without sarcopenia were included. Two independent investigators independently completed title and abstract screening, data extraction, and quality evaluation. We used a random effects model to examine the association between amino acids levels and sarcopenia. Sensitivity analyses restricted the analyses to studies in which muscle mass was measured by bioelectrical impedance analysis. Study quality was evaluated according to the Agency for Healthcare Research and Quality (AHRQ) checklist. RESULTS The systematic research yielded six eligible articles, comprising 1,120 participants. Five studies used muscle mass in combination with physical performance and/or muscle strength as the criteria to diagnose sarcopenia, while one study used muscle mass as a diagnostic criterion alone. We found that the concentrations of branched-chain amino acids leucine (standardized mean difference [SMD] -1.249; 95% confidence interval [CI]: -2.275, -0.223, P = 0.02, I2 = 97.7%), isoleucine (SMD -1.077; 95% CI: -2.106, -0.049, P = 0.04, I2 = 97.8%), and aromatic amino acid tryptophan (SMD -0.923; 95% CI: -1.580, -0.265, P = 0.01, I2 = 89.9%) were significantly reduced in individuals with sarcopenia. Study results were robust in sensitivity analysis. CONCLUSIONS The homeostasis of amino acids is critical to maintaining muscle health. The profiles of amino acids might be useful biomarkers for the characterization of sarcopenia. Future studies are warranted to study the clinical significance of amino acids in the diagnosis and treatment of sarcopenia.
2.
Diagnostic value of radiolabeled amino acid PET for detection of pseudoprogression of brain tumor after treatment: a meta-analysis.
Kim, SJ, Ryul Shim, S
Nuclear medicine communications. 2019;(9):965-972
Abstract
PURPOSE The purpose of the current study was to investigate the diagnostic performance of radiolabeled amino acid PET for detection of pseudoprogression (PsP) of brain tumor after treatment through a systematic review and meta-analysis. METHODS The PubMed and EMBASE database, from the earliest available date of indexing through 15 February 2019, were searched for studies evaluating the diagnostic performance of radiolabeled amino acid PET for detection of PsP. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios, and constructed summary receiver operating characteristic (SROC) curves. RESULTS Across seven results from six studies (971 patients), the pooled sensitivity was 0.89 [95% confidence interval (CI): 0.82-0.94] without heterogeneity (I2 = 0.0) and a pooled specificity of 0.88 (95% CI: 0.76-0.94) without heterogeneity (I2=29.4). Likelihood ratio syntheses gave an overall positive likelihood ratio of 7.3 (95% CI: 3.6-14.7) and negative likelihood ratio of 0.12 (95% CI: 0.07-0.21). The pooled diagnostic odds ratio (DOR) was 60 (95% CI: 23-152). Hierarchical SROC curve indicates that the areas under the curve (AUC) was 0.92 (95% CI: 0.90-0.94). CONCLUSION The current meta-analysis showed the good sensitivity and specificity of radiolabeled amino acid PET for detection of PsP of brain tumor after treatment. Also, the DOR was high and SROC curve showed high AUC value.
3.
Outcome of Carotid Artery Endarterectomy in Statin Users versus Statin-Naïve Patients: A Systematic Review and Meta-Analysis.
Texakalidis, P, Giannopoulos, S, Kokkinidis, DG, Jabbour, P, Reavey-Cantwell, J, Rangel-Castilla, L
World neurosurgery. 2018;:444-450.e1
Abstract
BACKGROUND Carotid artery endarterectomy (CEA) remains the most common surgical intervention for the treatment of symptomatic and asymptomatic carotid artery stenosis. Several studies have shown a lower risk of periprocedural adverse events in statin users who undergo coronary interventions or carotid artery stenting. The aim of this meta-analysis was to determine whether the use of statins is beneficial in patients undergoing CEA. METHODS This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were identified through a search of PubMed, Scopus, and Cochrane until August 2017. A random effects model meta-analysis was conducted and the I2 statistic was used to assess for heterogeneity. RESULTS Six studies and 7053 patients overall were included. Thirty days after CEA, 157 (2.2%) patients had a stroke (1.4% in the statin-user group vs. 3% in the statin-naïve group). Despite the difference in the absolute rate of stroke, there was no statistically significant difference in the 30-day stroke rate (odds ratio [OR] 0.40; 95% confidence interval [CI] 0.15-1.09; I2 = 75.6%). Overall, 141 (2%) patients suffered 30-day myocardial infarction, with no significant difference between the 2 groups (OR 0.77; 95% CI 0.26-2.24; I2 = 77%). Patients who received statins before CEA were at a significantly lower risk for 30-day death (OR 0.26; 95% CI 0.10-0.61; I2 = 17.7%). CONCLUSIONS Statin users undergoing CEA were at a significantly lower risk for periprocedural death compared with statin-naïve patients. Despite an absolute difference in the stroke rate, the current meta-analysis did not detect a statistically significant difference in the 30-day stroke rate between statin-user and statin-naïve patients undergoing CEA.
4.
Safety and efficacy of Cerebrolysin in early post-stroke recovery: a meta-analysis of nine randomized clinical trials.
Bornstein, NM, Guekht, A, Vester, J, Heiss, WD, Gusev, E, Hömberg, V, Rahlfs, VW, Bajenaru, O, Popescu, BO, Muresanu, D
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2018;(4):629-640
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Abstract
This meta-analysis combines the results of nine ischemic stroke trials, assessing efficacy of Cerebrolysin on global neurological improvement during early post-stroke period. Cerebrolysin is a parenterally administered neuropeptide preparation approved for treatment of stroke. All included studies had a prospective, randomized, double-blind, placebo-controlled design. The patients were treated with 30-50 ml Cerebrolysin once daily for 10-21 days, with treatment initiation within 72 h after onset of ischemic stroke. For five studies, original analysis data were available for meta-analysis (individual patient data analysis); for four studies, aggregate data were used. The combination by meta-analytic procedures was pre-planned and the methods of synthesis were pre-defined under blinded conditions. Search deadline for the present meta-analysis was December 31, 2016. The nonparametric Mann-Whitney (MW) effect size for National Institutes of Health Stroke Scale (NIHSS) on day 30 (or 21), combining the results of nine randomized, controlled trials by means of the robust Wei-Lachin pooling procedure (maximin-efficient robust test), indicated superiority of Cerebrolysin as compared with placebo (MW 0.60, P < 0.0001, N = 1879). The combined number needed to treat for clinically relevant changes in early NIHSS was 7.7 (95% CI 5.2 to 15.0). The additional full-scale ordinal analysis of modified Rankin Scale at day 90 in moderate to severe patients resulted in MW 0.61 with statistical significance in favor of Cerebrolysin (95% CI 0.52 to 0.69, P = 0.0118, N = 314). Safety aspects were comparable to placebo. Our meta-analysis confirms previous evidence that Cerebrolysin has a beneficial effect on early global neurological deficits in patients with acute ischemic stroke.